Experimental substantiation of the optimal technique for choosing the rotation of the femoral component of the knee endoprosthesis

2021 ◽  
Vol 23 (1) ◽  
pp. 129-134
Author(s):  
Vladimir V. Khominets ◽  
Ivan V. Gaivoronsky ◽  
Alexey L. Kudyashev ◽  
Alexey A. Semenov ◽  
Ivan S. Bazarov ◽  
...  
Keyword(s):  
Knee Joint ◽  
Femoral Component ◽  
Articular Surface ◽  
Standard Procedure ◽  
Collateral Ligaments ◽  
Morphometric Characteristics ◽  
Block Rotation ◽  
Optimal Technique ◽  
Femoral Condyles ◽  
Femoral Resection

There was experimental justification of the optimal technique for choosing the rotation of the femoral component of the knee joint endoprosthesis carried out in this research. The individual morphometric characteristics of the femoral condyles and the condition of the collateral ligaments were taken into account in the experiment. The research was conducted on polymer-embalmed preparations of the knee joint, which were divided into three groups, according to the forms of the femoral condyles. We used the standard technique of positioning the resection block and the technique of individual selection of the rotation of the resection block (rotation of the femoral component of the endoprosthesis), based on the assessment of individual morphometric characteristics of the femoral condyles and the state of the auxiliary elements of the knee joint. To implement this surgical approach, typical resections of the proximal condyles of the tibia and distal condyles of the femur were performed, which technically did not differ from the sawdust used in the standard procedure. Then the knee joint was flexed to an angle of 90, Homan retractors were removed and two laminar dilators (Laminar Spreader) were installed in the gap between the proximal tibial sawdust and the posterior parts of the lateral and medial condyles of the femur. This technique provided isometric tension of the fibular and tibial collateral ligaments of the knee joint. Then carried out the positioning of the femoral resection block "four in one". In this case, only the line of the proximal tibial sawdust was used as a reference point, for which the posterior flange of the resection block was positioned parallel to the sawed upper articular surface of the tibia. It is established that the use of the considered technique of positioning the femoral resection block ensures the formation of a uniform flexor gap, regardless of the variant anatomy of the femoral condyles. Thus, there was research a uniform flexion gap in the experiment, which ensured isometric movements in the knee joint and its stability at the control points of the amplitude after implantation of the trial or final components of the endoprosthesis.

Asymmetric Varus and Valgus Stability of the Anatomic Cadaver Knee and the Load Sharing Between Collateral Ligaments and Bearing Surfaces

2014 ◽  
Vol 136 (8) ◽  
Author(s):  
Xiaonan Wang ◽  
Aamer Malik ◽  
Donald L. Bartel ◽  
Thomas L. Wickiewicz ◽  
Timothy Wright
Keyword(s):  
Knee Joint ◽  
Articular Surface ◽  
Coronal Plane ◽  
Testing System ◽  
Joint Stability ◽  
Collateral Ligaments ◽  
Angular Rotation ◽  
Compressive Loads ◽  
Lift Off ◽  
The Moment

Knee joint stability is important in maintaining normal joint motion during activities of daily living. Joint instability not only disrupts normal motion but also plays a crucial role in the initiation and progression of osteoarthritis. Our goal was to examine knee joint coronal plane stability under varus or valgus loading and to understand the relative contributions of the mechanisms that act to stabilize the knee in response to varus–valgus moments, namely, load distribution between the medial and lateral condyles and the ligaments. A robot testing system was used to determine joint stability in human cadaveric knees as described by the moment versus angular rotation behavior under varus and valgus loads at extension and at 30 deg and 90 deg of flexion. The anatomic knee joint was more stable in response to valgus than varus moments, and stability decreased with flexion angle. The primary mechanism for providing varus–valgus stability was the redistribution of the contact force on the articular surfaces from both condyles to a single condyle. Stretching of the collateral ligaments provided a secondary stabilizing mechanism after the lift-off of a condyle occurred. Compressive loads applied across the knee joint, such as would occur with the application of muscle forces, enhanced the ability of the articular surface to provide varus–valgus moment, and thus, helped stabilize the joint in the coronal plane. Coupled internal/external rotations and anteroposterior and medial–lateral translations were variable and in the case of the rotations were often as large as the varus–valgus rotations created by the applied moment.

scholarly journals Biomechanical Performance of Menisci under Cyclic Loads

2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
J.-G. Tseng ◽  
B.-W. Huang ◽  
Y.-T. Chen ◽  
S.-J. Kuo ◽  
G.-W. Tseng
Keyword(s):  
Knee Joint ◽  
Dynamic Characteristics ◽  
Tibial Plateau ◽  
Articular Surface ◽  
Mode Shapes ◽  
Actual State ◽  
Human Body Model ◽  
Human Knee Joint ◽  
Fatigue Life Analysis ◽  
Femoral Condyles

