A biomechanical analysis of 3D stress and strain patterns in patellar tendon during knee flexion

Abstract

Patellar tendinopathy is among the most widespread patellar tendon diseases in athletes that participate in activities involving running and jumping. Although their symptoms can be detected, especially at the inferior pole of the patella, their biomechanical cause remains unknown. In this study, a three‐dimensional finite element model of knee complex was developed to investigate principal stress and strain distributions in the patellar tendon during 0° to 90° knee flexion and slow and fast level‐ground walking. Results indicate that the patellar tendon is subjected to tensile stress and strains during all three activities. During flexion, its central proximal posterior region exhibited highest peak stress and strain, followed by central distal posterior, central distal anterior and central proximal anterior region. Similar trends and magnitudes were reported during slow and fast walking. The region with highest principal stresses and strains, central proximal anterior region, also corresponds to the most commonly reported patellar tendinopathy lesion site, suggesting that principal stress and strain are good indicators of lesion site location. Additional factors such as regional variations in material properties and frequency and duration of cyclic loading also need to be considered when determining the biomechanical aetiology of patellar tendinopathy.

Model Properties and Clinical Application in the Finite Element Analysis of Knee Joint: A Review

“…compared three tendon models: Marlow, Neo‐Hookean, and linearly elastic models. They found that the Marlow model was more consistent with the experimental mechanical data of the patellar tendon 62 …”

“…They found that the Marlow model was more consistent with the experimental mechanical data of the patellar tendon. 62 OpenSim software can assist researchers in building a set of musculoskeletal models. Models constructed by OpenSim could simulate musculoskeletal dynamics and neuromuscular control to study joint activities, calculate muscle forces, and predict joint movements without the need for experiments, 63 but it is difficult to study the contact mechanics of joints.…”

Crossed doubled patellar tendon: A rare anatomical variant with potential clinical significance

“…Wang K et al demonstrated in their study that during knee flexion and slow and fast walking, the central proximal posterior region of the patellar tendon experienced the highest strain and stress, followed by the central distal posterior, central distal anterior, and central proximal anterior regions. The higher loading stress at the central proximal posterior region also corresponds to a higher incidence of tendinopathy at that site (jumper's knee) [15] . The anatomical structure of a doubled patellar tendon differs from that of a single patellar tendon, which likely results in a different magnitude and location of loading stress and strain as compared to those demonstrated by Wang K et al The influence of a doubled patellar tendon on patella tendinopathy and internal derangement as a result of altered mechanics is currently unknown and requires further investigation.…”

Full-Field Strain Measurements of the Muscle-Tendon Junction Using X-ray Computed Tomography and Digital Volume Correlation

“…Strain measurements of the muscle and tendon in 3D have been studied using finite element analysis (FEA) to predict deformation behavior [1,[24][25][26][27]. Rehorn et al reported that the stretch of the fiber in proximal MTJ before breaking was 1.64 times, which was higher than in muscle tissue (0.95 times) [25] Blemker et al showed that shear strain was concentrated near the aponeurosis in human biceps brachii, which reached 2.4 ε, whereas some parts of muscles showed zero ε during low-load elbow flexion.…”