Partial meniscectomy is believed to change the biomechanics of the knee joint through alterations in the contact of articular cartilages and menisci. Although fluid pressure plays an important role in the load support mechanism of the knee, the fluid pressurization in the cartilages and menisci has been ignored in the finite element studies of the mechanics of meniscectomy. In the present study, a 3D fibril-reinforced poromechanical model of the knee joint was used to explore the fluid flow dependent changes in articular cartilage following partial medial and lateral meniscectomies. Six partial longitudinal meniscectomies were considered under relaxation, simple creep, and combined creep loading conditions. In comparison to the intact knee, partial meniscectomy not only caused a substantial increase in the maximum fluid pressure but also shifted the location of this pressure in the femoral cartilage. Furthermore, these changes were positively correlated to the size of meniscal resection. While in the intact joint, the location of the maximum fluid pressure was dependent on the loading conditions, in the meniscectomized joint the location was predominantly determined by the site of meniscal resection. The partial meniscectomy also reduced the rate of the pressure dissipation, resulting in even larger difference between creep and relaxation times as compared to the case of the intact knee. The knee joint became stiffer after meniscectomy because of higher fluid pressure at knee compression followed by slower pressure dissipation. The present study indicated the role of fluid pressurization in the altered mechanics of meniscectomized knees.

References

References
1.
Fithian
,
D. C.
,
Kelly
,
M. A.
, and
Mow
,
V. C.
, 1990, “
Material Properties and Structure-Function Relationships in the Menisci
,”
Clin. Orthop. Relat. Res.
,
252
, pp.
19
31
.
2.
Kurosawa
,
H.
,
Fukubayashi
,
T.
, and
Nakajima
,
H.
, 1980, “
Load-Bearing Mode of the Knee Joint: Physical Behavior of the Knee Joint With or Without Menisci
,”
Clin. Orthop. Relat. Res.
,
149
, pp.
283
290
.
3.
Walker
,
P. S.
, and
Hajek
,
J. V.
, 1972, “
The Load-Bearing Area in the Knee Joint
,”
J. Biomech.
,
5
(
6
), pp.
581
589
.
4.
Shrive
,
N. G.
,
O’Connor
,
J. J.
, and
Goodfellow
,
J. W.
, 1978, “
Load-Bearing in the Knee Joint
,”
Clin. Orthop. Relat. Res.
,
131
, pp.
279
287
.
5.
Walker
,
P. S.
, and
Erkman
,
M. J.
, 1975, “
The Role of the Menisci in Force Transmission Across the Knee
,”
Clin. Orthop. Relat. Res.
,
109
, pp.
184
192
.
6.
Brindle
,
T.
,
Nyland
,
J.
, and
Johnson
,
D. L.
, 2001, “
The Meniscus: Review of Basic Principles With Application to Surgery and Rehabilitation
,”
J. Athl. Train.
,
36
(
2
), pp.
160
169
.
7.
Baratz
,
M. E.
,
Fu
,
F. H.
, and
Mengato
,
R.
, 1986, “
Meniscal Tears: The Effect of Meniscectomy and of Repair on Intraarticular Contact Areas and Stress in the Human Knee. A Preliminary Report
,”
Am. J. Sports Med.
,
14
(
4
), pp.
270
275
.
8.
Wyland
,
D. J.
,
Guilak
,
F.
,
Elliott
,
D. M.
,
Setton
,
L. A.
, and
Vail
,
T. P.
, 2002, “
Chondropathy After Meniscal Tear or Partial Meniscectomy in a Canine Model
,”
J. Orthop. Res.
,
20
(
5
), pp.
996
1002
.
9.
Schimmer
,
R. C.
,
Brulhart
,
K. B.
,
Duff
,
C.
, and
Glinz
,
W.
, 1998, “
Arthroscopic Partial Meniscectomy: A 12-Years Follow-Up and Two-Step Evaluation of the Long-Term Course
,”
Arthroscopy: J. Relat. Surg.