The meniscus, composed of fibrocartilage, is a very important part of the human knee joint that behaves like a buffer. Located in the middle of the femoral condyles and the tibial plateau, it is a necessary structure to maintain normal biomechanical properties of the knee. Whether walking or exercising, the meniscus plays a vital role to protect the articular surface of both the femoral condyles and the tibial plateau by absorbing the conveying shock from body weight. However, modern people often suffer from irreversible degeneration of joint tissue due to exercise-induced harm or aging. Therefore, understanding its dynamic characteristics will help to learn more about the actual state of motion and to avoid unnecessary injury. This study uses reverse engineering equipment, a 3D optical scanner, and a plastic teaching human body model to build the geometry of knee joint meniscus. Then, the finite element method (FEM) is employed to obtain the dynamic characteristics of the meniscus. The results show the natural frequencies, mode shapes, and fatigue life analysis of meniscus, with real human material parameters. The achieved results can be applied to do subsequent knee dynamic simulation analysis, to reduce the knee joint and lower external impacts, and to manufacture artificial meniscus through tissue engineering.

scholarly journals OP0083 DORSAL ROOT GANGLIA INFILTRATING MACROPHAGES MAINTAIN OSTEOARTHRITIS PAIN

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 55.2-56
Author(s):  
R. Raoof ◽  
C. Martin ◽  
H. De Visser ◽  
J. Prado ◽  
S. Versteeg ◽  
...  
Keyword(s):  
Knee Joint ◽  
Dorsal Root Ganglia ◽  
Immune Cells ◽  
Dorsal Root ◽  
Weight Bearing ◽  
Joint Damage ◽  
Osteoarthritis Pain ◽  
Knee Pathology ◽  
Femoral Condyles ◽  
Over Time

Background:Pain is a major debilitating symptom of knee osteoarthritis (OA). However, the extent of joint damage in OA does not correlate well with the severity of pain. The mechanisms that govern OA pain are poorly understood. Immune cells infiltrating nervous tissue may contribute to pain maintenance.Objectives:Here we investigated the role of macrophages in the initiation and maintenance of OA pain.Methods:Knee joint damage was induced by an unilateral injection of mono-iodoacetate (MIA) or after application of a groove at the femoral condyles of rats fed on high fat diet. Pain-like behaviors were followed over time using von Frey test and dynamic weight bearing. Joint damage was assessed by histology. Dorsal root ganglia (DRG) infiltrating immune cells were assessed over time using flow cytometry. To deplete monocytes and macrophages, Lysmcrex Csfr1-Stop-DTR were injected intrathecal or systemically with diptheria toxin (DT).Results:Intraarticular monoiodoacetate injection induced OA and signs of persistent pain, such as mechanical hyperalgesia and deficits in weight bearing. The persisting pain-like behaviors were associated with accumulation of F4/80+macrophages with an M1-like phenotype in the lumbar DRG appearing from 1 week after MIA injection, and that persisted till at least 4 weeks after MIA injection. Macrophages infiltrated DRG were also observed in the rat groove model of OA, 12 weeks after application of a groove at the femoral condyles. Systemic or local depletion of DRG macrophages during established MIA-induced OA completely ablated signs of pain, without affecting MIA-induced knee pathology. Intriguingly when monocytes/macrophages were depleted prior to induction of osteoarthritis, pain-like behaviors still developed, however these pain-like behaviors did not persist over time.In vitro,sensory neurons innervating the affected OA joint programmed macrophages into a M1 phenotype. Local repolarization of M1-like DRG macrophages towards M2 by intrathecal injection of M2 macrophages or anti-inflammatory cytokines resolved persistent OA-induced pain.Conclusion:Overall we show that macrophages infiltrate the DRG after knee damage and acquire a M1-like phenotype and maintain pain independent of the lesions in the knee joint. DRG-infiltrating macrophages are not required for induction of OA pain. Reprogramming M1-like DRG-infiltrating macrophages may represent a potential strategy to treat OA pain.Acknowledgments:This project has received funding from the European Union’s Horizon 2020 research and innovation programme under the Marie Sklodowska-Curie grant agreements No 814244 and No 642720. Dutch Arthritis SocietyDisclosure of Interests:Ramin Raoof: None declared, Christian Martin: None declared, Huub de Visser: None declared, Judith Prado: None declared, Sabine Versteeg: None declared, Anne Heinemans: None declared, Simon Mastbergen: None declared, Floris Lafeber Shareholder of: Co-founder and shareholder of ArthroSave BV, Niels Eijkelkamp: None declared

scholarly journals The Effects of External Loads and Muscle Forces on the Knee Joint Ligaments during Walking: A Musculoskeletal Model Study

