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Theilen E, Rörich A, Lange T, Bendak S, Huber C, Schmal H, Izadpanah K, Georgii J. Validation of a Finite Element Simulation for Predicting Individual Knee Joint Kinematics. IEEE OPEN JOURNAL OF ENGINEERING IN MEDICINE AND BIOLOGY 2023; 5:125-132. [PMID: 38487097 PMCID: PMC10939333 DOI: 10.1109/ojemb.2023.3258362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 12/31/2022] [Accepted: 03/14/2023] [Indexed: 03/17/2024] Open
Abstract
Goal: We introduce an in-vivo validated finite element (FE) simulation approach for predicting individual knee joint kinematics. Our vision is to improve clinicians' understanding of the complex individual anatomy and potential pathologies to improve treatment and restore physiological joint kinematics. Methods: Our 3D FE modeling approach for individual human knee joints is based on segmentation of anatomical structures extracted from routine static magnetic resonance (MR) images. We validate the predictive abilities of our model using static MR images of the knees of eleven healthy volunteers in dedicated knee poses, which are achieved using a customized MR-compatible pneumatic loading device. Results: Our FE simulations reach an average translational accuracy of 2 mm and an average angular accuracy of 1[Formula: see text] compared to the reference knee pose. Conclusions: Reaching high accuracy, our individual FE model can be used in the decision-making process to restore knee joint stability and functionality after various knee injuries.
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Affiliation(s)
- Elin Theilen
- Fraunhofer Institute for Digital Medicine MEVIS28359BremenGermany
| | - Anna Rörich
- Fraunhofer Institute for Digital Medicine MEVIS28359BremenGermany
| | - Thomas Lange
- Division of Medical Physics, Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of MedicineUniversity of Freiburg79104FreiburgGermany
| | - Sebastian Bendak
- Department of Orthopedic Surgery and Traumatology, Freiburg University HospitalAlbert-Ludwigs-University Freiburg79106FreiburgGermany
| | - Cora Huber
- Stryker Leibinger GmbH & Co. KG79111Freiburg im BreisgauGermany
| | - Hagen Schmal
- Department of Orthopedic Surgery and Traumatology, Freiburg University HospitalAlbert-Ludwigs-University Freiburg79106FreiburgGermany
| | - Kaywan Izadpanah
- Department of Orthopedic Surgery and Traumatology, Freiburg University HospitalAlbert-Ludwigs-University Freiburg79106FreiburgGermany
| | - Joachim Georgii
- Fraunhofer Institute for Digital Medicine MEVIS28359BremenGermany
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Katagiri H, Nakagawa Y, Miyatake K, Ohara T, Shioda M, Sekiya I, Koga H. Short-Term Outcomes after High Tibial Osteotomy Aimed at Neutral Alignment Combined with Arthroscopic Centralization of Medial Meniscus in Osteoarthritis Patients. J Knee Surg 2023; 36:261-268. [PMID: 34261157 DOI: 10.1055/s-0041-1731738] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The study aimed to improve the long-term outcomes of open-wedge high tibial osteotomy (OWHTO); procedures combining OWHTO aimed at neutral alignment and arthroscopic centralization for meniscal extrusion have been introduced. The present study evaluated short-term patient-reported outcome measures; namely, the patient subjective satisfaction scores and Numeric Rating Scale (NRS) for walking pain after OWHTO aimed at neutral alignment with and without arthroscopic centralization for an extruded medial meniscus. A retrospective review of 50 primary OWHTO patients was conducted. Thirty-nine patients were included in the analysis after applying the exclusion criteria. The centralization group included 21 patients with knee osteoarthritis patients who underwent the OWHTO with arthroscopic meniscal centralization, while the control group included 18 patients who underwent OWHTO alone. The patient subjective satisfaction scores and NRS for walking pain were recorded at outpatient visits from before surgery to 3 years after surgery. In terms of the Lysholm knee scale, International Knee Documentation Committee subjective score, and Knee Osteoarthritis Outcome Score, the latest data (at least 2 years after surgery) were reviewed. Radiographic changes in joint space width and joint line congruence angle were measured 2 years postoperatively. Patient demographic data were also reviewed. One patient in the centralization group experienced a superficial surgical site infection. The patient subjective satisfaction and NRS scores for walking pain gradually improved by 1 year after surgery and were sustained until 3 years after surgery in both groups, with no significant difference between the groups. The course of patient-reported outcome measures from before surgery to 3 years after surgery for solely OWHTO aimed at neutral alignment and OWHTO aimed at neutral alignment with arthroscopic centralization showed the similar trends.
