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Sun L, Han Y, Jing Z, Li D, Liu J, Li D. Finite element analysis of the effect of tibial osteotomy on the stress of polyethylene liner in total knee arthroplasty. J Orthop Surg (Hong Kong) 2024; 32:10225536241251926. [PMID: 38733065 DOI: 10.1177/10225536241251926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/13/2024] Open
Abstract
AIM To explore the effects of tibial osteotomy varus angle combined with posterior tibial slope (PTS) on the stress of polyethylene liner in total knee arthroplasty (TKA) by building finite element model (FEM). METHODS Established the FEM of standard TKA with tibial osteotomy varus angle 0° to 9° were established and divided into 10 groups. Next, each group was created 10 FEMs with 0° to 9° PTS separately. Calculated the stress on polyethylene liner in each group in Abaqus. Finally, the relevancy between tibial osteotomy angle and polyethylene liner stress was statistically analyzed using multiple regression analysis. RESULTS As the varus angle increased, the area of maximum stress gradually shifted medially on the polyethylene liner. As the PTS increases, the percentage of surface contact forces on the medial and lateral compartmental of the polyethylene liner gradually converge to the same. When the varus angle is between 0° and 3°, the maximum stress of the medial compartmental surfaces of polyethylene liner rises smoothly with the increase of the PTS. When the varus angle is between 4° and 9°, as the increase of the PTS, the maximum stress of polyethylene liner rises first and then falls, forming a trough at PTS 5° and then rises again. Compared to the PTS, the varus angle has a large effect on the maximum stress of the polyethylene liner (p < .001). CONCLUSION When the varus angle is 0° to 3°, PTS 0° is recommended, which will result in a more equalized stress distribution of the polyethylene liner in TKA.
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Affiliation(s)
- Lihui Sun
- Division of Bone and Joint Surgery, Center of Orthopedics, First Hospital of Jilin University, Changchun, P. R. China
| | - Yu Han
- Division of Bone and Joint Surgery, Center of Orthopedics, First Hospital of Jilin University, Changchun, P. R. China
| | - Zheng Jing
- Division of Bone and Joint Surgery, Center of Orthopedics, First Hospital of Jilin University, Changchun, P. R. China
| | - Dongbo Li
- Division of Bone and Joint Surgery, Center of Orthopedics, First Hospital of Jilin University, Changchun, P. R. China
| | - Jianguo Liu
- Division of Bone and Joint Surgery, Center of Orthopedics, First Hospital of Jilin University, Changchun, P. R. China
| | - Dongsong Li
- Division of Bone and Joint Surgery, Center of Orthopedics, First Hospital of Jilin University, Changchun, P. R. China
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Dong Z, Yang C, Zhang D, Dong S. The application of human medical image-based finite element analysis in the construction of mouse osteoarthritis models. Heliyon 2024; 10:e26226. [PMID: 38390145 PMCID: PMC10882037 DOI: 10.1016/j.heliyon.2024.e26226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 02/08/2024] [Accepted: 02/08/2024] [Indexed: 02/24/2024] Open
Abstract
The anterior cruciate ligament plays an important role in maintaining the stability of the knee joint. Its injury is a common cause of articular cartilage degeneration and osteoarthritis (OA). The anterior cruciate ligament transection (ACLT) method is commonly employed to construct animal models for studying osteoarthritis pathogenesis. However, the precise mechanism of how anterior cruciate ligament injury leads to osteoarthritis is not fully understood. This study utilized finite element analysis (FEA) with human medical images to simulate the biomechanical characteristics of anterior cruciate ligament (ACL) injury. Osteoarthritis models were subsequently established in C57BL/6 mice using ACLT to explore the link between ACL injury and osteoarthritis development. The results of FEA showed that, after an anterior cruciate ligament injury, abnormal stress was concentrated in the medial and lateral of the femoral and tibial articular cartilage during knee flexion and extension. In order to better display the pathological changes of articular cartilage in the stress areas, the medial tibial cartilage was selected as a representative area to observe the continuous pathological changes of articular cartilage in ACLT-induced OA mice. The articular cartilage degeneration was most dramatic at four weeks post ACLT operation and then remained relatively stable. This study may have significant implications for the development of animal models of osteoarthritis and provide a reference for histopathological research on osteoarthritis.