2021 ◽  
Vol 11 (5) ◽  
pp. 2356
Author(s):  
Carlo Albino Frigo ◽  
Lucia Donno
Keyword(s):  
Knee Joint ◽  
Cruciate Ligament ◽  
Musculoskeletal Model ◽  
Optimization Approach ◽  
Muscle Forces ◽  
Collateral Ligaments ◽  
Flexion Extension ◽  
Lateral Collateral Ligaments ◽  
Gastrocnemius Muscles ◽  
External Loads

A musculoskeletal model was developed to analyze the tensions of the knee joint ligaments during walking and to understand how they change with changes in the muscle forces. The model included the femur, tibia, patella and all components of cruciate and collateral ligaments, quadriceps, hamstrings and gastrocnemius muscles. Inputs to the model were the muscle forces, estimated by a static optimization approach, the external loads (ground reaction forces and moments) and the knee flexion/extension movement corresponding to natural walking. The remaining rotational and translational movements were obtained as a result of the dynamic equilibrium of forces. The validation of the model was done by comparing our results with literature data. Several simulations were carried out by sequentially removing the forces of the different muscle groups. Deactivation of the quadriceps produced a decrease of tension in the anterior cruciate ligament (ACL) and an increase in the posterior cruciate ligament (PCL). By removing the hamstrings, the tension of ACL increased at the late swing phase, while the PCL force dropped to zero. Specific effects were observed also at the medial and lateral collateral ligaments. The removal of gastrocnemius muscles produced an increase of tension only on PCL and lateral collateral ligaments. These results demonstrate how musculoskeletal models can contribute to knowledge about complex biomechanical systems as the knee joint.

scholarly journals Simple geometry tribological study of osteochondral graft implantation in the knee

2018 ◽  
Vol 232 (3) ◽  
pp. 249-256 ◽  
Author(s):  
Philippa Bowland ◽  
Eileen Ingham ◽  
John Fisher ◽  
Louise M Jennings
Keyword(s):  
Knee Joint ◽  
Articular Surface ◽  
Cartilage Damage ◽  
Surface Damage ◽  
Negative Control ◽  
Osteochondral Allograft ◽  
Cartilage Defects ◽  
Osteochondral Grafts ◽  
Osteochondral Repair ◽  
Simple Geometry

Robust preclinical test methods involving tribological simulations are required to investigate and understand the tribological function of osteochondral repair interventions in natural knee tissues. The aim of this study was to investigate the effects of osteochondral allograft implantation on the local tribology (friction, surface damage, wear and deformation) of the tissues in the natural knee joint using a simple geometry, reciprocating pin-on-plate friction simulator. In addition, the study aimed to assess the ability of osteochondral grafts to restore a low surface damage, deformation and wear articulation when compared to the native state. A method was developed to characterise and quantify surface damage wear and deformation of the opposing cartilage-bone pin surface using a non-contacting optical profiler (Alicona Infinite Focus). Porcine 12 mm diameter cartilage-bone pins were reciprocated against bovine cartilage-bone plates that had 6 mm diameter osteochondral allografts, cartilage defects or stainless steel pins (positive controls) inserted centrally. Increased levels of surface damage with changes in geometry were not associated with significant increases in the coefficient of dynamic friction. Significant damage to the opposing cartilage surface was observed in the positive control groups. Cartilage damage, deformation and wear (as measured by change in geometry) in the xenograft (2.4 mm3) and cartilage defect (0.99 mm3) groups were low and not significantly different (p > 0.05) compared to the negative control in either group. The study demonstrated the potential of osteochondral grafts to restore the congruent articular surface and biphasic tribology of the natural joint. An optical method has been developed to characterise cartilage wear, damage and deformation that can be applied to the tribological assessment of osteochondral grafts in a whole natural knee joint simulation model.

A Study of Collagen Crimp Pattern in the Bovine Anterior and Posterior Medial Meniscal Horn Attachments

2007 ◽  
Author(s):  
Diego Villegas ◽  
William Dehlin ◽  
Tammy L. Haut Donahue
Keyword(s):  
Mechanical Properties ◽  
Stress Relaxation ◽  
Knee Joint ◽  
Tibial Plateau ◽  
Ultimate Strain ◽  
Theoretical Studies ◽  
Joint Lubrication ◽  
Meniscal Attachments ◽  
Experimental And Theoretical Studies ◽  
Femoral Condyles

Menisci are fibrocartilagenous structures located between the femoral condyles and tibial plateau that aid in joint lubrication and stability in the knee joint. Previous experimental and theoretical studies have shown that the meniscal horn attachments, which serve as the transition from mensical fibrocartilage into subchondral bone, are important for proper meniscal function [1–3]. Meniscal attachments did not show significant differences in surface mechanical properties such as ultimate strain or moduli, however, there were significant differences in overall behavior of the anterior versus posterior attachments [4]. No significant differences in creep or stress relaxation properties were found between the different meniscal attachments [5].