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Affiliation(s)
- Hiroki Katagiri
- Department of Joint Surgery and Sports Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan.,Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Yusuke Nakagawa
- Department of Joint Surgery and Sports Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan.,Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Kazumasa Miyatake
- Department of Joint Surgery and Sports Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan.,Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Toshiyuki Ohara
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Mikio Shioda
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Ichiro Sekiya
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Hideyuki Koga
- Department of Joint Surgery and Sports Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan.,Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital of Medicine, Bunkyo-ku, Tokyo, Japan
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Autologous semitendinosus meniscus graft significantly improves knee joint kinematics and the tibiofemoral contact after complete lateral meniscectomy. Knee Surg Sports Traumatol Arthrosc 2023:10.1007/s00167-022-07300-z. [PMID: 36604322 DOI: 10.1007/s00167-022-07300-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 12/20/2022] [Indexed: 01/07/2023]
Abstract
PURPOSE The purpose of this study was to investigate the potential of a doubled semitendinosus (ST) and a single gracilis tendon (GT) lateral meniscus autograft to restore the knee joint kinematics and tibiofemoral contact after total lateral meniscectomy (LMM). METHODS Fourteen human knee joints were tested intact, after LMM and after ST and GT meniscus autograft treatment under an axial load of 200 N during full range of motion (0°-120°) and four randomised loading situations: without external moments, external rotation, valgus stress and a combination of external rotation and valgus stress using a knee joint simulator. Non-parametric statistical analyses were performed on joint kinematics and on the tibiofemoral contact mechanics. RESULTS LMM led to significant rotational instability of the knee joints (p < 0.02), which was significantly improved after ST autograft application (p < 0.04), except for knee joint flexions > 60°. The GT autograft failed to restore the joint kinematics. LMM significantly increased the tibiofemoral contact pressure (p < 0.03), while decreasing the contact area (p < 0.05). The ST autograft was able to restore the contact mechanics after LMM (p < 0.02), while the GT replacement displayed only an improvement trend. CONCLUSION The doubled ST lateral meniscus autograft improved the knee joint kinematics significantly and restored the tibiofemoral contact mechanics almost comparable to the native situation. Thus, from a biomechanical point of view, ST meniscus autografts might be a potential treatment alternative for patients who are indicated for meniscus allograft transplantation.
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Rasheed B, Ayyalasomayajula V, Schaarschmidt U, Vagstad T, Schaathun HG. Region- and layer-specific investigations of the human menisci using SHG imaging and biaxial testing. Front Bioeng Biotechnol 2023; 11:1167427. [PMID: 37143602 PMCID: PMC10151675 DOI: 10.3389/fbioe.2023.1167427] [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: 02/16/2023] [Accepted: 04/04/2023] [Indexed: 05/06/2023] Open
Abstract
In this paper, we examine the region- and layer-specific collagen fiber morphology via second harmonic generation (SHG) in combination with planar biaxial tension testing to suggest a structure-based constitutive model for the human meniscal tissue. Five lateral and four medial menisci were utilized, with samples excised across the thickness from the anterior, mid-body, and posterior regions of each meniscus. An optical clearing protocol enhanced the scan depth. SHG imaging revealed that the top samples consisted of randomly oriented fibers with a mean fiber orientation of 43.3 o . The bottom samples were dominated by circumferentially organized fibers, with a mean orientation of 9.5 o . Biaxial testing revealed a clear anisotropic response, with the circumferential direction being stiffer than the radial direction. The bottom samples from the anterior region of the medial menisci exhibited higher circumferential elastic modulus with a mean value of 21 MPa. The data from the two testing protocols were combined to characterize the tissue with an anisotropic hyperelastic material model based on the generalized structure tensor approach. The model showed good agreement in representing the material anisotropy with a mean r 2 = 0.92.
