Effect of partial posterior root tear of medial meniscus on biomechanics of the knee joint during gait cycle

doi:10.12307/2023.293

Abstract

Abstract: BACKGROUND: At present, most of biomechanical studies on medial meniscus posterior root tearing to accelerate knee joint degeneration are limited to testing the complete tear model of the posterior root of the medial meniscus on the basis of static simulation design. However, the biomechanical behavior of medial meniscus posterior root tear in the full gait cycle is not clear.
OBJECTIVE: To compare the biomechanical differences between the normal knee joint model and the medial meniscus posterior root partial tear model in the complete gait cycle using dynamic finite element analysis method.
METHODS: Based on the CT scan data of the right knee joint of healthy adults, the finite element model of healthy knee joint including bone, meniscus and articular cartilage was established, and the posterior root tear model of medial meniscus of knee joint was further established on the basis of healthy model. The standard gait load of ISO was applied to the two models for simulation test. The differences of stress, displacement and contact area of the corresponding parts of the two models were compared.
RESULTS AND CONCLUSION: (1) Under the complete gait cycle, the stress distribution of the posterior root of the medial meniscus in the healthy model was uniform, while the pathological model showed stress concentration in the injured area. The maximum stress of the former appeared at the inner edge of the lateral meniscus at 30% time, with a value of 29.68 MPa. The latter maximum stress appeared at the inner edge of the lateral meniscus at 50% time, with a value of 30.34 MPa. (2) During the complete gait cycle, the stress distribution of tibial cartilage in healthy and pathological models was roughly the same. The maximum stress of the two models appeared at 50% and 20% around the gait, respectively, and the values were 5.11 MPa and 6.85 MPa, respectively. (3) The difference between the medial intercompartment group and the lateral intercompartment group was greater than that in the lateral intercompartment group. The average stress of the medial tibial plateau of the pathological model was 9.3% higher than that of the normal model, and the maximum value of 5.73 MPa appeared in the middle of the support phase. The peak contact area of femur and tibia appeared at 40% time, and the average contact area of femoral cartilage in each phase of the pathological model decreased by 14.6% compared with the normal model. (4) The results show that alterations in the biomechanical properties of the knee joint after a partial tear of the medial meniscus posterior root increase the risk of osteoarthritis.

Key words: medial meniscus posterior root tears, finite element analysis, biomechanics, gait cycle, knee joint

CLC Number:

Xu Zhi, Li Yuwan, Jin Ying, Liu Yi. Effect of partial posterior root tear of medial meniscus on biomechanics of the knee joint during gait cycle[J]. Chinese Journal of Tissue Engineering Research, 2023, 27(18): 2824-2830.

Figures/Tables 4

2.3 两个模型在步态周期内各时相Mises应力、位移、接触面积指标对比完整模型和病理模型在步态周期中关节内、外侧间室生物力学特性存在差异。2个模型内侧间室最大应力在完整的步态周期中波动幅度不大，峰值分别出现在100%，80%时刻，分别为21.17，17.40 MPa。外侧间室最大应力数值则有明显随着步态行进活动而变化的规律，表现为在支撑相时应力值升高，并维持于高位至支撑相末期，进入摆动相后应力明显回落，其峰值出现在30%，50%时刻，分别为29.68，30.34 MPa，见图6A，表6。观察2个模型内侧半月板后根局部最大应力的走势，病理模型因内侧半月板后根撕裂导致半月板环形结构破坏，应力云图可以发现损伤处基底部因受到牵拉产生裂口边缘应力集中(图4)，导致局部峰应力在大多数时相高于同时期健康半月板，见图6B，表6。对比健康和病理模型内侧胫骨平台软骨下骨承受的最大应力可以发现，在内侧半月板后根撕裂发生后同侧的胫骨软骨下骨承受应力轻度升高，峰应力为5.73 MPa，出现30%时刻，见图6C，表6。与健康模型相比后根撕裂的半月板最大位移数值轻度升高，最大位移为1.94 mm，出现在20%与80%时刻，时间上分别对应支撑相与摆动相中期，反映了半月板后根撕裂后结构的稳定性下降，见图6D。比较2种模型步态周期中股骨、胫骨软骨接触面积，可以发现病理模型软骨接触面的数值在各个时相中都小于健康模型。股骨、胫骨接触面积峰值均出现在40%时刻，此时期股骨软骨接触面积由健康状态下的263.04 mm2下降到损伤状态下的245.93 mm2，胫骨软骨接触面积则由267.64 mm2下降到256.69 mm2。值得注意的是在60%时刻接触面积落差最大，股骨、胫骨软骨接触面积分别下降36.67，54.79 mm2，见图6E，F。"

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