A role for calcitonin gene-related peptide in rabbit knee joint ligament healing

2000 ◽  
Vol 78 (7) ◽  
pp. 535-540 ◽  
Author(s):  
Jason J McDougall ◽  
Grace Yeung ◽  
Catherine A Leonard ◽  
Robert C Bray
Keyword(s):  
Knee Joint ◽  
Wound Repair ◽  
Topical Administration ◽  
Calcitonin Gene Related Peptide ◽  
Collateral Ligaments ◽  
Rabbit Knee ◽  
Beneficial Effects ◽  
Related Peptide ◽  
Calcitonin Gene ◽  
Ligament Healing

Knee joint ligament healing has been shown to be improved when the torn ligament ends remain in contact, however, the rationale for these effects is unknown. The sensory neuropeptide calcitonin gene related peptide (CGRP) has potent trophic and vasodilatatory properties and as such is thought to be advantageous in wound repair. In ascertaining a role for CGRP in rabbit medial collateral ligament healing, the present study examined changes in CGRP-like immunoreactivity (CGRP-LI) and CGRP-mediated vasomotor responses in gap injured (non-contact), Z-plasty apposed (contact), and sham operated control medial collateral ligaments. At 6 weeks post-trauma, CGRP-LI decreased in the healing zone of gap injured and Z-plasty apposed medial collateral ligaments compared with controls, and non-contact ligament nerve fibres exhibited an abnormal morphology. Topical administration of CGRP (10-13 to 10-9 mol) caused a dose-dependent increase in ligament perfusion in each experimental group of knees. The CGRP-mediated vasodilatation associated with gap injured ligaments was not significantly different from controls (P = 0.06), whereas apposed medial collateral ligaments showed an augmented response to the peptide (P < 0.0005). These findings indicate that the beneficial effects of ligament interposition post-trauma may be related to an enhanced responsiveness to CGRP in conjunction with a more typical re-innervation profile. Conversely, the aberrant characteristics of CGRP-LI nerves occurring in gap injured tissue is suggestive of impaired CGRP release which may explain the poor functional recovery associated with these ligaments.Key words: blood flow, injury, knee joint, neuropeptides, wound repair.

A Two-Dimensional Dynamic Anatomical Model of the Human Knee Joint

1993 ◽  
Vol 115 (4A) ◽  
pp. 357-365 ◽  
Author(s):  
Eihab Abdel-Rahman ◽  
Mohamed Samir Hefzy
Keyword(s):  
Knee Joint ◽  
Posterior Cruciate Ligament ◽  
Numerical Solutions ◽  
Cruciate Ligament ◽  
Posterior Part ◽  
Geometric Constraints ◽  
Two Dimensional ◽  
Algebraic Equations ◽  
Collateral Ligaments ◽  
Nonlinear Algebraic Equations

The objective of this study is to develop a two-dimensional dynamic model of the knee joint to simulate its response under sudden impact. The knee joint is modeled as two rigid bodies, representing a fixed femur and a moving tibia, connected by 10 nonlinear springs representing the different fibers of the anterior and posterior cruciate ligaments, the medial and lateral collateral ligaments, and the posterior part of the capsule. In the analysis, the joint profiles were represented by polynomials. Model equations include three nonlinear differential equations of motion and three nonlinear algebraic equations representing the geometric constraints. A single point contact was assumed to exist at all times. Numerical solutions were obtained by applying Newmark constant-average-acceleration scheme of differential approximation to transform the motion equations into a set of nonlinear simultaneous algebraic equations. The equations reduced thus to six nonlinear algebraic equations in six unknowns. The Newton-Raphson iteration technique was then used to obtain the solution. Knee response was determined under sudden rectangular pulsing posterior forces applied to the tibia and having different amplitudes and durations. The results indicate that increasing pulse amplitude and/or duration produced a decrease in the magnitude of the tibio-femoral contact force, indicating thus a reduction in the joint stiffness. It was found that the anterior fibers of the posterior cruciate and the medial collateral ligaments are the primary restraints for a posterior forcing pulse in the range of 20 to 90 degrees of knee flexion; this explains why most isolated posterior cruciate ligament injuries and combined injuries to the posterior cruciate ligament and the medial collateral results from a posterior impact on a flexed knee.

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