Biomechanical Difference between Conventional Transtibial Single-Bundle and Anatomical Transportal Double-Bundle Anterior Cruciate Ligament Reconstruction Using Three-Dimensional Finite Element Model Analysis

Kim, Jae Gyoon; Kang, Kyoung‐Tak; Wang, Joon Ho

doi:10.3390/jcm10081625

Cited by 16 publications

(8 citation statements)

References 38 publications

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“…Similarly, a forward pushing force of 134N is applied on the front side of the femur. With these inputs, you can calculate the contact pressure and displacement of the femur in the model [ 14 , 21 ]. The knee joint finite element model consists of the femur, tibia, fibula, meniscus, articular cartilage of the femur, articular cartilage of the tibia, medial and lateral collateral ligaments, and anterior and posterior cruciate ligaments.…”

Section: Resultsmentioning

confidence: 99%

Anterior cruciate ligament injury should not be considered a contraindication for medial unicompartmental knee arthroplasty: Finite element analysis

Ou,

Ye,

Pan

et al. 2024

PLoS ONE

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Purpose The research objective of this study is to use finite element analysis to investigate the impact of anterior cruciate ligament (ACL) injury on medial unicompartmental knee arthroplasty (UKA) and explore whether patients with ACL injuries can undergo UKA. Methods Based on the morphology of the ACL, models of ACL with diameters ranging from 1 to 10mm are created. Finite element models of UKA include ACL absence and ACLs with different diameters. After creating a complete finite element model and validating it, four different types of loads are applied to the knee joint. Statistical analysis is conducted to assess the stress variations in the knee joint structure. Results A total of 11 finite element models of UKA were established. Regarding the stress on the ACL, as the diameter of the ACL increased, when a vertical load of 750N was applied to the femur, combined with an anterior tibial load of 105N, the stress on the ACL increased from 2.61 MPa to 4.62 MPa, representing a 77.05% increase. Regarding the equivalent stress on the polyethylene gasket, a notable high stress change was observed. The stress on the gasket remained between 12.68 MPa and 14.33 MPa in all models. the stress on the gasket demonstrated a decreasing trend. The equivalent stress in the lateral meniscus and lateral femoral cartilage decreases, reducing from the maximum stress of 4.71 MPa to 2.61 MPa, with a mean value of 3.73 MPa. This represents a reduction of 44.72%, and the statistical significance is (P < 0.05). However, under the other three loads, there was no significant statistical significance (P > 0.05). Conclusion This study suggests that the integrity of the ACL plays a protective role in performing medial UKA. However, this protective effect is limited when performing medial UKA. When the knee joint only has varying degrees of ACL injury, even ACL rupture, and the remaining structures of the knee joint are intact with anterior-posterior stability in the knee joint, it should not be considered a contraindication for medial UKA.

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Section: Resultsmentioning

confidence: 99%

Anterior cruciate ligament injury should not be considered a contraindication for medial unicompartmental knee arthroplasty: Finite element analysis

Ou,

Ye,

Pan

et al. 2024

PLoS ONE

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“…According to previous literature reports, articular cartilage and meniscus are considered to be a single-phase linear elastic and isotropic material with elastic moduli of 5 MPa and 59 MPa, respectively, and the Poisson's ratios of articular cartilage and meniscus are 0.46 and 0.49, respectively [ 31 , 32 ]. We set the ligament as a homogeneous, continuous, hyperelastic, rubber-like material, which represents the nonlinear stress‒strain relationships [ 33 ]. Finally, to simulate the real-life knee structure, each accessory and tissue were anatomically linked.…”

Section: Methodsmentioning

confidence: 99%

Different femoral tunnel placement in posterior cruciate ligament reconstruction: a finite element analysis

