1
|
Ou D, Ye Y, Pan J, Huang Y, Kuang H, Tang S, Huang R, Mo Y, Pan S. Anterior cruciate ligament injury should not be considered a contraindication for medial unicompartmental knee arthroplasty: Finite element analysis. PLoS One 2024; 19:e0299649. [PMID: 38470904 DOI: 10.1371/journal.pone.0299649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 02/12/2024] [Indexed: 03/14/2024] Open
Abstract
PURPOSE The research objective of this study is to use finite element analysis to investigate the impact of anterior cruciate ligament (ACL) injury on medial unicompartmental knee arthroplasty (UKA) and explore whether patients with ACL injuries can undergo UKA. METHODS Based on the morphology of the ACL, models of ACL with diameters ranging from 1 to 10mm are created. Finite element models of UKA include ACL absence and ACLs with different diameters. After creating a complete finite element model and validating it, four different types of loads are applied to the knee joint. Statistical analysis is conducted to assess the stress variations in the knee joint structure. RESULTS A total of 11 finite element models of UKA were established. Regarding the stress on the ACL, as the diameter of the ACL increased, when a vertical load of 750N was applied to the femur, combined with an anterior tibial load of 105N, the stress on the ACL increased from 2.61 MPa to 4.62 MPa, representing a 77.05% increase. Regarding the equivalent stress on the polyethylene gasket, a notable high stress change was observed. The stress on the gasket remained between 12.68 MPa and 14.33 MPa in all models. the stress on the gasket demonstrated a decreasing trend. The equivalent stress in the lateral meniscus and lateral femoral cartilage decreases, reducing from the maximum stress of 4.71 MPa to 2.61 MPa, with a mean value of 3.73 MPa. This represents a reduction of 44.72%, and the statistical significance is (P < 0.05). However, under the other three loads, there was no significant statistical significance (P > 0.05). CONCLUSION This study suggests that the integrity of the ACL plays a protective role in performing medial UKA. However, this protective effect is limited when performing medial UKA. When the knee joint only has varying degrees of ACL injury, even ACL rupture, and the remaining structures of the knee joint are intact with anterior-posterior stability in the knee joint, it should not be considered a contraindication for medial UKA.
Collapse
Affiliation(s)
- Deyan Ou
- Department of Limb and Joint Ward, Wuzhou Red Cross Hospital, Wuzhou, Guangxi Province, China
| | - Yongqing Ye
- Department of Medical Imaging Department, Wuzhou Red Cross Hospital, Wuzhou, Guangxi Province, China
| | - Jingwei Pan
- Department of Spine Ward, Wuzhou Red Cross Hospital, Wuzhou, Guangxi Province, China
| | - Yu Huang
- Department of Spine Ward, Wuzhou Red Cross Hospital, Wuzhou, Guangxi Province, China
| | - Haisheng Kuang
- Department of Limb and Joint Ward, Wuzhou Red Cross Hospital, Wuzhou, Guangxi Province, China
| | - Shilin Tang
- Department of Spine Ward, Wuzhou Red Cross Hospital, Wuzhou, Guangxi Province, China
| | - Richao Huang
- Department of Limb and Joint Ward, Wuzhou Red Cross Hospital, Wuzhou, Guangxi Province, China
| | - Yongxin Mo
- Department of Limb and Joint Ward, Wuzhou Red Cross Hospital, Wuzhou, Guangxi Province, China
| | - Shixin Pan
- Department of Spine Ward, Wuzhou Red Cross Hospital, Wuzhou, Guangxi Province, China
| |
Collapse
|
2
|
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.