,
14
(
2
), pp.
136
142
.
10.
Englund
,
M.
,
Roos
,
E. M.
,
Roos
,
H. P.
, and
Lohmander
,
L. S.
, 2001, “
Patient-Relevant Outcomes Fourteen Years After Meniscectomy: Influence of Type of Meniscal Tear and Size of Resection
,”
Rheumatology
,
40
(
6
), pp.
631
639
.
11.
Rangger
,
C.
,
Klestil
,
T.
,
Gloetzer
,
W.
,
Kemmler
,
G.
, and
Benedetto
,
K. P.
, 1995, “
Osteoarthritis After Arthroscopic Partial Meniscectomy
,”
Am. J. Sports Med.
,
23
(
2
), pp.
240
244
.
12.
Zielinska
,
B.
, and
Donahue
,
T. L.
, 2006, “
3D Finite Element Model of Meniscectomy: Changes in Joint Contact Behavior
,”
J. Biomech. Eng.
,
128
(
1
), pp.
115
123
.
13.
Shirazi
,
R.
, and
Shirazi-Adl
,
A.
, 2009, “
Analysis of Partial Meniscectomy and ACL Reconstruction in Knee Joint Biomechanics Under a Combined Loading
,”
Clin. Biomech. (Bristol, Avon)
,
24
(
9
), pp.
755
761
.
14.
Peña
,
E.
,
Calvo
,
B.
,
Martínez
,
M. A.
,
Palanca
,
D.
, and
Doblaré
,
M.
, 2005, “
Finite Element Analysis of the Effect of Meniscal Tears and Meniscectomies on Human Knee Biomechanics
,”
Clin. Biomech. (Bristol, Avon)
,
20
(
5
), pp.
498
507
.
15.
Yang
,
N.
,
Nayeb-Hashemi
,
H.
, and
Canavan
,
P. K.
, 2009, “
The Combined Effect of Frontal Plane Tibiofemoral Knee Angle and Meniscectomy on the Cartilage Contact Stresses and Strains
,”
Ann. Biomed. Eng.
,
37
(
11
), pp.
2360
2372
.
16.
Fung
,
Y. C.
, 1993,
Biomechanics: Mechanical Properties of Living Tissues
,
2nd ed.
,
Springer-Verlag
,
New York
, Chap. 12.
17.
Daniels
,
D. M.
, 1990,
Knee Ligaments: Structure, Function, Injury and Repair
,
Raven Press
,
New York
, pp.
366
374
.
18.
Mak
,
A. F.
, 1986, “
The Apparent Viscoelastic Behavior of Articular Cartilage–The Contributions From the Intrinsic Matrix Viscoelasticity and Interstitial Fluid Flows
,”
J. Biomech. Eng.
,
108
(
2
), pp.
123
130
.
19.
Ateshian
,
G. A.
,
Lai
,
W. M.
,
Zhu
,
W. B.
, and
Mow
,
V. C.
, 1994, “
An Asymptotic Solution for the Contact of Two Biphasic Cartilage Layers
,”
J. Biomech.
,
27
(
11
), pp.
1347
1360
.
20.
Garon
,
M.
,
Légaré
,
A.
,
Guardo
,
R.
,
Savard
,
P.
, and
Buschmann
,
M. D.
, 2002, “
Streaming Potentials Maps are Spatially Resolved Indicators of Amplitude, Frequency and Ionic Strength Dependant Responses of Articular Cartilage to Load
,”
J. Biomech.
,
35
(
2
), pp.
207
216
.
21.
Li
,
L. P.
,
Korhonen
,
R. K.
,
Iivarinen
,
J.
,
Jurvelin
,
J. S.
, and
Herzog
,
W.
, 2008, “
Fluid Pressure Driven Fibril Reinforcement in Creep and Relaxation Tests of Articular Cartilage
,”
Med. Eng. Phys.
,
30
(
2
), pp.
182
189
.
22.
