The biomechanical changes of load distribution with longitudinal tears of meniscal horns on knee joint: a finite element
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(2019) 14:237
RESEARCH ARTICLE
Open Access
The biomechanical changes of load distribution with longitudinal tears of meniscal horns on knee joint: a finite element analysis Kaijia Zhang1†, Lan Li1,2,6†, Longfei Yang2, Jianping Shi3, Liya Zhu3, Huixin Liang4, Xingsong Wang2, Xianfeng Yang5* and Qing Jiang1,6*
Abstract Background: Meniscal horns are important structures of meniscus, and longitudinal tears of these places could significantly change the load distribution among the knee joint. Few studies concerned the stress concentrated on bones, which may induce the osteonecrosis of subchondral bone. The goal of this study was to construct a finite element (FE) model with high fidelity of the knee joint and evaluate the biomechanical changes of load distribution of components after longitudinal tears of the horns of meniscus. Methods: Computed tomography and magnetic resonance images were used to develop the FE model, and two different kinds of simulations, the vertical and the anterior load, mimicking the static stance and slight flexion simulations, were applied after longitudinal tears of the horns of meniscus. Results: Significantly elevated peak compressive and shear stress was observed on the menisci, cartilages, and subchondral bones, and enlarged meniscus extrusion was noticed. Between all the four types of longitudinal tears investigated in this study, longitudinal tears at the posterior horn of the medial meniscus were found to be the most significant. Conclusions: These findings showed that longitudinal tears of the meniscal horns lead to increased magnitude and changed distribution of stress and indicated the important role of posterior horn of medial meniscus. This may contribute to the mechanism between meniscal tears and spontaneous subchondral bone osteonecrosis. Keywords: Meniscus, Longitudinal tear, Finite element analysis, Subchondral bone osteonecrosis
Background The meniscus is critical for load transmission, stabilization, shock absorption, and lubrication of the knee [1]. It is estimated that the medial and lateral meniscus bear 50% and 70% of the load of the medial and lateral compartment individually [2]. This indicates * Correspondence: [email protected]; [email protected] † Kaijia Zhang and Lan Li are co-first authors and contributed equally to the work. 5 Department of Radiology, Drum Tower Hospital affiliated to Medical School of Nanjing University, Nanjing, China 1 State Key Laboratory of Pharmaceutical Biotechnology, Department of Sports Medicine and Adult Reconstructive Surgery, Drum Tower Hospital affiliated to Medical School of Nanjing University, Nanjing, China Full list of author information is available at the end of the article
the essential role in load transmission of the meniscus in the knee joint. Meniscal tears often occur when the knee twists or rotates forcefully, resulting in approximately 650,000 meniscus surgeries annually in the USA [3]. Longitudinal tears run parallel to the peripheral rim of the meniscus and are situated in highly vascularized regions [4, 5].
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