Collapse
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
| |
Collapse
|
3
|
Naya Y, Takanari H. Elastin is responsible for the rigidity of the ligament under shear and rotational stress: a mathematical simulation study. J Orthop Surg Res 2023; 18:310. [PMID: 37072855 PMCID: PMC10114388 DOI: 10.1186/s13018-023-03794-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 04/11/2023] [Indexed: 04/20/2023] Open
Abstract
BACKGROUND An accurate understanding of the mechanical response of ligaments is important for preventing their damage and rupture. To date, ligament mechanical responses are being primarily evaluated using simulations. However, many mathematical simulations construct models of uniform fibre bundles or sheets using merely collagen fibres and ignore the mechanical properties of other components such as elastin and crosslinkers. Here, we evaluated the effect of elastin-specific mechanical properties and content on the mechanical response of ligaments to stress using a simple mathematical model. METHODS Based on multiphoton microscopic images of porcine knee collateral ligaments, we constructed a simple mathematical simulation model that individually includes the mechanical properties of collagen fibres and elastin (fibre model) and compared with another model that considers the ligament as a single sheet (sheet model). We also evaluated the mechanical response of the fibre model as a function of the elastin content, from 0 to 33.5%. Both ends of the ligament were fixed to a bone, and tensile, shear, and rotational stresses were applied to one of the bones to evaluate the magnitude and distribution of the stress applied to the collagen and elastin at each load. RESULTS Uniform stress was applied to the entire ligament in the sheet model, whereas in the fibre model, strong stress was applied at the junction between collagen fibres and elastin. Even in the same fibre model, as the elastin content increased from 0 to 14.4%, the maximum stress and displacement applied to the collagen fibres during shear stress decreased by 65% and 89%, respectively. The slope of the stress-strain relationship at 14.4% elastin was 6.5 times greater under shear stress than that of the model with 0% elastin. A positive correlation was found between the stress required to rotate the bones at both ends of the ligament at the same angle and elastin content. CONCLUSIONS The fibre model, which includes the mechanical properties of elastin, can provide a more precise evaluation of the stress distribution and mechanical response. Elastin is responsible for ligament rigidity during shear and rotational stress.
Collapse
Affiliation(s)
- Yuki Naya
- Division of Interdisciplinary Research for Medicine and Photonics, Institute of Post-LED Photonics, Tokushima University, 3-18-15, Kuramoto, Tokushima, 770-8503, Japan
- Graduate School of Medical Sciences, Tokushima University, Tokushima, Japan
| | - Hiroki Takanari
- Division of Interdisciplinary Research for Medicine and Photonics, Institute of Post-LED Photonics, Tokushima University, 3-18-15, Kuramoto, Tokushima, 770-8503, Japan.
| |
Collapse
|
4
|
González AK, Rodríguez-Reséndiz J, Gonzalez-Durán JEE, Olivares Ramírez JM, Estévez-Bén AA. Development of a Hip Joint Socket by Finite-Element-Based Analysis for Mechanical Assessment. Bioengineering (Basel) 2023; 10:bioengineering10020268. [PMID: 36829762 PMCID: PMC9952638 DOI: 10.3390/bioengineering10020268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/04/2023] [Accepted: 02/15/2023] [Indexed: 02/22/2023] Open
Abstract
This article evaluates a hip joint socket design by finite element method (FEM). The study was based on the needs and characteristics of a patient with an oncological amputation; however, the solution and the presented method may be generalized for patients with similar conditions. The research aimed to solve a generalized problem, taking a typical case from the study area as a reference. Data were collected on the use of the current improving prosthesis-specifically in interaction with its socket-to obtain information on the new approach design: this step constituted the work's starting point, where the problems to be solved in conventional designs were revealed. Currently, the development of this type of support does not consider the functionality and comfort of the patient. Research has reported that 58% of patients with sockets have rejected their use, because they do not fit comfortably and functionally; therefore, patients' low acceptance or rejection of the use of the prosthesis socket has been documented. In this study, different designs were evaluated, based on the FEM as scientific support for the results obtained, for the development of a new ergonomic fit with a 60% increase in patient compliance, that had correct gait performance when correcting postures, improved fit-user interaction, and that presented an esthetic fit that met the usability factor. The validation of the results was carried out through the physical construction of the prototype. The research showed how the finite element method improved the design, analyzing the structural behavioral, and that it could reduce cost and time instead of generating several prototypes.
Collapse
Affiliation(s)
- Ana Karen González
- Engineering Faculty, Universidad Autónoma de Querétaro, Querétaro 76010, Mexico
| | - Juvenal Rodríguez-Reséndiz
- Engineering Faculty, Universidad Autónoma de Querétaro, Querétaro 76010, Mexico
- Correspondence: (J.R.-R.); (J.M.O.R.)
| | | | - Juan Manuel Olivares Ramírez
- Department of Renewable Energy, Universidad Tecnológica de San Juan del Río, Querétaro 76800, Mexico
- Correspondence: (J.R.-R.); (J.M.O.R.)
| | - Adyr A. Estévez-Bén
- Engineering Faculty, Universidad Autónoma de Querétaro, Querétaro 76010, Mexico
- Chemistry Faculty, Universidad Autónoma de Querétaro, Querétaro 76010, Mexico
| |
Collapse
|