Knee instability caused by altered graft mechanical properties after anterior cruciate ligament reconstruction: the early onset of osteoarthritis?

Frontiers in Bioengineering and Biotechnology

Bioengineering and Biotechnology

Marloes Van den Hengel¹  Rob P. A. Janssen²  Bert Van Rietbergen³  Keita Ito³  Jasper Foolen³  Janne Spierings³ 

[1] Department of Biomedical Engineering, Orthopaedic Biomechanics, Eindhoven University of Technology, Eindhoven, Netherlands;Department of Biomedical Engineering, Orthopaedic Biomechanics, Eindhoven University of Technology, Eindhoven, Netherlands;Department of Orthopaedic Surgery and Trauma, Máxima Medical Centre Eindhoven/Veldhoven, Eindhoven, Netherlands;Department of Paramedical Sciences, Health Innovations and Technology, Fontys University of Applied Sciences, Eindhoven, Netherlands;Department of Biomedical Engineering, Orthopaedic Biomechanics, Eindhoven University of Technology, Eindhoven, Netherlands;Institute of Complex Molecular Systems, Eindhoven University of Technology, Eindhoven, Netherlands;

关键词: anterior cruciate ligament reconstruction;    graft remodeling;    knee instability;    osteoarthritis;    knee biomechanics;   

DOI  :  10.3389/fbioe.2023.1244954

 received in 2023-06-23, accepted in 2023-08-15,  发布年份 2023

来源: Frontiers

【 摘 要 】

Anterior cruciate ligament (ACL) rupture is a very common knee joint injury. Torn ACLs are currently reconstructed using tendon autografts. However, half of the patients develop osteoarthritis (OA) within 10 to 14 years postoperatively. Proposedly, this is caused by altered knee kine(ma)tics originating from changes in graft mechanical properties during the in vivo remodeling response. Therefore, the main aim was to use subject-specific finite element knee models and investigate the influence of decreasing graft stiffness and/or increasing graft laxity on knee kine(ma)tics and cartilage loading. In this research, 4 subject-specific knee geometries were used, and the material properties of the ACL were altered to either match currently used grafts or mimic in vivo graft remodeling, i.e., decreasing graft stiffness and/or increasing graft laxity. The results confirm that the in vivo graft remodeling process increases the knee range of motion, up to >300 percent, and relocates the cartilage contact pressures, up to 4.3 mm. The effect of remodeling-induced graft mechanical properties on knee stability exceeded that of graft mechanical properties at the time of surgery. This indicates that altered mechanical properties of ACL grafts, caused by in vivo remodeling, can initiate the early onset of osteoarthritis, as observed in many patients clinically.

【 授权许可】

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Copyright © 2023 Spierings, Van den Hengel, Janssen, Van Rietbergen, Ito and Foolen.