Partial meniscectomy is believed to change the biomechanics of the knee joint through alterations in the contact of articular cartilages and menisci. Although fluid pressure plays an important role in the load support mechanism of the knee, the fluid pressurization in the cartilages and menisci has been ignored in the finite element studies of the mechanics of meniscectomy. In the present study, a 3D fibril-reinforced poromechanical model of the knee joint was used to explore the fluid flow dependent changes in articular cartilage following partial medial and lateral meniscectomies. Six partial longitudinal meniscectomies were considered under relaxation, simple creep, and combined creep loading conditions. In comparison to the intact knee, partial meniscectomy not only caused a substantial increase in the maximum fluid pressure but also shifted the location of this pressure in the femoral cartilage. Furthermore, these changes were positively correlated to the size of meniscal resection. While in the intact joint, the location of the maximum fluid pressure was dependent on the loading conditions, in the meniscectomized joint the location was predominantly determined by the site of meniscal resection. The partial meniscectomy also reduced the rate of the pressure dissipation, resulting in even larger difference between creep and relaxation times as compared to the case of the intact knee. The knee joint became stiffer after meniscectomy because of higher fluid pressure at knee compression followed by slower pressure dissipation. The present study indicated the role of fluid pressurization in the altered mechanics of meniscectomized knees.
Issue Section:
Research Papers
References
1.
Fithian
, D. C.
, Kelly
, M. A.
, and Mow
, V. C.
, 1990, “Material Properties and Structure-Function Relationships in the Menisci
,” Clin. Orthop. Relat. Res.
, 252
, pp. 19
–31
.2.
Kurosawa
, H.
, Fukubayashi
, T.
, and Nakajima
, H.
, 1980, “Load-Bearing Mode of the Knee Joint: Physical Behavior of the Knee Joint With or Without Menisci
,” Clin. Orthop. Relat. Res.
, 149
, pp. 283
–290
.3.
Walker
, P. S.
, and Hajek
, J. V.
, 1972, “The Load-Bearing Area in the Knee Joint
,” J. Biomech.
, 5
(6
), pp. 581
–589
.4.
Shrive
, N. G.
, O’Connor
, J. J.
, and Goodfellow
, J. W.
, 1978, “Load-Bearing in the Knee Joint
,” Clin. Orthop. Relat. Res.
, 131
, pp. 279
–287
.5.
Walker
, P. S.
, and Erkman
, M. J.
, 1975, “The Role of the Menisci in Force Transmission Across the Knee
,” Clin. Orthop. Relat. Res.
, 109
, pp. 184
–192
.6.
Brindle
, T.
, Nyland
, J.
, and Johnson
, D. L.
, 2001, “The Meniscus: Review of Basic Principles With Application to Surgery and Rehabilitation
,” J. Athl. Train.
, 36
(2
), pp. 160
–169
.7.
Baratz
, M. E.
, Fu
, F. H.
, and Mengato
, R.
, 1986, “Meniscal Tears: The Effect of Meniscectomy and of Repair on Intraarticular Contact Areas and Stress in the Human Knee. A Preliminary Report
,” Am. J. Sports Med.
, 14
(4
), pp. 270
–275
.8.
Wyland
, D. J.
, Guilak
, F.
, Elliott
, D. M.
, Setton
, L. A.
, and Vail
, T. P.
, 2002, “Chondropathy After Meniscal Tear or Partial Meniscectomy in a Canine Model
,” J. Orthop. Res.
, 20
(5
), pp. 996
–1002
.9.
Schimmer
, R. C.
, Brulhart
, K. B.
, Duff
, C.
, and Glinz
, W.
, 1998, “Arthroscopic Partial Meniscectomy: A 12-Years Follow-Up and Two-Step Evaluation of the Long-Term Course
,” Arthroscopy: J. Relat. Surg.
, 14
(2
), pp. 136
–142
.10.
Englund
, M.
, Roos
, E. M.
, Roos
, H. P.
, and Lohmander
, L. S.
, 2001, “Patient-Relevant Outcomes Fourteen Years After Meniscectomy: Influence of Type of Meniscal Tear and Size of Resection
,” Rheumatology
, 40
(6
), pp. 631
–639
.11.
Rangger
, C.
, Klestil
, T.
, Gloetzer
, W.
, Kemmler
, G.
, and Benedetto
, K. P.
, 1995, “Osteoarthritis After Arthroscopic Partial Meniscectomy
,” Am. J. Sports Med.
, 23
(2
), pp. 240
–244
.12.
Zielinska
, B.
, and Donahue
, T. L.
, 2006, “3D Finite Element Model of Meniscectomy: Changes in Joint Contact Behavior
,” J. Biomech. Eng.
, 128
(1
), pp. 115
–123
.13.
Shirazi
, R.
, and Shirazi-Adl
, A.
, 2009, “Analysis of Partial Meniscectomy and ACL Reconstruction in Knee Joint Biomechanics Under a Combined Loading
,” Clin. Biomech. (Bristol, Avon)
, 24
(9
), pp. 755
–761
.14.