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Affiliation(s)
- Bismi Rasheed
- Cyber-Physical Systems Laboratory, Department of ICT and Natural Sciences, Norwegian University of Science and Technology (NTNU), Ålesund, Norway
- Ålesund Biomechanics Lab, Ålesund General Hospital, Møre and Romsdal Hospital Trust, Ålesund, Norway
- *Correspondence: Bismi Rasheed,
| | - Venkat Ayyalasomayajula
- Division of Biomechanics, Department of Structural Engineering, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Ute Schaarschmidt
- Cyber-Physical Systems Laboratory, Department of ICT and Natural Sciences, Norwegian University of Science and Technology (NTNU), Ålesund, Norway
| | - Terje Vagstad
- Cyber-Physical Systems Laboratory, Department of ICT and Natural Sciences, Norwegian University of Science and Technology (NTNU), Ålesund, Norway
- Ålesund Biomechanics Lab, Ålesund General Hospital, Møre and Romsdal Hospital Trust, Ålesund, Norway
- Department of Orthopaedic Surgery, Medi3, Ålesund, Norway
| | - Hans Georg Schaathun
- Cyber-Physical Systems Laboratory, Department of ICT and Natural Sciences, Norwegian University of Science and Technology (NTNU), Ålesund, Norway
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Daszkiewicz K, Łuczkiewicz P. Biomechanics of the medial meniscus in the osteoarthritic knee joint. PeerJ 2021; 9:e12509. [PMID: 34900428 PMCID: PMC8627128 DOI: 10.7717/peerj.12509] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 10/27/2021] [Indexed: 11/20/2022] Open
Abstract
Background Increased mechanical loading and pathological response of joint tissue to the abnormal mechanical stress can cause degradation of cartilage characteristic of knee osteoarthritis (OA). Despite osteoarthritis is risk factor for the development of meniscal lesions the mechanism of degenerative meniscal lesions is still unclear. Therefore, the aim of the study is to investigate the influence of medial compartment knee OA on the stress state and deformation of the medial meniscus. Methods The finite element method was used to simulate the stance phase of the gait cycle. An intact knee model was prepared based on magnetic resonance scans of the left knee joint of a healthy volunteer. Degenerative changes in the medial knee OA model were simulated by nonuniform reduction in articular cartilage thickness in specific areas and by a decrease in the material parameters of cartilage and menisci. Two additional models were created to separately evaluate the effect of alterations in articular cartilage geometry and material parameters of the soft tissues on the results. A nonlinear dynamic analysis was performed for standardized knee loads applied to the tibia bone. Results The maximum von Mises stress of 26.8 MPa was observed in the posterior part of the medial meniscus body in the OA model. The maximal hoop stress for the first peak of total force was 83% greater in the posterior horn and only 11% greater in the anterior horn of the medial meniscus in the OA model than in the intact model. The reduction in cartilage thickness caused an increase of 57% in medial translation of the medial meniscus body. A decrease in the compressive modulus of menisci resulted in a 2.5-fold greater reduction in the meniscal body width compared to the intact model. Conclusions Higher hoop stress levels on the inner edge of the posterior part of the medial meniscus in the OA model than in the intact model are associated with a greater medial translation of the meniscus body and a greater reduction in its width. The considerable increase in hoop stresses shows that medial knee OA may contribute to the initiation of meniscal radial tears.
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Affiliation(s)
- Karol Daszkiewicz
- Department of Mechanics of Materials and Structures, Faculty of Civil and Environmental Engineering, Gdańsk University of Technology, Gdańsk, Poland
| | - Piotr Łuczkiewicz
- II Department of Orthopaedics and Kinetic Organ Traumatology, Medical University of Gdańsk, Gdańsk, Poland
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Seyedpour SM, Nafisi S, Nabati M, Pierce DM, Reichenbach JR, Ricken T. Magnetic Resonance Imaging-based biomechanical simulation of cartilage: A systematic review. J Mech Behav Biomed Mater 2021; 126:104963. [PMID: 34894500 DOI: 10.1016/j.jmbbm.2021.104963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 10/30/2021] [Accepted: 11/06/2021] [Indexed: 11/19/2022]
Abstract
MRI-based mathematical and computational modeling studies can contribute to a better understanding of the mechanisms governing cartilage's mechanical performance and cartilage disease. In addition, distinct modeling of cartilage is needed to optimize artificial cartilage production. These studies have opened up the prospect of further deepening our understanding of cartilage function. Furthermore, these studies reveal the initiation of an engineering-level approach to how cartilage disease affects material properties and cartilage function. Aimed at researchers in the field of MRI-based cartilage simulation, research articles pertinent to MRI-based cartilage modeling were identified, reviewed, and summarized systematically. Various MRI applications for cartilage modeling are highlighted, and the limitations of different constitutive models used are addressed. In addition, the clinical application of simulations and studied diseases are discussed. The paper's quality, based on the developed questionnaire, was assessed, and out of 79 reviewed papers, 34 papers were determined as high-quality. Due to the lack of the best constitutive models for various clinical conditions, researchers may consider the effect of constitutive material models on the cartilage disease simulation. In the future, research groups may incorporate various aspects of machine learning into constitutive models and MRI data extraction to further refine the study methodology. Moreover, researchers should strive for further reproducibility and rigorous model validation and verification, such as gait analysis.
