Biomechanical assessment of disease outcome in surgical interventions for medial meniscal posterior root tears: a finite element analysis

Abstract

Background The adverse consequences of medial meniscus posterior root tears have become increasingly familiar to surgeons, and treatment strategies have become increasingly abundant. In this paper, the finite element gait analysis method was used to explore the differences in the biomechanical characteristics of the knee joint under different conditions. Methods Based on CT computed tomography and MR images, (I) an intact knee (IK) model with bone, cartilage, meniscus and main ligaments was established. Based on this model, the posterior root of the medial meniscus was resected, and (ii) the partial tear (PT) model, (iii) the entire radial tear (ERT) model, and (iv) the entire oblique tear (EOT) model were established according to the scope and degree of resection. Then, the (v) meniscus repair (MR) model and (vi) partial meniscectomy (PM) model were developed according to the operation method. The differences in stress, displacement and contact area among different models were evaluated under ISO gait loading conditions. Results Under gait loading, there was no significant difference in the maximum stress of the medial and lateral tibiofemoral joints among the six models. Compared with the medial tibiofemoral joint stress of the IK model, the stress of the PM model increased by 8.3%, while that of the MR model decreased by 18.9%; at the same time, the contact stress of the medial tibiofemoral joint of the ERT and EOT models increased by 17.9 and 25.3%, respectively. The displacement of the medial meniscus in the ERT and EOT models was significantly larger than that in the IK model (P < 0.05), and the tibial and femoral contact areas of these two models were lower than those of the IK model (P < 0.05). Conclusions The integrity of the posterior root of the medial meniscus plays an important role in maintaining normal tibial-femoral joint contact mechanics. Partial meniscectomy is not beneficial for improving the tibial-thigh contact situation. Meniscal repair has a positive effect on restoring the normal biomechanical properties of the medial meniscus.

Repair of medial meniscus posterior root tear is effective for root healing and cartilage regeneration in opening wedge high tibial osteotomy

“…Another notable finding of this study was that the cartilage regeneration of the MFC in the OWHTO-with-MMPRT-repair group was superior to that in the OWHTO alone group, regardless of whether microfracture was performed. Biomechanical studies have shown that peak contact pressure is significantly lower in patients with repaired MMPRT than in those with MMPRT [34,35]. Similar to our findings, a previous cadaveric biomechanical study reported that MMPRT repair decreased contact pressure and increased contact area irrespective of whether OWHTO was performed [34].…”

Effect of residual volume after surgery of the discoid lateral meniscus on tibiofemoral joint biomechanics: a finite element analysis

“…Through comparison with previous literature on finite element studies of the knee joint [ 14 , 15 ], it was found that the results of shear stress and compressive stress of femoral cartilage, meniscus and tibial cartilage were similar, thus verifying the validity of this model (Table 2 ).…”

Effect of meniscus modelling assumptions in a static tibiofemoral finite element model: importance of geometry over material

“…Mootanah et al 2014 ; Steineman et al 2020 ; Shriram et al 2021 ), or on cartilage pressure (e.g. D'Lima et al 2009 ; Khoshgoftar et al 2015 ; Xu et al 2022 ) but may not be accurate for both types of outputs. Further, while validation studies often replicate an equivalent experimental (or computational) protocol, they often do not report on how sensitive the model outputs are to its inputs or which assumptions can be modified and still produce a “valid” outcome.…”