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Affiliation(s)
- Zicai Dong
- Department of Biomedical Materials Science, Third Military Medical University (Army Medical University), 400038, Chongqing, PR China
| | - Chunhan Yang
- School of Stomatology, Kunming Medical University, 650000, Kunming, PR China
| | - Dingsong Zhang
- Department of Hematology, 920th Hospital of Joint Logistics Support Force, PLA, 650118, Kunming, PR China
| | - Shiwu Dong
- Department of Biomedical Materials Science, Third Military Medical University (Army Medical University), 400038, Chongqing, PR China
- State Key Laboratory of Trauma and Chemical Poisoning, Third Military Medical University (Army Medical University), 400038, Chongqing, PR China
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Yan M, Liang T, Zhao H, Bi Y, Wang T, Yu T, Zhang Y. Model Properties and Clinical Application in the Finite Element Analysis of Knee Joint: A Review. Orthop Surg 2024; 16:289-302. [PMID: 38174410 PMCID: PMC10834231 DOI: 10.1111/os.13980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 11/21/2023] [Accepted: 12/04/2023] [Indexed: 01/05/2024] Open
Abstract
The knee is the most complex joint in the human body, including bony structures like the femur, tibia, fibula, and patella, and soft tissues like menisci, ligaments, muscles, and tendons. Complex anatomical structures of the knee joint make it difficult to conduct precise biomechanical research and explore the mechanism of movement and injury. The finite element model (FEM), as an important engineering analysis technique, has been widely used in many fields of bioengineering research. The FEM has advantages in the biomechanical analysis of objects with complex structures. Researchers can use this technology to construct a human knee joint model and perform biomechanical analysis on it. At the same time, finite element analysis can effectively evaluate variables such as stress, strain, displacement, and rotation, helping to predict injury mechanisms and optimize surgical techniques, which make up for the shortcomings of traditional biomechanics experimental research. However, few papers introduce what material properties should be selected for each anatomic structure of knee FEM to meet different research purposes. Based on previous finite element studies of the knee joint, this paper summarizes various modeling strategies and applications, serving as a reference for constructing knee joint models and research design.
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Affiliation(s)
- Mingyue Yan
- Department of Orthopedics, The Affiliated Hospital of Qingdao University, Qingdao, China
- Institute of Sports Medicine and Health, Qingdao University, Qingdao, China
| | - Ting Liang
- Department of Orthopedics, The Affiliated Hospital of Qingdao University, Qingdao, China
- Institute of Sports Medicine and Health, Qingdao University, Qingdao, China
| | - Haibo Zhao
- Department of Orthopedics, The Affiliated Hospital of Qingdao University, Qingdao, China
- Institute of Sports Medicine and Health, Qingdao University, Qingdao, China
| | - Yanchi Bi
- Department of Orthopedics, The Affiliated Hospital of Qingdao University, Qingdao, China
- Institute of Sports Medicine and Health, Qingdao University, Qingdao, China
| | - Tianrui Wang
- Department of Orthopedics, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Tengbo Yu
- Institute of Sports Medicine and Health, Qingdao University, Qingdao, China
- Department of Orthopedic Surgery, Qingdao Hospital, University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital), Qingdao, China
| | - Yingze Zhang
- Department of Orthopedics, The Third Hospital of Hebei Medical University, Shijiazhuang, China
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Liu H, Gong H, Chen P, Zhang L, Cen H, Fan Y. Biomechanical effects of typical lower limb movements of Chen-style Tai Chi on knee joint. Med Biol Eng Comput 2023; 61:3087-3101. [PMID: 37624535 DOI: 10.1007/s11517-023-02906-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 08/09/2023] [Indexed: 08/26/2023]
Abstract
The load and stress distribution on cartilage and meniscus of the knee joint in typical lower limb movements of Chen-style Tai Chi (TC) and deep squat (DS) were analyzed using finite element (FE) analysis. The loadings for this analysis consisted of muscle forces and ground reaction force (GRF), which were calculated through the inverse dynamic approach based on kinematics and force plate measurements obtained from motion capture experiments. Thirteen experienced practitioners performed four typical TC movements, namely, single whip (SW), brush knee and twist step (BKTS), stretch down (SD), and part the wild horse's mane (PWHM), which exhibit lower posture and greater lower limb force compared to other TC styles. The results indicated that TC required greater lower limb muscle strength than DS, resulting in greater knee joint forces. The stress on the medial cartilage in SW and BKTS fell within a range conductive to maintaining the balance between anabolism and catabolism of cartilage matrix. This was due to the fact that SW and BKTS reduce the medial to total tibiofemoral contact force ratios through knee abduction, which may effectively alleviate mild medial knee osteoarthritis (KOA). However, the greater medial contact force ratios observed in SD and PWHM resulted in great contact stresses that may aggravate the pain of patients with KOA. To mitigate these effects, practitioners should consider elevating their postures appropriately to reduce knee flexion angles, especially during the single-leg support phase. This adjustment can decrease the required muscle strength, load and stress on the knee joint.