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Affiliation(s)
- S M Seyedpour
- Institute of Mechanics, Structural Analysis and Dynamics, Faculty of Aerospace Engineering and Geodesy, University of Stuttgart, Pfaffenwaldring 27, 70569 Stuttgart, Germany; Biomechanics Lab, Institute of Mechanics, Structural Analysis and Dynamics, Faculty of Aerospace Engineering and Geodesy, University of Stuttgart, Pfaffenwaldring 27, 70569 Stuttgart, Germany
| | - S Nafisi
- Faculty of Pharmacy, Istinye University, Maltepe, Cirpici Yolu B Ck. No. 9, 34010 Zeytinburnu, Istanbul, Turkey
| | - M Nabati
- Department of Mechanical Engineering, Faculty of Engineering, Boğaziçi University, 34342 Bebek, Istanbul, Turkey
| | - D M Pierce
- Department of Mechanical Engineering, University of Connecticut, 191 Auditorium Road, Unit 3139, Storrs, CT, 06269, USA; Department of Biomedical Engineering, University of Connecticut, 260 Glenbrook Road, Unit 3247, Storrs, CT, 06269, USA
| | - J R Reichenbach
- Medical Physics Group, Institute of Diagnostic and Interventional Radiology, Jena University Hospital-Friedrich Schiller University Jena, Jena, Germany; Center of Medical Optics and Photonics, Friedrich Schiller University Jena, Germany; Michael Stifel Center for Data-driven and Simulation Science Jena, Friedrich Schiller University Jena, Germany
| | - T Ricken
- Institute of Mechanics, Structural Analysis and Dynamics, Faculty of Aerospace Engineering and Geodesy, University of Stuttgart, Pfaffenwaldring 27, 70569 Stuttgart, Germany; Biomechanics Lab, Institute of Mechanics, Structural Analysis and Dynamics, Faculty of Aerospace Engineering and Geodesy, University of Stuttgart, Pfaffenwaldring 27, 70569 Stuttgart, Germany.
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Mohamadi A, Momenzadeh K, Masoudi A, Walley KC, Ierardi K, Ramappa A, DeAngelis JP, Nazarian A. Evolution of knowledge on meniscal biomechanics: a 40 year perspective. BMC Musculoskelet Disord 2021; 22:625. [PMID: 34266442 PMCID: PMC8283839 DOI: 10.1186/s12891-021-04492-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 06/21/2021] [Indexed: 02/08/2023] Open
Abstract
Background Knowledge regarding the biomechanics of the meniscus has grown exponentially throughout the last four decades. Numerous studies have helped develop this knowledge, but these studies have varied widely in their approach to analyzing the meniscus. As one of the subcategories of mechanical phenomena Medical Subject Headings (MeSH) terms, mechanical stress was introduced in 1973. This study aims to provide an up-to-date chronological overview and highlights the evolutionary comprehension and understanding of meniscus biomechanics over the past forty years. Methods A literature review was conducted in April 2021 through PubMed. As a result, fifty-seven papers were chosen for this narrative review and divided into categories; Cadaveric, Finite element (FE) modeling, and Kinematic studies. Results Investigations in the 1970s and 1980s focused primarily on cadaveric biomechanics. These studies have generated the fundamental knowledge basis for the emergence of FE model studies in the 1990s. As FE model studies started to show comparable results to the gold standard cadaveric models in the 2000s, the need for understanding changes in tissue stress during various movements triggered the start of cadaveric and FE model studies on kinematics. Conclusion This study focuses on a chronological examination of studies on meniscus biomechanics in order to introduce concepts, theories, methods, and developments achieved over the past 40 years and also to identify the likely direction for future research. The biomechanics of intact meniscus and various types of meniscal tears has been broadly studied. Nevertheless, the biomechanics of meniscal tears, meniscectomy, or repairs in the knee with other concurrent problems such as torn cruciate ligaments or genu-valgum or genu-varum have not been extensively studied.