Spilker
,
R. L.
,
Donzelli
,
P. S.
, and
Mow
,
V. C.
, 1992, “
A Transversely Isotropic Biphasic Finite Element Model of the Meniscus
,”
J. Biomech.
,
25
(
9
), pp.
1027
1045
.
23.
Gu
,
K. B.
, and
Li
,
L. P.
, 2011, “
A Human Knee Joint Model Considering Fluid Pressure and Fiber Orientation in Cartilages and Menisci
,”
Med. Eng. Phys.
,
33
(
4
), pp.
497
503
.
24.
Kazemi
,
M.
,
Li
,
L. P.
,
Savard
,
P.
, and
Buschmann
,
M. D.
, 2011, “
Creep Behavior of the Intact and Meniscectomy Knee Joints
,”
J. Mech. Behav. Biomed. Mater.
,
4
(
7
), pp.
1351
1358
.
25.
Cheung
,
J. T. M.
,
Zhang
,
M.
,
Leung
,
A. K. L.
, and
Fan
,
Y. B.
, 2005, “
Three-Dimensional Finite Element Analysis of the Foot During Standing – A Material Sensitivity Study
,”
J. Biomech.
,
38
(
5
), pp.
1045
1054
.
26.
Dandy
,
D. J.
, 1990, “
The Arthroscopic Anatomy of Symptomatic Meniscal Lesions
,”
J. Bone Jt. Surg.
,
72
(
4
), pp.
628
633
.
27.
Greis
,
P. E.
,
Bardana
,
D. D.
,
Holmstrom
,
M. C.
, and
Burks
,
R. T.
, 2002, “
Meniscal Injury: I. Basic Science and Evaluation
,”
J. Am. Acad. Orthop. Surg.
,
10
(
3
), pp.
168
176
.
28.
Athanasiou
,
K. A.
, and
Sanchez-Adams
,
J.
, 2009,
Engineering the Knee Meniscus
,
Morgan and Claypool
,
San Rafael, CA
, Chap. 2.
29.
Fayard
,
J. M.
,
Pereira
,
H.
,
Servien
,
E.
,
Lustig
,
S.
, and
Neyret
,
P.
, 2010. “
Meniscectomy: Global Results- Complications
,”
The Meniscus
,
P.
Beaufils
and
R.
Verdonk
, eds.,
Springer
,
New York
, pp.
177
199
.
30.
Below
,
S.
,
Arnoczky
,
S. P.
,
Dodds
,
J.
,
Kooima
,
C.
, and
Walter
,
N.
, 2002, “
The Split-Line Pattern of the Distal Femur: A Consideration in the Orientation of Autologous Cartilage Grafts
,”
Arthroscopy: J. Relat. Surg.
,
18
(
6
), pp.
613
617
.
31.
Grood
,
E. S.
, and
Hefzy
,
M. S.
, 1982, “
An Analytical Technique for Modeling Knee Joint Stiffness. Part I: Ligamentous Forces
,”
J. Biomech. Eng.
,
104
(
4
), pp.
330
337
.
32.
Hirokawa
,
S.
, and
Tsuruno
,
R.
, 2000, “
Three-Dimensional Deformation and Stress Distribution in an Analytical/Computational Model of the Anterior Cruciate Ligament
,”
J. Biomech.
,
33
(
9
), pp.
1069
1077
.
33.
Li
,
L. P.
,
Buschmann
,
M. D.
, and
Shirazi-Adl
,
A.
, 2003, “
Strain Rate Dependent Stiffness of Articular Cartilage in Unconfined Compression
,”
J. Biomech. Eng.
,
125
(
2
), pp.
161
168
.
34.
Shirazi
,
R.
,
Shirazi-Adl
,
A.
, and
Hurtig
,
M.
, 2008, “
Role of Cartilage Collagen Fibrils Networks in Knee Joint Biomechanics Under Compression
,”
J. Biomech.
,
41
(
16
), pp.
3340
3348
.
35.