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Affiliation(s)
- Haibo Liu
- Key Laboratory for Biomechanics and Mechanobiology (Beihang University) of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, No.37, Xueyuan Road, Haidian District, Beijing, 100083, People's Republic of China
| | - He Gong
- Key Laboratory for Biomechanics and Mechanobiology (Beihang University) of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, No.37, Xueyuan Road, Haidian District, Beijing, 100083, People's Republic of China.
| | - Peng Chen
- Key Laboratory for Biomechanics and Mechanobiology (Beihang University) of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, No.37, Xueyuan Road, Haidian District, Beijing, 100083, People's Republic of China
| | - Le Zhang
- Key Laboratory for Biomechanics and Mechanobiology (Beihang University) of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, No.37, Xueyuan Road, Haidian District, Beijing, 100083, People's Republic of China
| | - Haipeng Cen
- Key Laboratory for Biomechanics and Mechanobiology (Beihang University) of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, No.37, Xueyuan Road, Haidian District, Beijing, 100083, People's Republic of China
| | - Yubo Fan
- Key Laboratory for Biomechanics and Mechanobiology (Beihang University) of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, No.37, Xueyuan Road, Haidian District, Beijing, 100083, People's Republic of China
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Guo Y, Liu Y, Sun W, Yu S, Han XJ, Qu XH, Wang G. Digital twin-driven dynamic monitoring system of the upper limb force. Comput Methods Biomech Biomed Engin 2023:1-13. [PMID: 37713212 DOI: 10.1080/10255842.2023.2254881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 08/01/2023] [Accepted: 08/26/2023] [Indexed: 09/16/2023]
Abstract
Digital twin represents the core technology to realize the dynamic monitoring of complex industrial systems. However, the human body, as the most complex system in the physical world, digital twin is rarely applied in it. In this study, we successfully demonstrated a digital twin in the human biomedical application by proposing a dynamic monitoring system of the upper limb force. In this system, the real upper limb drives the motion of the virtual one in real-time and dynamically updates the force. Meanwhile, the virtual upper limb feeds back the monitoring-results of the force to the controller of the real upper limb via immersive virtual reality interaction. Experimental results of the typical motions of the upper limb revealed that the proposed system functioned interactively in real-time in a non-invasive manner, while ensuring the accurate solving of the muscle force. In conclusion, our digital twin-driven system is of great importance for rehabilitation medicine, biomechanical scientific research and physical training, promoting the application of the digital twin in the human biomedical field.
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Affiliation(s)
- Yanbin Guo
- Hubei Bioinformatics & Molecular Imaging Key Laboratory, Department of Biomedical Engineering, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, China
| | - Yingbin Liu
- Hubei Bioinformatics & Molecular Imaging Key Laboratory, Department of Biomedical Engineering, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, China
| | - Wenxuan Sun
- Hubei Bioinformatics & Molecular Imaging Key Laboratory, Department of Biomedical Engineering, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, China
| | - Shuai Yu
- Hubei Bioinformatics & Molecular Imaging Key Laboratory, Department of Biomedical Engineering, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, China
| | - Xiao-Jian Han
- Institute of Geriatrics, Jiangxi Provincial People's Hospital & The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, P.R. China
- Department of Neurology, Jiangxi Provincial People's Hospital & the First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, P.R. China
| | - Xin-Hui Qu
- Department of Neurology, Jiangxi Provincial People's Hospital & the First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, P.R. China
| | - Guoping Wang
- Hubei Bioinformatics & Molecular Imaging Key Laboratory, Department of Biomedical Engineering, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, China
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Sadeqi S, Norte GE, Murray A, Erbulut DU, Goel VK. Effect of Whole Body Parameters on Knee Joint Biomechanics: Implications for ACL Injury Prevention During Single-Leg Landings. Am J Sports Med 2023; 51:2098-2109. [PMID: 37259968 DOI: 10.1177/03635465231174899] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND Previous studies have examined the effect of whole body (WB) parameters on anterior cruciate ligament (ACL) strain and loads, as well as knee joint kinetics and kinematics. However, articular cartilage damage occurs in relation to ACL failure, and the effect of WB parameters on ACL strain and articular cartilage biomechanics during dynamic tasks is unclear. PURPOSES (1) To investigate the effect of WB parameters on ACL strain, as well as articular cartilage stress and contact force, during a