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Affiliation(s)
- Amin Mohamadi
- Musculoskeletal Translational Innovation Initiative, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, RN123, Boston, MA, 02215, USA.,Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Kaveh Momenzadeh
- Musculoskeletal Translational Innovation Initiative, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, RN123, Boston, MA, 02215, USA.,Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Aidin Masoudi
- Musculoskeletal Translational Innovation Initiative, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, RN123, Boston, MA, 02215, USA
| | - Kempland C Walley
- Musculoskeletal Translational Innovation Initiative, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, RN123, Boston, MA, 02215, USA.,Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Kenny Ierardi
- Musculoskeletal Translational Innovation Initiative, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, RN123, Boston, MA, 02215, USA
| | - Arun Ramappa
- Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Joseph P DeAngelis
- Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Ara Nazarian
- Musculoskeletal Translational Innovation Initiative, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, RN123, Boston, MA, 02215, USA. .,Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA. .,Department of Orthopaedic Surgery, Yerevan State Medical University, Yerevan, Armenia.
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Liu Y, Du G. The association of meniscal body height with knee structural changes in middle-aged and elderly patients with symptomatic knee osteoarthritis. Br J Radiol 2021; 94:20210152. [PMID: 34192479 DOI: 10.1259/bjr.20210152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES To investigate whether and how meniscal height is associated with osteoarthritis (OA)-related knee structural changes in symptomatic knee OA. METHODS We studied 106 patients (61 female, aged 40-73 years) with symptomatic knee OA. X-ray was used for Kellgren-Lawrence score. Meniscal body heights and extrusion were measured on coronal sections of intermediate-weighted MRI sequence. Knee structural changes were assessed using the modified whole-organ magnetic resonance imaging score (WORMS). Associations between meniscal body height and knee structural changes were assessed using linear regression analysis. RESULTS Higher medial meniscal body height was significantly associated with severe medial meniscal lesions (p = 0.001-0.023), medial compartmental cartilage lesions (p = 0.045), patellofemoral compartmental and medial compartmental bone marrow edema patterns (p = 0.001-0.037), anterior cruciate ligament and patellar ligament abnormalities (p = 0.020-0.023), and loose bodies (p = 0.017). However, lateral meniscal body height was negatively correlated with WORMS scores for lateral meniscal lesions (p ≤ 0.018), lateral compartmental cartilage lesions (p ≤ 0.011), and lateral compartmental bone marrow edema patterns (p = 0.038). CONCLUSION Higher medial meniscal body height was associated with more severe medial compartment structural abnormalities and patellofemoral bone marrow edema patterns, while lateral meniscal body height was inversely correlated with the severity of lateral compartment structural abnormalities. ADVANCES IN KNOWLEDGE Our study revealed that meniscal body height was associated with multiple OA-related knee structural changes, which would be beneficial in identifying patients with or at risks for knee OA.