Peña
, E.
, Calvo
, B.
, Martínez
, M. A.
, Palanca
, D.
, and Doblaré
, M.
, 2005, “Finite Element Analysis of the Effect of Meniscal Tears and Meniscectomies on Human Knee Biomechanics
,” Clin. Biomech. (Bristol, Avon)
, 20
(5
), pp. 498
–507
.15.
Yang
, N.
, Nayeb-Hashemi
, H.
, and Canavan
, P. K.
, 2009, “The Combined Effect of Frontal Plane Tibiofemoral Knee Angle and Meniscectomy on the Cartilage Contact Stresses and Strains
,” Ann. Biomed. Eng.
, 37
(11
), pp. 2360
–2372
.16.
Fung
, Y. C.
, 1993, Biomechanics: Mechanical Properties of Living Tissues
, 2nd ed., Springer-Verlag
, New York
, Chap. 12.17.
Daniels
, D. M.
, 1990, Knee Ligaments: Structure, Function, Injury and Repair
, Raven Press
, New York
, pp. 366
–374
.18.
Mak
, A. F.
, 1986, “The Apparent Viscoelastic Behavior of Articular Cartilage–The Contributions From the Intrinsic Matrix Viscoelasticity and Interstitial Fluid Flows
,” J. Biomech. Eng.
, 108
(2
), pp. 123
–130
.19.
Ateshian
, G. A.
, Lai
, W. M.
, Zhu
, W. B.
, and Mow
, V. C.
, 1994, “An Asymptotic Solution for the Contact of Two Biphasic Cartilage Layers
,” J. Biomech.
, 27
(11
), pp. 1347
–1360
.20.
Garon
, M.
, Légaré
, A.
, Guardo
, R.
, Savard
, P.
, and Buschmann
, M. D.
, 2002, “Streaming Potentials Maps are Spatially Resolved Indicators of Amplitude, Frequency and Ionic Strength Dependant Responses of Articular Cartilage to Load
,” J. Biomech.
, 35
(2
), pp. 207
–216
.21.
Li
, L. P.
, Korhonen
, R. K.
, Iivarinen
, J.
, Jurvelin
, J. S.
, and Herzog
, W.
, 2008, “Fluid Pressure Driven Fibril Reinforcement in Creep and Relaxation Tests of Articular Cartilage
,” Med. Eng. Phys.
, 30
(2
), pp. 182
–189
.22.
Spilker
, R. L.
, Donzelli
, P. S.
, and Mow
, V. C.
, 1992, “A Transversely Isotropic Biphasic Finite Element Model of the Meniscus
,” J. Biomech.
, 25
(9
), pp. 1027
–1045
.23.
Gu
, K. B.
, and Li
, L. P.
, 2011, “A Human Knee Joint Model Considering Fluid Pressure and Fiber Orientation in Cartilages and Menisci
,” Med. Eng. Phys.
, 33
(4
), pp. 497
–503
.24.
Kazemi
, M.
, Li
, L. P.
, Savard
, P.
, and Buschmann
, M. D.
, 2011, “Creep Behavior of the Intact and Meniscectomy Knee Joints
,” J. Mech. Behav. Biomed. Mater.
, 4
(7
), pp. 1351
–1358
.25.
Cheung
, J. T. M.
, Zhang
, M.
, Leung
, A. K. L.
, and Fan
, Y. B.
, 2005, “Three-Dimensional Finite Element Analysis of the Foot During Standing – A Material Sensitivity Study
,” J. Biomech.
, 38
(5
), pp. 1045
–1054
.26.
Dandy
, D. J.
, 1990, “The Arthroscopic Anatomy of Symptomatic Meniscal Lesions
,” J. Bone Jt. Surg.
, 72
(4
), pp. 628
–633
.27.
Greis
, P. E.
, Bardana
, D. D.
, Holmstrom
, M. C.
, and Burks
, R. T.
, 2002, “Meniscal Injury: I. Basic Science and Evaluation
,” J. Am. Acad. Orthop. Surg.
, 10
(3
), pp. 168
–176
.28.
Athanasiou
, K. A.
, and Sanchez-Adams
, J.
, 2009, Engineering the Knee Meniscus
, Morgan and Claypool
, San Rafael, CA
, Chap. 2.29.
Fayard
, J. M.
, Pereira
, H.
, Servien
, E.
, Lustig
, S.
, and Neyret
, P.
, 2010. “Meniscectomy: Global Results- Complications
,” The Meniscus
, P.
Beaufils
and R.
Verdonk
, eds., Springer
, New York
, pp. 177
–199
.30.
Below
, S.
, Arnoczky
, S. P.
, Dodds
, J.
, Kooima
, C.
, and Walter
, N.
, 2002, “The Split-Line Pattern of the Distal Femur: A Consideration in the Orientation of Autologous Cartilage Grafts
,” Arthroscopy: J. Relat. Surg.
