Altered Knee Joint Mechanics in Simple Compression Associated with Early Cartilage Degeneration

The progression of osteoarthritis can be accompanied by depth-dependent changes in the properties of articular cartilage. The objective of the present study was to determine the subsequent alteration in the fluid pressurization in the human knee using a three-dimensional computer model. Only a small compression in the femur-tibia direction was applied to avoid numerical difficulties. The material model for articular cartilages and menisci included fluid, fibrillar and nonfibrillar matrices as distinct constituents. The knee model consisted of distal femur, femoral cartilage, menisci, tibial cartilage, and proximal tibia. Cartilage degeneration was modeled in the high load-bearing region of the medial condyle of the femur with reduced fibrillar and nonfibrillar elastic properties and increased hydraulic permeability. Three case studies were implemented to simulate (1) the onset of cartilage degeneration from the superficial zone, (2) the progression of cartilage degeneration to the middle zone, and (3) the progression of cartilage degeneration to the deep zone. As compared with a normal knee of the same compression, reduced fluid pressurization was observed in the degenerated knee. Furthermore, faster reduction in fluid pressure was observed with the onset of cartilage degeneration in the superficial zone and progression to the middle zone, as compared to progression to the deep zone. On the other hand, cartilage degeneration in any zone would reduce the fluid pressure in all three zones. The shear strains at the cartilage-bone interface were increased when cartilage degeneration was eventually advanced to the deep zone. The present study revealed, at the joint level, altered fluid pressurization and strains with the depth-wise cartilage degeneration. The results also indicated redistribution of stresses within the tissue and relocation of the loading between the tissue matrix and fluid pressure. These results may only be qualitatively interesting due to the small compression considered.

[1]  L. P. Li,et al.  Erratum:“Strain-rate Dependent Stiffness of Articular Cartilage in Unconfined Compression” [ASME J. Biomechanical Engineering, 2003, 125, pp. 161–168] , 2003 .

[2]  R K Korhonen,et al.  Effect of superficial collagen patterns and fibrillation of femoral articular cartilage on knee joint mechanics-a 3D finite element analysis. , 2012, Journal of biomechanics.

[3]  A. Weiler,et al.  Arthroscopic evaluation of articular cartilage lesions in posterior-cruciate-ligament-deficient knees. , 2003, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[4]  Federica Boschetti,et al.  Tensile and compressive properties of healthy and osteoarthritic human articular cartilage. , 2008, Biorheology.

[5]  A Shirazi-Adl,et al.  Nonlinear analysis of cartilage in unconfined ramp compression using a fibril reinforced poroelastic model. , 1999, Clinical biomechanics.

[6]  E. Taşkıran,et al.  Analysis of meniscal and chondral lesions accompanying anterior cruciate ligament tears: relationship with age, time from injury, and level of sport , 2004, Knee Surgery, Sports Traumatology, Arthroscopy.

[7]  H J Helminen,et al.  Normal and pathological adaptations of articular cartilage to joint loading , 2000, Scandinavian journal of medicine & science in sports.

[8]  Walter Herzog,et al.  Erratum: “Effect of Fluid Boundary Conditions on Joint Contact Mechanics and Applications to the Modelling of Osteoarthritic Joints,” J. Biomech. Eng., 126(2), pp. 220–225 , 2005 .

[9]  Prevalence of self-reported arthritis or chronic joint symptoms among adults--United States, 2001. , 2002, MMWR. Morbidity and mortality weekly report.

[10]  P. Savard,et al.  Creep behavior of the intact and meniscectomy knee joints. , 2011, Journal of the mechanical behavior of biomedical materials.

[11]  R K Korhonen,et al.  Depth-wise progression of osteoarthritis in human articular cartilage: investigation of composition, structure and biomechanics. , 2010, Osteoarthritis and cartilage.

[12]  C. McCutchen.  The frictional properties of animal joints , 1962 .

[13]  V. Mow,et al.  The mechanical environment of the chondrocyte: a biphasic finite element model of cell-matrix interactions in articular cartilage. , 2000, Journal of biomechanics.

[14]  A Shirazi-Adl,et al.  A fibril reinforced nonhomogeneous poroelastic model for articular cartilage: inhomogeneous response in unconfined compression. , 2000, Journal of biomechanics.

[15]  D. Felson,et al.  An update on the epidemiology of knee and hip osteoarthritis with a view to prevention. , 1998, Arthritis and rheumatism.

[16]  R. McCarney,et al.  Knee pain and osteoarthritis in older adults: a review of community burden and current use of primary health care , 2001, Annals of the rheumatic diseases.

[17]  Manuel Doblaré,et al.  Effect of the size and location of osteochondral defects in degenerative arthritis. A finite element simulation , 2007, Comput. Biol. Medicine.

[18]  Nicola Maffulli,et al.  Articular cartilage lesions in the symptomatic anterior cruciate ligament-deficient knee. , 2003, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[19]  Ming Ding,et al.  Changes in the stiffness of the human tibial cartilage-bone complex in early-stage osteoarthrosis. , 1998, Acta orthopaedica Scandinavica.

[20]  G. Li,et al.  Variability of a three-dimensional finite element model constructed using magnetic resonance images of a knee for joint contact stress analysis. , 2001, Journal of biomechanical engineering.

[21]  E. Radin,et al.  Microfractures and microcracks in subchondral bone: are they relevant to osteoarthrosis? , 2003, Rheumatic diseases clinics of North America.

[22]  King H. Yang,et al.  Osteochondral Defects in the Human Knee , 2004, The American journal of sports medicine.