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Affiliation(s)
- Yao Liu
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Guiying Du
- Department of Radiology, Teda International Cardiovascular Hospital, Tianjin, China
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Zhu LY, Li L, Li ZA, Shi JP, Tang WL, Yang JQ, Jiang Q. Design and biomechanical characteristics of porous meniscal implant structures using triply periodic minimal surfaces. J Transl Med 2019; 17:89. [PMID: 30885229 PMCID: PMC6423829 DOI: 10.1186/s12967-019-1834-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 03/06/2019] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Artificial meniscal implants can be used to replace a severely injured meniscus after meniscectomy and restore the normal functionality of a knee joint. The aim of this paper was to design porous meniscal implants and assess their biomechanical properties. METHODS Finite element simulations were conducted on eight different cases including intact healthy knees, knee joints with solid meniscal implants, and knee joints with meniscal implants with two types of triply periodic minimal surfaces. Compression stresses, shear stresses, and characteristics of stress concentrated areas were evaluated using an axial compressive load of 1150 N and an anterior load of 350 N. RESULTS Compared to the solid meniscal implant, the proposed porous meniscal implant produced lower levels of compression and shear stresses on the cartilage, which facilitated the cartilage to retain a semilunar characteristic similar to the natural meniscus. Moreover, both compression and shear stresses on the artificial cartilage were found to be sensitive to the pore properties of the meniscal implant. The meniscal implants with primitive surfaces (porosity: 41%) showed a better performance in disseminating stresses within the knee joint. CONCLUSION The present commercial meniscal implant has the problem of equivalent biomechanical properties compared to natural menisci. The main advantage of the proposed porous structure is that it can be used to prevent excessive compression and shear stresses on the articular cartilages. This structure has advantages both in terms of mechanics and printability, which can be beneficial for future clinical applications.
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Affiliation(s)
- Li-ya Zhu
- Jiangsu Key Laboratory of 3D Printing Equipment and Manufacturing, School of Electrical and Automation Engineering, Nanjing Normal University, Nanjing, China
- Nanjing Institute of Intelligent Advanced Equipment Industry Co., Ltd., Nanjing, China
| | - Lan Li
- School of Mechanical Engineering, Southeast University, Nanjing, China
- 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
| | - Zong-an Li
- Jiangsu Key Laboratory of 3D Printing Equipment and Manufacturing, School of Electrical and Automation Engineering, Nanjing Normal University, Nanjing, China
- Nanjing Institute of Intelligent Advanced Equipment Industry Co., Ltd., Nanjing, China
| | - Jian-ping Shi
- Jiangsu Key Laboratory of 3D Printing Equipment and Manufacturing, School of Electrical and Automation Engineering, Nanjing Normal University, Nanjing, China
- Nanjing Institute of Intelligent Advanced Equipment Industry Co., Ltd., Nanjing, China
| | - Wen-lai Tang
- Jiangsu Key Laboratory of 3D Printing Equipment and Manufacturing, School of Electrical and Automation Engineering, Nanjing Normal University, Nanjing, China
- Nanjing Institute of Intelligent Advanced Equipment Industry Co., Ltd., Nanjing, China
| | - Ji-quan Yang
- Jiangsu Key Laboratory of 3D Printing Equipment and Manufacturing, School of Electrical and Automation Engineering, Nanjing Normal University, Nanjing, China
- Nanjing Institute of Intelligent Advanced Equipment Industry Co., Ltd., Nanjing, China
| | - Qing Jiang
- 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
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DeFrate LE, Kim-Wang SY, Englander ZA, McNulty AL. Osteoarthritis year in review 2018: mechanics. Osteoarthritis Cartilage 2019; 27:392-400. [PMID: 30597275 PMCID: PMC6489451 DOI: 10.1016/j.joca.2018.12.011] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 12/20/2018] [Accepted: 12/20/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To review recent biomechanics literature focused on the interactions between biomechanics and articular cartilage health, particularly focused on macro-scale and human studies. DESIGN A literature search was conducted in PubMed using the search terms (biomechanics AND osteoarthritis) OR (biomechanics AND cartilage) OR (mechanics AND osteoarthritis) OR (mechanics AND cartilage) for publications from April 2017 to April 2018. RESULTS Abstracts from the 559 articles generated from the literature search were reviewed. Due to the wide range of topics, 62 full texts with a focus on in vivo biomechanical studies were included for further discussion. Several overarching themes in the recent literature were identified and are summarized, including 1) new methods to detect early osteoarthritis (OA) development, 2) studies describing healthy and OA cartilage and biomechanics, 3) ACL injury and OA development, 4) meniscus injury and OA development, and 5) OA prevention, treatment, and management. CONCLUSIONS Mechanical loading is a critical factor in the maintenance of joint health. Abnormal mechanical loading can lead to the onset and progression of OA. Thus, recent studies have utilized various biomechanical models to better describe the etiology of OA development and the subsequent effects of OA on the mechanics of joint tissues and whole body biomechanics.