Woo
,
S. L. Y.
,
Akeson
,
W. H.
, and
Jemmott
,
G. F.
, 1976, “
Measurements of Nonhomogeneous, Directional Mechanical Properties of Articular Cartilage in Tension
,”
J. Biomech.
,
9
(
12
), pp.
785
791
.
36.
Li
,
L. P.
,
Cheung
,
J. T. M.
, and
Herzog
,
W.
, 2009, “
Three-Dimensional Fibril-Reinforced Finite Element Model of Articular Cartilage
,”
Med. Biol. Eng. Comput.
,
47
(
6
), pp.
607
615
.
37.
Bendjaballah
,
M. Z.
,
Shirazi-Adl
,
A.
, and
Zukor
,
D. J.
, 1995, “
Biomechanics of the Human Knee Joint in Compression: Reconstruction, Mesh Generation and Finite Element Analysis
,”
The Knee
,
2
(
2
), pp.
69
79
.
38.
Mow
,
V. C.
,
Ateshian
,
G. A.
, and
Spilker
,
R. L.
, 1993, “
Biomechanics of Diarthrodial Joints: A Review of Twenty Years of Progress
,”
J. Biomech. Eng.
,
115
(
4B
), pp.
460
467
.
39.
Fukubayashi
,
T.
, and
Kurosawa
,
H.
, 1980, “
The Contact Area and Pressure Distribution Pattern of the Knee. A Study of Normal and Osteoarthrotic Knee Joints
,”
Acta Orthop. Scand.
,
51
(
6
), pp.
871
879
.
40.
Peña
,
E.
,
Calvo
,
B.
,
Martínez
,
M. A.
, and
Doblaré
,
M.
, 2008, “
Computer Simulation of Damage on Distal Femoral Articular Cartilage After Meniscectomies
,”
Comput. Biol. Med.
,
38
(
1
), pp.
69
81
.
41.
Hsu
,
R.
,
Himeno
,
S.
,
Coventry
,
M.
, and
Chao
,
E.
, 1990, “
Normal Axial Alignment of the Lower Extremity and Load-Bearing Distribution at the Knee
,”
Clin. Orthop. Relat. Res.
,
255
, pp.
215
227
.
42.
Johnson
,
F.
,
Leitl
,
S.
, and
Waugh
,
W.
, 1980, “
The Distribution of Load Across the Knee. A Comparison of Static and Dynamic Measurements
,”
J. Bone Jt. Surg. Br. Vol.
,
62
(
3
), pp.
346
349
.
43.
Shelburne
,
K. B.
,
Torry
,
M. R.
, and
Pandy
,
M. G.
, 2005, “
Muscle, Ligament, and Joint-Contact Forces at the Knee During Walking
,”
Med. Sci. Sports Exercise
,
37
(
11
), pp.
1948
1956
.
44.
Peña
,
E.
,
Calvo
,
B.
,
Martinez
,
M. A.
,
Palanca
,
D.
, and
Doblaré
,
M.
, 2006, “
Why Lateral Meniscectomy is More Dangerous Than Medial Meniscectomy. A Finite Element Study
,”
J. Orthop. Res.
,
24
(
5
), pp.
1001
1010
.
45.
Chatain
,
F.
,
Adeleine
,
P.
,
Chambat
,
P.
, and
Neyret
,
P.
, Société Française d’Arthroscopie, 2003, “
A Comparative Study of Medial Versus Lateral Arthroscopic Partial Meniscectomy on Stable Knees: 10-Year Minimum Follow-up
,”
Arthroscopy: J. Relat. Surg.
,
19
(
8
), pp.
842
849
.
46.
McNicholas
,
M. J.
,
Rowley
,
D. I.
,
McGurty
,
D.
,
Adalberth
,
T.
,
Abdon
,
P.
,
Lindstrand
,
A.
, and
Lohmander
,
L. S.
, 2000, “
Total Meniscectomy in Adolescent: A Thirty-Year Follow-up
,”
J. Bone Jt. Surg. Br. Vol.
,
82
(
2
), pp.
217
221
.
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