The Effects of Medial Meniscal Transplantation Techniques on Intra-Articular Contact Pressures

Nn, Verma; Kolb, E.; Bj, Cole; Berkson, Eric M.; Garretson, Ralph; Farr, Jack; Fregly, Benjamin J.

doi:10.1055/s-0030-1247787

Cited by 55 publications

(34 citation statements)

References 30 publications

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“…3a). The cartilage area experiencing high pressures (45 MPa, which is the peak pressure observed for the native medial meniscus loading conditions comparable to those in our study (Allaire et al, 2008;Lee et al, 2006;Verma et al, 2008;Wang et al, 2014)) was considerably lower for the allograft and average implant, particularly for the femur ( Fig. 4a and b).…”

Section: Resultssupporting

confidence: 82%

“…This is quite a large strain to be accommodated by the implant material, which will be The relative number of nodes experiencing contact pressures 4 5 MPa (which is the peak pressure observed for the native medial meniscus under loading conditions comparable to those applied in this study (Allaire et al, 2008;Lee et al, 2006;Verma et al, 2008;Wang et al, 2014)). (c) The relative number of nodes experiencing contact pressures 4 0 MPa, which can be seen as a measure for the total cartilage contact area.…”

Section: Discussionmentioning

confidence: 83%

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The sensitivity of cartilage contact pressures in the knee joint to the size and shape of an anatomically shaped meniscal implant

Khoshgoftar¹,

Vrancken²,

Tienen³

et al. 2015

Journal of Biomechanics

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Since meniscal geometry affects the cartilage contact pressures, it is essential to carefully define the geometry of the synthetic meniscal implant that we developed. Recently, six independent modes of size- and shape-related geometry variation were identified through 3D statistical shape modeling (SSM) of the medial meniscus. However, this model did not provide information on the functional importance of these geometry characteristics. Therefore, in this study finite element simulations were performed to determine the influence of anatomically-based meniscal implant size and shape variations on knee cartilage contact pressures. Finite element simulations of the knee joint were performed for a total medial meniscectomy, an allograft, the average implant geometry, six implant sizes and ten shape variations. The geometries of the allograft and all implant variations were based on the meniscus SSM. Cartilage contact pressures and implant tensile strains were evaluated in full extension under 1200N of axial compression. The average implant induced cartilage peak pressures intermediate between the allograft and meniscectomy and also reduced the cartilage area subjected to pressures >5MPa compared to the meniscectomy. The smaller implant sizes resulted in lower cartilage peak pressures and compressive strains than the allograft, yet high implant tensile strains were observed. Shape modes 2, 3 and 6 affected the cartilage contact stresses but to a lesser extent than the size variations. Shape modes 4 and 5 did not result in changes of the cartilage stress levels. The present study indicates that cartilage contact mechanics are more sensitive to implant size than to implant shape. Down-sizing the implant resulted in more favorable contact mechanics, but caused excessive material strains. Further evaluations are necessary to balance cartilage contact pressures and material strains to ensure cartilage protection and longevity of the implant.

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Section: Resultssupporting

confidence: 82%

Section: Discussionmentioning

confidence: 83%

The sensitivity of cartilage contact pressures in the knee joint to the size and shape of an anatomically shaped meniscal implant

Khoshgoftar¹,

Vrancken²,

Tienen³

et al. 2015

Journal of Biomechanics

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“…Meniscectomy is known to alter the contact mechanics of the tibiofemoral joint and results in radiographic cartilage degeneration [4,33]. Removal of greater than 1 .…”

Section: Months 2 Monthsmentioning

confidence: 99%

Performance of a Sterile Meniscal Allograft in an Ovine Model

McNickle¹,

Wang²,

Shewman³

et al. 2009

Clinical Orthopaedics &Amp; Related Research

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Meniscus transplantation is indicated for persistent pain in a meniscectomized knee. Currently, grafts are prepared aseptically, which provides limited protection against donor-derived infection. The performance of a novel, sterilized meniscus was compared with an aseptically prepared one in an experimental model. Twenty-two sheep were divided into three groups: aseptic meniscal allograft, sterile meniscal allograft, and medial meniscectomy. Animals were euthanized 2 and 4 months after surgery. Meniscal assessments included cell viability, histology, and biomechanical testing. Articular cartilage was evaluated through histology and Outerbridge scoring. Aseptic and sterile allografts had cell viabilities of 59.7% and 58.7%, respectively, at 4 months, which was less than native controls. Grafts had decreased compressive strength at 4 months compared with their preimplantation moduli and were weaker than native menisci. In operated knees, the tibial plateau had more severe degenerative changes, although Outerbridge scores were similar between operated groups. Overall, the allografts were similar in their cellularity and biomechanical properties but were inferior to the native tissue at these end points. The severity of chondral damage in the allograft knees could not be distinguished from meniscectomized joints. The sterilization process does not appear to compromise tissue integrity and provides additional allograft safety.

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“…Indeed, degenerative changes associated with meniscectomies have been linked to increased joint contact stress (hereafter referred to as contact pressure) in the adjacent articular cartilage as measured in vitro [18][19][20][21][22][23][24][25][26][27] . To date, however, experimental models have been primarily conducted under static or quasi-static uniaxial loading conditions 8,[28][29][30][31][32][33] . Given the sensitivity of joint contact pressures to the magnitude and direction of an applied load 34,35 , these models do not accurately capture the physiological effect of meniscal repair or meniscectomy on knee contact mechanics.…”

mentioning

confidence: 99%

Dynamic Contact Mechanics of the Medial Meniscus as a Function of Radial Tear, Repair, and Partial Meniscectomy

Bedi

Kelly

Baad

et al. 2010

The Journal of Bone and Joint Surgery-American Volume

248

212

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The Effects of Medial Meniscal Transplantation Techniques on Intra-Articular Contact Pressures

Cited by 55 publications

References 30 publications

The sensitivity of cartilage contact pressures in the knee joint to the size and shape of an anatomically shaped meniscal implant

The sensitivity of cartilage contact pressures in the knee joint to the size and shape of an anatomically shaped meniscal implant

Performance of a Sterile Meniscal Allograft in an Ovine Model

Dynamic Contact Mechanics of the Medial Meniscus as a Function of Radial Tear, Repair, and Partial Meniscectomy

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