[23]  Seungbum Koo,et al.  A Framework for the in Vivo Pathomechanics of Osteoarthritis at the Knee , 2004, Annals of Biomedical Engineering.

[24]  G. Bentley,et al.  Horizontal splitting in patellar articular cartilage. , 1978, Arthritis and rheumatism.

[25]  D. Carter,et al.  Articular cartilage functional histomorphology and mechanobiology: a research perspective. , 2003, Bone.

[26]  A Shirazi-Adl,et al.  Strain-rate dependent stiffness of articular cartilage in unconfined compression. , 2003, Journal of biomechanical engineering.

[27]  A Shirazi-Adl,et al.  Role of cartilage collagen fibrils networks in knee joint biomechanics under compression. , 2008, Journal of biomechanics.

[28]  W Herzog,et al.  Joint contact mechanics in the early stages of osteoarthritis. , 2000, Medical engineering & physics.

[29]  Trevor Hastie,et al.  Risk factors for progressive cartilage loss in the knee: a longitudinal magnetic resonance imaging study in forty-three patients. , 2002, Arthritis and rheumatism.

[30]  Michele M. Temple,et al.  Age- and site-associated biomechanical weakening of human articular cartilage of the femoral condyle. , 2007, Osteoarthritis and cartilage.

[31]  R. Rose,et al.  Role of Subchondral Bone in the Initiation and Progression of Cartilage Damage , 1986, Clinical orthopaedics and related research.

[32]  V C Mow,et al.  Mechanical Properties of Canine Articular Cartilage Are Significantly Altered Following Transection of the Anterior Cruciate Ligament , 1994, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[33]  Juha Töyräs,et al.  Ultrasound attenuation in normal and spontaneously degenerated articular cartilage. , 2004, Ultrasound in medicine & biology.

[34]  V C Mow,et al.  Variations in the intrinsic mechanical properties of human articular cartilage with age, degeneration, and water content. , 1982, The Journal of bone and joint surgery. American volume.

[35]  T. Schacker,et al.  Clinical and Epidemiologic Features of Primary HIV Infection , 1996, Annals of Internal Medicine.

[36]  Gerard A Ateshian,et al.  Patellofemoral joint biomechanics and tissue engineering. , 2005, Clinical orthopaedics and related research.

[37]  A. Shirazi-Adl,et al.  A " bril reinforced nonhomogeneous poroelastic model for articular cartilage : inhomogeneous response in uncon " ned compression , 2022 .

[38]  V Wright,et al.  Mechanical factors and patellofemoral osteoarthrosis. , 1979, Annals of the rheumatic diseases.

[39]  Klaus Linde,et al.  Meta-analysis: Acupuncture for Osteoarthritis of the Knee , 2007, Annals of Internal Medicine.

[40]  T. Oegema,et al.  Subchondral damage after acute transarticular loading: An in vitro model of joint injury , 1992, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[41]  M. Adams,et al.  Mechanical properties of articular cartilage in knees with unicompartmental osteoarthritis. , 1994, The Journal of bone and joint surgery. British volume.

[42]  Benedicte Vanwanseele,et al.  A review on the mechanical quality of articular cartilage - implications for the diagnosis of osteoarthritis. , 2006, Clinical biomechanics.

[43]  Marcy Wong,et al.  The mechanobiology of articular cartilage development and degeneration. , 2004, Clinical orthopaedics and related research.

[44]  T. Griffin,et al.  The Role of Mechanical Loading in the Onset and Progression of Osteoarthritis , 2005, Exercise and sport sciences reviews.

[45]  Won C. Bae,et al.  Topographic Patterns of Cartilage Lesions in Knee Osteoarthritis , 2010, Cartilage.

[46]  J. Dodds,et al.  The split-line pattern of the distal femur: A consideration in the orientation of autologous cartilage grafts. , 2002, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[47]  Juha Töyräs,et al.  Fibril reinforced poroelastic model predicts specifically mechanical behavior of normal, proteoglycan depleted and collagen degraded articular cartilage. , 2003, Journal of biomechanics.

[48]  T. Brown,et al.  In vitro contact stress distribution on the femoral condyles , 1984, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[49]  K. An,et al.  Gait characteristics of patients with knee osteoarthritis. , 2001, Journal of biomechanics.

[50]  LePing Li,et al.  Three-dimensional fibril-reinforced finite element model of articular cartilage , 2009, Medical & Biological Engineering & Computing.

[51]  L. P. Li,et al.  A human knee joint model considering fluid pressure and fiber orientation in cartilages and menisci. , 2011, Medical engineering & physics.

[52]  V C Mow,et al.  Altered mechanics of cartilage with osteoarthritis: human osteoarthritis and an experimental model of joint degeneration. , 1999, Osteoarthritis and cartilage.

[53]  Rik Huiskes,et al.  Causes of mechanically induced collagen damage in articular cartilage , 2006, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[54]  M. Brittberg,et al.  Evaluation of Cartilage Injuries and Repair , 2003, The Journal of bone and joint surgery. American volume.

[55]  A M Walker,et al.  Incidence of symptomatic hand, hip, and knee osteoarthritis among patients in a health maintenance organization. , 1995, Arthritis and rheumatism.

[56]  Walter Herzog,et al.  Effect of fluid boundary conditions on joint contact mechanics and applications to the modeling of osteoarthritic joints. , 2004, Journal of biomechanical engineering.

[57]  V C Mow,et al.  The biphasic poroviscoelastic behavior of articular cartilage: role of the surface zone in governing the compressive behavior. , 1993, Journal of biomechanics.