Three-dimensional finite-element analysis of aggravating medial meniscus tears on knee osteoarthritis

Abstract

BackgroundThe biomechanical change during the medial meniscus damage in the process of knee osteoarthritis has not been explored. The purpose of this study was to determine the effect of aggravating medial meniscus degenerative tear on the progress of knee osteoarthritis through the finite-element simulation method.MethodsThe three-dimensional digital model of a total-knee joint was obtained using a combination of magnetic resonance imaging and computed tomography images. Four types of medial meniscus tears were created to represent the aggravating degenerative meniscus lesions. Meniscectomy of each meniscal tear was also utilized in the simulation. The compression and shear stress of bony tissue, cartilage, and meniscus were evaluated, and meniscus extrusion of the healthy knee, postinjured knee, and postmeniscectomy knee were investigated under the posture of balanced standing.ResultsBased on the results of finite-element simulation, the peak shear principal stress, peak compression principal stress, and meniscus extrusion increased gradually as the meniscus tears’ region enlarged progressively (from 7.333 MPa to 15.14 MPa on medial femur and from 6 MPa to 20.94 MPa on medial tibia). The higher stress and larger meniscus extrusion displacement in all tests were observed in the flap and complex tears. The oblique tears also had a biomechanical variation of stress and meniscus extrusion in the knee joint, but their level was milder. Both the peak value of the stress and meniscus displacement increased after the meniscectomy.ConclusionIn contrast to the damaged hemijoint, the stress applied on the healthy lateral hemijoint increased. The change of biomechanics was more obvious with the aggravation of meniscus injury. The advanced degenerative damage resulted in increasing stress that was more likely to cause symptomatic clinical manifestation in the knee joint and accelerate the progress of osteoarthritis. Moreover, we found that the meniscus injury caused higher stress concentration on the contralateral side of the joint. We also discovered that the meniscectomy can lead to more serious biomechanical changes, and although this technique can relieve pain over a period of time, it increased the risk of osteoarthritis (OA) occurrence.The translational potential of this articleIt is clear that the meniscal lesions can cause osteoarthritic knee, but the biomechanical change during the meniscus damage period has not been explored. We have evaluated the variation of stress during the aggravating medial degenerative meniscus tears and the relationship in the process of knee OA through finite-element simulation. This study does favour to obtain a better understanding on the symptoms and pathological changes of OA. It also may provide some potential directions for the prophylaxis and treatment of OA.

Biomechanical study on the stress distribution of the knee joint after distal femoral fracture malunion with residual varus-valgus deformity

“…In biomechanics research, the contact position, contact area and contact stress between joint surfaces are often measured. At present, there are a variety of experimental measurement methods for joints, including 3D photoelastic measurement, pressure sensing and finite element analysis [26][27], but these methods have a large error in the measurement of joint stress and the operation method is relatively complex. Therefore, we choose pressure-sensitive film technology, which can not only directly measure the pressure value, but also can measure the contact area, intuitively see the distribution of pressure, has obvious advantages.…”

Morphological Analysis of Normal Meniscus on Magnetic Resonance Imaging (MRI)-Based Three-Dimensional Reconstruction Models in Healthy Chinese Adults

“…In a longitudinal cohort study using population-based healthcare data from Sweden, Snoeker et al [ 8 ] reportedthat meniscal tear increased the risk of future diagnosed knee OA. Through 3D finite-elemental analyses, Li et al [ 9 ] demonstrated meniscal injury leads to biomechanical changes that can accelerate the progression of knee OA, and they found meniscectomy can relieve symptoms but increases the incidence of osteoarthritis. Because of the high incidence of discoid lateral meniscus [ 10 – 12 ], corresponding morphological research has been published [ 6 , 13 , 14 ], but little attention was paid to the medial side.…”

Biomechanical study on the stress distribution of the knee joint after distal femoral fracture malunion with residual varus-valgus deformity 

“…In biomechanics research, the contact position, contact area and contact stress between joint surfaces are often measured. At present, there are a variety of experimental measurement methods for joints, including 3D photoelastic measurement, pressure sensing and nite element analysis [28][29], but these methods have a large error in the measurement of joint stress and the operation method is relatively complex. Therefore, we choose pressure-sensitive lm technology, which can not only directly measure the pressure value, but also can measure the contact area, intuitively see the distribution of pressure, has obvious advantages.…”