Loading of the medial meniscus in the ACL deficient knee: A multibody computational study

Abstract

The menisci of the knee reduce tibiofemoral contact pressures and aid in knee lubrication and nourishment. Meniscal injury occurs in half of knees sustaining anterior cruciate ligament injury and the vast majority of tears in the medial meniscus transpire in the posterior horn region. In this study, computational multibody models of the knee were derived from medical images and passive leg motion for two female subjects. The models were validated against experimental measures available in the literature and then used to evaluate medial meniscus contact force and internal hoop tension. The models predicted that the loss of anterior cruciate ligament (ACL) constraint increased contact and hoop forces in the medial menisci by a factor of 4 when a 100 N anterior tibial force was applied. Contact forces were concentrated in the posterior horn and hoop forces were also greater in this region. No differences were found in contact or hoop tension between the intact and ACL deficient (ACLd) knees when only a 5 Nm external tibial torque was applied about the long axis of the tibia. Combining a 100 N anterior tibial force and a 5 Nm external tibial torque increased posterior horn contact and hoop forces, even in the intact knee. The results of this study show that the posterior horn region of the medial meniscus experiences higher contact forces and hoop tension, making this region more susceptible to injury, especially with the loss of anterior tibia motion constraint provided by the ACL. The contribution of the dMCL in constraining posterior medial meniscus motion, at the cost of higher posterior horn hoop tension, is also demonstrated.

Anatomically and Biomechanically Accurate 3D Modeling of the Human Knee Joint

“…The collision was limited to the cartilages and the menisci. The collision volume with the medial meniscus was estimated to be between 0.02 cm 3 and 0.78 cm 3 whereas that with the lateral meniscus ranged from below 0.01 cm 3 to 0.36 cm 3 .…”

“…In particular, gait analysis, jumping, standing, and other movements have been simulated and analyzed by various groups in physiotherapy, sport and rehabilitation research. [1][2][3] In total knee replacement surgeries, it has been demonstrated that malalignment causes increased wear of the implant, decreases longevity of the construct, and alters kinematics of the knee. [4][5][6] Simulations provide us insight into the intricate working of the musculoskeletal system, and augments our knowledge from experimental measurements.…”

Thin deformable tissues modeling for simulation of arthroscopic knee surgery

“…Generally, soft tissues are deformable. The elastic properties of soft tissues within the knee remain challenging [7][8][9]. This sub-section gives a brief description of the elasticity of the soft tissues that is related to the surgical simulation.…”

“…The fiber reinforcement was discussed in [30] and biphasic linearity was used in [31]. Besides, many research efforts have been made on the meniscus, such as mechanical response in indentation experiments [7], contact mechanics using a sensor [32], micromechanical properties of extracellular matrix [33], loading in ACL injured knee [8], and structure and function relationships of tissues [34].…”

“…Ω ∆ can be obtained by solving linear system (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16), and then ∆ is calculated by equation (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). Finally, the position vectors in the next time step +∆ can be updated.…”