Effects of radial tears and partial meniscectomy of lateral meniscus on the knee joint mechanics during the stance phase of the gait cycle - A 3D finite element study

摘要

The purpose of the current study was to evaluate influences of radial tears and partial meniscectomy of lateral meniscus on the knee joint mechanics during normal walking by using computational modeling. A 3D geometry of a knee joint of a healthy patient was obtained from our previous study, whereas the data of normal walking were taken from the literature. Cartilage tissue was modeled as a fibril reinforced poroviscoelastic material, whereas meniscal tissue was modeled as a transverse isotropic elastic material. The realistic gait cycle data were implemented into the computational model and the effects of radial tears and partial meniscectemy of lateral meniscus on the knee joint mechanics were simulated. Middle, posterior, and anterior radial tears in lateral meniscus increased stresses by 300%, 430%, and 1530%, respectively, at the ends of tears compared to corresponding areas in the model with intact lateral meniscus. Meniscus tears did not alter stresses and strains at the tibial cartilage surface, whereas partial meniscectomy increased contact pressures, stresses, strains and pore pressures in the tibial cartilage by 50%, 44%, 21%, and 43%, respectively. Increased stresses and strains were observed primarily during the first ～50% of the stance phase of the gait cycle. The present study suggests that anterior radial tear causes the highest risk for the development of total meniscal rupture, whereas partial meniscectomy increases the risk for the development of OA in lateral tibial cartilage. Highest risks for meniscus and cartilage failures are suggested to occur during the loading response and mid-stance of the gait cycle. In the future, the present modeling may be further developed to offer a clinical tool for aid in decision making of clinical interventions for patients with knee joint injuries.