single-leg cross drop (SLCD) and single-leg drop (SLD). (2) To identify WB parameters predictive of high ACL strain during these tasks. STUDY DESIGN Descriptive laboratory study. METHODS Three-dimensional motion analysis data from 14 physically active men and women were recorded during an SLCD and SLD. OpenSim was used to obtain their kinematics, kinetics, and muscle forces for the WB model. Using these data in kinetically driven finite element simulations of the knee joint produced outputs of ACL strains and articular cartilage stresses and contact forces. Spearman correlation coefficients were used to assess relationships between WB parameters and ACL strain and cartilage biomechanics. Moreover, receiver operating characteristic curve analyses and multivariate binary logistic regressions were used to find the WB parameters that could discriminate high from low ACL strain trials. RESULTS Correlations showed that more lumbar rotation away from the stance limb at peak ACL strain had the strongest overall association (ρ = 0.877) with peak ACL strain. Higher knee anterior shear force (ρ = 0.895) and lower gluteus maximus muscle force (ρ = 0.89) at peak ACL strain demonstrated the strongest associations with peak articular cartilage stress or contact force in ≥1 of the analyzed tasks. The regression model that used muscle forces to predict high ACL strain trials during the dominant limb SLD yielded the highest accuracy (93.5%), sensitivity (0.881), and specificity (0.952) among all regression models. CONCLUSION WB parameters that were most consistently associated with and predictive of high ACL strain and poor articular cartilage biomechanics during the SLCD and SLD tasks included greater knee abduction angle at initial contact and higher anterior shear force at peak ACL strain, as well as lower gracilis, gluteus maximus, and medial gastrocnemius muscle forces. CLINICAL RELEVANCE Knowledge of which landing postures create a high risk for ACL or cartilage injury may help reduce injuries in athletes by avoiding those postures and practicing the tasks with reduced high-risk motions, as well as by strengthening the muscles that protect the knee during single-leg landings.
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Affiliation(s)
- Sara Sadeqi
- Engineering Center for Orthopaedic Research Excellence (E-CORE), Departments of Bioengineering and Orthopaedic Surgery, University of Toledo, Toledo, OH, USA
| | - Grant E Norte
- Motion Analysis and Integrative Neurophysiology Lab, Department of Exercise and Rehabilitation Sciences, College of Health and Human Services, University of Toledo, Toledo, Ohio, USA
| | - Amanda Murray
- Motion Analysis and Integrative Neurophysiology Lab, Department of Exercise and Rehabilitation Sciences, College of Health and Human Services, University of Toledo, Toledo, Ohio, USA
| | - Deniz U Erbulut
- Engineering Center for Orthopaedic Research Excellence (E-CORE), Departments of Bioengineering and Orthopaedic Surgery, University of Toledo, Toledo, OH, USA
| | - Vijay K Goel
- Engineering Center for Orthopaedic Research Excellence (E-CORE), Departments of Bioengineering and Orthopaedic Surgery, University of Toledo, Toledo, OH, USA
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Shu L, Abe N, Li S, Sugita N. Importance of posterior tibial slope in joint kinematics with an anterior cruciate ligament-deficient knee. Bone Joint Res 2022; 11:739-750. [PMID: 36226477 PMCID: PMC9582864 DOI: 10.1302/2046-3758.1110.bjr-2022-0039.r1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Aims To fully quantify the effect of posterior tibial slope (PTS) angles on joint kinematics and contact mechanics of intact and anterior cruciate ligament-deficient (ACLD) knees during the gait cycle. Methods In this controlled laboratory study, we developed an original multiscale subject-specific finite element musculoskeletal framework model and integrated it with the tibiofemoral and patellofemoral joints with high-fidelity joint motion representations, to investigate the effects of 2.5° increases in PTS angles on joint dynamics and contact mechanics during the gait cycle. Results The ACL tensile force in the intact knee was significantly affected with increasing PTS angle. Considerable differences were observed in kinematics and initial posterior femoral translation between the intact and ACLD joints as the PTS angles increased by more than 2.5° (beyond 11.4°). Additionally, a higher contact stress was detected in the peripheral posterior horn areas of the menisci with increasing PTS angle during the gait cycle. The maximum tensile force on the horn of the medial meniscus increased from 73.9 N to 172.4 N in the ACLD joint with increasing PTS angles. Conclusion Knee joint instability and larger loading on the medial meniscus were found on the ACLD knee even at a 2.5° increase in PTS angle (larger than 11.4°). Our biomechanical findings support recent clinical evidence of a high risk of failure of ACL reconstruction with steeper PTS and the necessity of ACL reconstruction, which would prevent meniscus tear and thus the development or progression of osteoarthritis. Cite this article: Bone Joint Res 2022;11(10):739–750.