, 18
(6
), pp. 613
–617
.31.
Grood
, E. S.
, and Hefzy
, M. S.
, 1982, “An Analytical Technique for Modeling Knee Joint Stiffness. Part I: Ligamentous Forces
,” J. Biomech. Eng.
, 104
(4
), pp. 330
–337
.32.
Hirokawa
, S.
, and Tsuruno
, R.
, 2000, “Three-Dimensional Deformation and Stress Distribution in an Analytical/Computational Model of the Anterior Cruciate Ligament
,” J. Biomech.
, 33
(9
), pp. 1069
–1077
.33.
Li
, L. P.
, Buschmann
, M. D.
, and Shirazi-Adl
, A.
, 2003, “Strain Rate Dependent Stiffness of Articular Cartilage in Unconfined Compression
,” J. Biomech. Eng.
, 125
(2
), pp. 161
–168
.34.
Shirazi
, R.
, Shirazi-Adl
, A.
, and Hurtig
, M.
, 2008, “Role of Cartilage Collagen Fibrils Networks in Knee Joint Biomechanics Under Compression
,” J. Biomech.
, 41
(16
), pp. 3340
–3348
.35.
Woo
, S. L. Y.
, Akeson
, W. H.
, and Jemmott
, G. F.
, 1976, “Measurements of Nonhomogeneous, Directional Mechanical Properties of Articular Cartilage in Tension
,” J. Biomech.
, 9
(12
), pp. 785
–791
.36.
Li
, L. P.
, Cheung
, J. T. M.
, and Herzog
, W.
, 2009, “Three-Dimensional Fibril-Reinforced Finite Element Model of Articular Cartilage
,” Med. Biol. Eng. Comput.
, 47
(6
), pp. 607
–615
.37.
Bendjaballah
, M. Z.
, Shirazi-Adl
, A.
, and Zukor
, D. J.
, 1995, “Biomechanics of the Human Knee Joint in Compression: Reconstruction, Mesh Generation and Finite Element Analysis
,” The Knee
, 2
(2
), pp. 69
–79
.38.
Mow
, V. C.
, Ateshian
, G. A.
, and Spilker
, R. L.
, 1993, “Biomechanics of Diarthrodial Joints: A Review of Twenty Years of Progress
,” J. Biomech. Eng.
, 115
(4B
), pp. 460
–467
.39.
Fukubayashi
, T.
, and Kurosawa
, H.
, 1980, “The Contact Area and Pressure Distribution Pattern of the Knee. A Study of Normal and Osteoarthrotic Knee Joints
,” Acta Orthop. Scand.
, 51
(6
), pp. 871
–879
.40.
Peña
, E.
, Calvo
, B.
, Martínez
, M. A.
, and Doblaré
, M.
, 2008, “Computer Simulation of Damage on Distal Femoral Articular Cartilage After Meniscectomies
,” Comput. Biol. Med.
, 38
(1
), pp. 69
–81
.41.
Hsu
, R.
, Himeno
, S.
, Coventry
, M.
, and Chao
, E.
, 1990, “Normal Axial Alignment of the Lower Extremity and Load-Bearing Distribution at the Knee
,” Clin. Orthop. Relat. Res.
, 255
, pp. 215
–227
.42.
Johnson
, F.
, Leitl
, S.
, and Waugh
, W.
, 1980, “The Distribution of Load Across the Knee. A Comparison of Static and Dynamic Measurements
,” J. Bone Jt. Surg. Br. Vol.
, 62
(3
), pp. 346
–349
.43.
Shelburne
, K. B.
, Torry
, M. R.
, and Pandy
, M. G.
, 2005, “Muscle, Ligament, and Joint-Contact Forces at the Knee During Walking
,” Med. Sci. Sports Exercise
, 37
(11
), pp. 1948
–1956
.44.
Peña
, E.
, Calvo
, B.
, Martinez
, M. A.
, Palanca
, D.
, and Doblaré
, M.
, 2006, “Why Lateral Meniscectomy is More Dangerous Than Medial Meniscectomy. A Finite Element Study
,” J. Orthop. Res.
, 24
(5
), pp. 1001
–1010
.45.
Chatain
, F.
, Adeleine
, P.
, Chambat
, P.
, and Neyret
, P.
, Société Française d’Arthroscopie, 2003, “A Comparative Study of Medial Versus Lateral Arthroscopic Partial Meniscectomy on Stable Knees: 10-Year Minimum Follow-up
,” Arthroscopy: J. Relat. Surg.
, 19
(8
), pp. 842
–849
.46.
McNicholas
, M. J.
, Rowley
, D. I.
, McGurty
, D.
, Adalberth
, T.
, Abdon
, P.
, Lindstrand
, A.
, and Lohmander
, L. S.
, 2000, “Total Meniscectomy in Adolescent: A Thirty-Year Follow-up
,” J. Bone Jt. Surg. Br. Vol.
, 82
(2
), pp. 217
–221
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