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Affiliation(s)
- Louis E. DeFrate
- Department of Orthopaedic Surgery, Duke University School of Medicine, Duke University, Durham, North Carolina, USA,Department of Biomedical Engineering, Duke University, Durham, North Carolina, USA,Department of Mechanical Engineering and Materials Science, Duke University, Durham, North Carolina, USA
| | - Sophia Y. Kim-Wang
- Department of Orthopaedic Surgery, Duke University School of Medicine, Duke University, Durham, North Carolina, USA,Department of Biomedical Engineering, Duke University, Durham, North Carolina, USA
| | - Zoë A. Englander
- Department of Orthopaedic Surgery, Duke University School of Medicine, Duke University, Durham, North Carolina, USA,Department of Biomedical Engineering, Duke University, Durham, North Carolina, USA
| | - Amy L. McNulty
- Department of Orthopaedic Surgery, Duke University School of Medicine, Duke University, Durham, North Carolina, USA,Department of Pathology, Duke University School of Medicine, Duke University, Durham, North Carolina, USA
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Li L, Yang X, Yang L, Zhang K, Shi J, Zhu L, Liang H, Wang X, Jiang Q. Biomechanical analysis of the effect of medial meniscus degenerative and traumatic lesions on the knee joint. Am J Transl Res 2019; 11:542-556. [PMID: 30899361 PMCID: PMC6413253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 12/23/2018] [Indexed: 06/09/2023]
Abstract
The purpose of this study was to determine the effect of the degenerative medial meniscus and traumatic lesions on the biomechanical behavior of the knee. An elaborate three-dimensional (3D) finite element model of the total knee joint containing bones, articular cartilages, main ligaments, and menisci was developed from a combination of magnetic resonance images and computed tomography. Three types of meniscus tears were employed to represent the degenerative and traumatic lesions. The stress and meniscus extrusion of healthy and injured knees were investigated under the posture of static stance. The traumatic longitudinal tear demonstrated the highest stress and the largest meniscus extrusion displacement. The degenerative horizontal and peripheral tears also showed an irregular biomechanical balance in the knee joint. Despite the damaged hemijoint, the stress on the healthy lateral hemijoint was increased. Although the biomechanics was deteriorated in all meniscus tear models, the variation degree was diverse. The transfixion damage could potentially cause future injury in the knee joint and accelerate the progress of osteoarthritis. Moreover, the meniscus injury may cause high-stress concentration on the contralateral side of the joint. The current results revealed the cause of different clinical manifestation after meniscus tears and the risk of knee osteoarthritis through biomechanical aspects.
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Affiliation(s)
- Lan Li
- School of Mechanical Engineering, Southeast UniversityChina
- State Key Laboratory of Pharmaceutical Biotechnology, Department of Sports Medicine and Adult Reconstructive Surgery, Drum Tower Hospital Affiliated to Medical School of Nanjing UniversityNanjing, China
- Institute of Medical 3D Printing, Nanjing UniversityNanjing, China
| | - Xianfeng Yang
- Department of Radiology, Drum Tower Hospital Affiliated to Medical School of Nanjing UniversityNanjing, China
| | - Longfei Yang
- School of Mechanical Engineering, Southeast UniversityChina
| | - Kaijia Zhang
- State Key Laboratory of Pharmaceutical Biotechnology, Department of Sports Medicine and Adult Reconstructive Surgery, Drum Tower Hospital Affiliated to Medical School of Nanjing UniversityNanjing, China
| | - Jianping Shi
- School of Electrical and Automation Engineering, Nanjing Normal UniversityNanjing, China
| | - Liya Zhu
- School of Electrical and Automation Engineering, Nanjing Normal UniversityNanjing, China
| | - Huixin Liang
- School of Mechanical and Electrical Engineering, Nanjing University of Aeronautics and AstronauticsNanjing, China
| | - Xingsong Wang
- School of Mechanical Engineering, Southeast UniversityChina
| | - Qing Jiang
- State Key Laboratory of Pharmaceutical Biotechnology, Department of Sports Medicine and Adult Reconstructive Surgery, Drum Tower Hospital Affiliated to Medical School of Nanjing UniversityNanjing, China
- Institute of Medical 3D Printing, Nanjing UniversityNanjing, China
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