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Affiliation(s)
- Liming Shu
- Research into Artifacts, Center for Engineering, School of Engineering, The University of Tokyo, Tokyo, Japan,Department of Mechanical Engineering, School of Engineering, The University of Tokyo, Tokyo, Japan,Department of Mechanical Engineering, Dalian University of Technology, Dalian, China
| | - Nobuhiro Abe
- Department of Orthopaedic Surgery and Sport Medicine, General Medical Center, Kawasaki Medical School, Okayama, Japan, Nobuhiro Abe. E-mail:
| | - Shihao Li
- Research into Artifacts, Center for Engineering, School of Engineering, The University of Tokyo, Tokyo, Japan,Department of Mechanical Engineering, School of Engineering, The University of Tokyo, Tokyo, Japan
| | - Naohiko Sugita
- Research into Artifacts, Center for Engineering, School of Engineering, The University of Tokyo, Tokyo, Japan,Department of Mechanical Engineering, School of Engineering, The University of Tokyo, Tokyo, Japan
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Wang S, Hase K, Kita S, Ogaya S. Biomechanical effects of medial meniscus radial tears on the knee joint during gait: A concurrent finite element musculoskeletal framework investigation. Front Bioeng Biotechnol 2022; 10:957435. [PMID: 36299291 PMCID: PMC9589217 DOI: 10.3389/fbioe.2022.957435] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 09/26/2022] [Indexed: 11/22/2022] Open
Abstract
The biomechanical variation in the knee during walking that accompanies medial meniscal radial tears stemming from knee osteoarthritis (OA) has not been explored. This study introduced a finite element musculoskeletal model using concurrent lower limb musculoskeletal dynamics and knee joint finite element analysis in a single framework and expanded the models to include knees with medial meniscal radial tears and total medial meniscectomy. The radial tears involved three locations: anterior horn, midbody, and posterior horn with grades of 33%, 50%, and 83% of the meniscus width. The shear and hoop stresses of the tear meniscus and tibial cartilage contact load, accompanying tears, and postmeniscectomy were evaluated during the stance phase of the gait cycle using the models. In the 83% width midbody tear group, shear stress at the end of the tear was significantly greater than in the intact meniscus and other tear groups, and the maximum shear stress was increased by 310% compared to the intact meniscus. A medial meniscus radial tear has a much smaller effect on the tibial cartilage load (even though in the 83% width tear, the cartilage/total load ratio increased by only 9%). However, the contact force on the tibial cartilage with total postmeniscectomy was increased by 178.93% compared with a healthy intact meniscus, and the peak contact pressure after meniscectomy increased from 11.94 to 12.45 MPa to 17.64 and 13.76 MPa, at the maximum weight acceptance and push-off, respectively. Our study shows that radial tears with larger medial meniscus widths are prone to high stress concentrations at the end of the tears, leading to the potential risk of complete meniscal rupture. Furthermore, although the tears did not change the cartilage load distribution, they disrupted the circumferential stress-transmitting function of the meniscus, thus greatly increasing the likelihood of the onset of knee OA. The significant increase in the tibial cartilage load with total postmeniscectomy indicates a potential risk of OA flare-ups. This study contributes to a better understanding of meniscal tear-induced OA biomechanical changes during human activities and offers some potential directions for surgical guidance of meniscectomies and the prophylaxis and treatment of OA.
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Affiliation(s)
- Sentong Wang
- Human-Mechanical System Laboratory, Graduate School of Systems Design, Tokyo Metropolitan University, Hachioji, Japan
- *Correspondence: Sentong Wang, ; Kazunori Hase,
| | - Kazunori Hase
- Human-Mechanical System Laboratory, Faculty of Systems Design, Tokyo Metropolitan University, Hachioji, Japan
- *Correspondence: Sentong Wang, ; Kazunori Hase,
| | - Shunsuke Kita
- Biomechanics of Exercise and Sports in Physical Therapy Laboratory, Graduate Course of Health and Social Services, Saitama Prefectural University, Koshigaya, Japan
- Department of Rehabilitation, Soka Orthopedics Internal Medicine, Saitama, Japan
| | - Shinya Ogaya
- Biomechanics of Exercise and Sports in Physical Therapy Laboratory, Department of Physical Therapy, Saitama Prefectural University, Koshigaya, Japan
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