Predicting meniscal tear stability across knee-joint flexion using finite-element analysis
File(s)Kedgley2019_Article_PredictingMeniscalTearStabilit.pdf (1.8 MB)
Published version
Author(s)
Type
Journal Article
Abstract
Purpose: To analyse the stress distribution through longitudinal and radial meniscal tears in three tear locations in weight-bearing conditions and use it to ascertain the impact of tear location and type on the potential for healing of meniscal tears. Methods: Subject-specific finite-element models of a healthy knee under static loading at 0°, 20°, and 30° knee flexion were developed from unloaded magnetic resonance images and weight-bearing, contrast-enhanced computed tomography images. Simulations were then run after introducing tears into the anterior, posterior, and midsections of the menisci. Results: Absolute differences between the displacements of anterior and posterior segments modelled in the intact state and those quantified from in vivo weight-bearing images were less than 0.5 mm. There were tear-location-dependent differences between hoop stress distributions along the inner and outer surfaces of longitudinal tears; the longitudinal tear surfaces were compressed together to the greatest degree in the lateral meniscus and were most consistently in compression on the midsections of both menisci. Radial tears resulted in an increase in stress at the tear apex and in a consistent small compression of the tear surfaces throughout the flexion range when in the posterior segment of the lateral meniscus. Conclusions: Both the type of meniscal tear and its location within the meniscus influenced the stresses on the tear surfaces under weight bearing. Results agree with clinical observations and suggest reasons for the inverse correlation between longitudinal tear length and healing, the inferior healing ability of medial compared with lateral menisci, and the superior healing ability of radial tears in the posterior segment of the lateral meniscus compared with other radial tears. This study has shown that meniscal tear location in addition to type likely plays a crucial role in dictating the success of non-operative treatment of the menisci. This may be used in decision making regarding conservative or surgical management.
Date Issued
2019-01
Date Acceptance
2018-07-31
Citation
Knee Surgery, Sports Traumatology, Arthroscopy, 2019, 27 (1), pp.206-214
ISSN
0942-2056
Publisher
Springer
Start Page
206
End Page
214
Journal / Book Title
Knee Surgery, Sports Traumatology, Arthroscopy
Volume
27
Issue
1
Copyright Statement
© 2018 The Author(s). Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
Identifier
https://link.springer.com/article/10.1007%2Fs00167-018-5090-4
Subjects
Science & Technology
Life Sciences & Biomedicine
Orthopedics
Sport Sciences
Surgery
Meniscus
Meniscal tear
Repair
Reconstruction
Knee
Biomechanics
Finite element analysis
Arthroscopy
PARTIAL MENISCECTOMY
LATERAL MENISCUS
IN-VIVO
REPAIR
BIOMECHANICS
MODEL
TIME
Arthroscopy
Biomechanics
Finite element analysis
Knee
Meniscal tear
Meniscus
Reconstruction
Repair
Surgery
Adult
Arthroscopy
Finite Element Analysis
Humans
Knee
Knee Injuries
Knee Joint
Magnetic Resonance Imaging
Male
Menisci, Tibial
Models, Biological
Pressure
Range of Motion, Articular
Tibial Meniscus Injuries
Tomography, X-Ray Computed
Weight-Bearing
Wound Healing
Knee
Menisci, Tibial
Knee Joint
Humans
Knee Injuries
Tomography, X-Ray Computed
Magnetic Resonance Imaging
Arthroscopy
Range of Motion, Articular
Wound Healing
Finite Element Analysis
Weight-Bearing
Pressure
Models, Biological
Adult
Male
Tibial Meniscus Injuries
Orthopedics
1103 Clinical Sciences
1106 Human Movement and Sports Sciences
Publication Status
Published
Date Publish Online
2018-08-10