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Sci Rep. 2016 Nov 29;6:37538. doi: 10.1038/srep37538.

Quantitative Evaluation of the Mechanical Risks Caused by Focal Cartilage Defects in the Knee.

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Department of Applied Physics, University of Eastern Finland, POB 1627, FI-70211 Kuopio, Finland.
Cancer Center, Kuopio University Hospital, POB 100, FI-70029 KUH, Kuopio, Finland.
Department of Orthopaedics, Traumatology and Hand Surgery, Kuopio University Hospital, POB 100, FI-70029 KUH, Kuopio, Finland.
Hospital Mehiläinen, FI-00260, Helsinki, Finland.
Diagnostic Imaging Center, Kuopio University Hospital, POB 100, FI-70029 KUH, Kuopio, Finland.


Focal cartilage lesions can proceed to severe osteoarthritis or remain unaltered even for years. A method to identify high risk defects would be of utmost importance to guide clinical decision making and to identify the patients that are at the highest risk for the onset and progression of osteoarthritis. Based on cone beam computed tomography arthrography, we present a novel computational model for evaluating changes in local mechanical responses around cartilage defects. Our model, based on data obtained from a human knee in vivo, demonstrated that the most substantial alterations around the defect, as compared to the intact tissue, were observed in minimum principal (compressive) strains and shear strains. Both strain values experienced up to 3-fold increase, exceeding levels previously associated with chondrocyte apoptosis and failure of collagen crosslinks. Furthermore, defects at the central regions of medial tibial cartilage with direct cartilage-cartilage contact were the most vulnerable to loading. Also locations under the meniscus experienced substantially increased minimum principal strains. We suggest that during knee joint loading particularly minimum principal and shear strains are increased above tissue failure limits around cartilage defects which might lead to osteoarthritis. However, this increase in strains is highly location-specific on the joint surface.

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