Wang

Yao

et al. 2023

BMC Musculoskelet Disord

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Background At present, there is no consensus on the optimal biomechanical method for Posterior cruciate ligament (PCL) reconstruction, and the “critical corner” that is produced by the femoral tunnel is currently considered to be one of the main reasons for PCL failure. Thus, the purpose of this study was to identify one or several different tunnels of the femur, thereby reducing the influence of the "critical corner" without reducing the posterior stability of the knee. Methods CT and MRI data of the knee joint of a healthy adult man were collected, and computer-related software was used to reconstruct the finite element model of the knee joint, to provide different properties to different materials and to allow for the performance of a finite element analysis of the reconstructed model. The position of the femoral tunnel was positioned and partitioned according to anatomical posture, and three areas were divided (the antero-proximal region, the antero-distal region and the posterior region). In addition, we applied a posterior tibial load of 134 N to the reconstructed model, recorded and compared different tunnels of the femur, conducted peak stress at the flexion of the knee joint of 0°, 30°, 60° and 90°, and elicited the displacement of the proximal tibia. Results Among the 20 different femoral tunnels, the graft peak stress was lower in tunnels 4, 12 and 18 than in the PCL anatomical footpath tunnel 13, especially at high flexion angles (60° and 90°). These three tunnels did not increase the posterior displacement of the proximal tibia compared with the anatomical footpath tunnel 13. Conclusion In summary, among the options for PCL reconstruction of the femoral tunnel, the tunnels located 5 mm distal to the footprint and 5 mm anterior to the footprint could reduce the peak stress of the graft; additionally, it may reduce the "critical corner" and was shown to not reduce the posterior stability of the knee joint.

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“…According to previous literature reports, articular cartilage and meniscus are considered to be a single-phase linear elastic and isotropic material with elastic moduli of 5 MPa and 59 MPa, respectively, and the Poisson's ratios of articular cartilage and meniscus are 0.46 and 0.49, respectively [22,23]. We set the ligament as a homogeneous, continuous, hyperelastic, rubber-like material, which represents the nonlinear stress-strain relationships [24]. Finally, to simulate the real-life knee structure, each accessory and tissue were anatomically linked.…”

Section: Materials Modelingmentioning

confidence: 99%

Different Femoral Tunnel Placement in Posterior Cruciate ligament reconstruction: A finite element Analysis

Wang

Yao

et al. 2022

Preprint

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Background At present, there is no consensus on the optimal biomechanical method for PCL reconstruction, and the “critical corner” that is produced by the femoral tunnel is currently considered to be one of the main reasons for PCL failure. Thus, the purpose of this study was to identify one or several different tunnels of the femur, thereby reducing the influence of the "critical corner" without reducing the posterior stability of the knee. Methods CT and MRI data of the knee joint of a healthy adult man were collected, and computer-related software was used to reconstruct the finite element model of the knee joint, to provide different properties to different materials and to allow for the performance of a finite element analysis of the reconstructed model. The position of the femoral tunnel was positioned and partitioned according to anatomical posture, and three areas were divided (the antero-proximal region, the antero-distal region and the posterior region). In addition, we applied a posterior tibial load of 134 N to the reconstructed model, recorded and compared different tunnels of the femur, conducted peak stress at the flexion of the knee joint of 0°, 30°, 60° and 90°, and elicited the displacement of the proximal tibia. Results Among the 20 different femoral tunnels, the graft peak stress was lower in tunnels 4, 12 and 18 than in the PCL anatomical footpath tunnel 13, especially at high flexion angles (60° and 90°). These three tunnels did not increase the posterior displacement of the proximal tibia compared with the anatomical footpath tunnel 13. Conclusion In summary, among the options for PCL reconstruction of the femoral tunnel, the tunnels located 5 mm distal to the footprint and 5 mm anterior to the footprint could reduce the peak stress of the graft; additionally, it may reduce the "critical corner" and was shown to not reduce the posterior stability of the knee joint.

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Biomechanical Difference between Conventional Transtibial Single-Bundle and Anatomical Transportal Double-Bundle Anterior Cruciate Ligament Reconstruction Using Three-Dimensional Finite Element Model Analysis

Cited by 16 publications

References 38 publications

Anterior cruciate ligament injury should not be considered a contraindication for medial unicompartmental knee arthroplasty: Finite element analysis

Anterior cruciate ligament injury should not be considered a contraindication for medial unicompartmental knee arthroplasty: Finite element analysis

Different femoral tunnel placement in posterior cruciate ligament reconstruction: a finite element analysis

Different Femoral Tunnel Placement in Posterior Cruciate ligament reconstruction: A finite element Analysis

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