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Mechanics and Growth of Articular Cartilage Around a Localized Metal Implant
KTH, School of Engineering Sciences (SCI), Mechanics, Biomechanics.
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Articular cartilage is a specialized connective soft tissue that resides on the ends of long-bones, and transfers the load smoothly between the bones in diarthrodial joints by providing almost frictionless, wear resistant sliding surfaces during joint articulation. Focal chondral or osteochondral defects in articular cartilage are common and show limited capacity for biological repair. Furthermore, changes in the bio-mechanical forces at the defect site may make the tissue more susceptible to continued degeneration. Alternatively, a contoured focal resurfacing metal implant can be used to treat such full-thickness cartilage defects. Physiological and biomechanical studies on animal models with metal implant have shown good clinical outcomes. However, the mechanical behavior of cartilage surrounding the implant has remained largely unanswered with respect to the joint function.

First, we developed a simple 3-dimensional finite element model by approximating one of the condyles of a sheep knee joint and parametrically studied the effects of shape, size and positioning of the implant on the mechanical behavior of the cartilage surrounding the implant. The mechanical sealing effect due to the wedge shape of the implant was studied. We also simulated the time dependent behavior of the cartilage surrounding the implant. In the second part, we developed a more sophisticated model accounting for biological growth aspects of the cartilage around the implant together with the in vivo mechanical response of the cartilage in an intact human knee joint. An axisymmetric representation of a human knee condyle including both cartilage layers, meniscus and tibia was considered. A cartilage growth finite element model incorporating dynamic loading from walking, which drives the growth stimulation in the cartilage, was developed. Two individually growing constituents in the solid matrix of cartilage together with the biphasic contacts in the joint were considered in the growth model. From our simulations it is evident that the cartilage near the implant was more stimstimulated, whence the defect edge of the cartilage was growing onto the implant.

The models developed in the present work are simulation tools and have a potential, in relevant aspects, to predict the physiological behavior of the cartilage surrounding the metal implant.

Place, publisher, year, edition, pages
Stockholm: KTH Royal Institute of Technology, 2013. , x, 48 p.
Series
Trita-MEK, ISSN 0348-467X ; 2013:08
Keyword [en]
finite element analysis, articular cartilage defects, growth, knee, focal knee resurfacing, metal implant, poroelastic, porohyperelastic, biphasic
National Category
Applied Mechanics
Identifiers
URN: urn:nbn:se:kth:diva-121573ISBN: 978-91-7501-720-4 (print)OAI: oai:DiVA.org:kth-121573DiVA: diva2:619130
Public defence
2013-05-22, F3, Lindstedtsvägen 26, Lindstedtsvägen 26, KTH, Stockholm, 10:00 (English)
Opponent
Supervisors
Note

QC 20130502

Available from: 2013-05-02 Created: 2013-05-02 Last updated: 2013-05-08Bibliographically approved
List of papers
1. Finite element simulations of a focal knee resurfacing implant applied to localized cartilage defects in a sheep model
Open this publication in new window or tab >>Finite element simulations of a focal knee resurfacing implant applied to localized cartilage defects in a sheep model
2011 (English)In: Journal of Biomechanics, ISSN 0021-9290, E-ISSN 1873-2380, Vol. 44, no 5, 794-801 p.Article in journal (Refereed) Published
Abstract [en]

Articular resurfacing metal implants have recently been tested in animal models to treat full thickness localized articular cartilage defects, showing promising results. However, the mechanical behavior of cartilage surrounding the metal implant has not been studied yet as it is technically challenging to measure in vivo contact areas, pressures, stresses and deformations from the metal implant. Therefore, we implemented a detailed numerical finite element model by approximating one of the condyles of the sheep tibiofemoral joint and created a defect of specific size to accommodate the implant. Using this model, the mechanical behavior of the surrounding of metal implant was studied. The model showed that the metal implant plays a significant role in the force transmission. Two types of profiles were investigated for metal implant. An implant with a double-curved profile, i.e., a profile fully congruent with the articular surfaces in the knee, gives lower contact pressures and stresses at the rim of the defect than the implant with unicurved spherical profile. The implant should be placed at a certain distance into the cartilage to avoid damage to opposing biological surface. Too deep positions, however, lead to high shear stresses in the cartilage edges around the implant. Mechanical sealing was achieved with a wedge shape of the implant, also useful for biochemical sealing of cartilage edges at the defect.

Keyword
Articular cartilage, Implant, Finite element analysis, Poroelastic, Biphasic, Knee, Sheep
National Category
Other Materials Engineering
Identifiers
urn:nbn:se:kth:diva-26394 (URN)10.1016/j.jbiomech.2010.12.026 (DOI)000288925800002 ()2-s2.0-79952034335 (Scopus ID)
Note

QC 20120328. Updated from submitted to published. Previous title: "Finite element simulation of a focal knee resurfacing implant applied to localized cartilage defects in a sheep model"

Available from: 2010-11-25 Created: 2010-11-25 Last updated: 2017-12-12Bibliographically approved
2. Time-dependent behavior of cartilage surrounding a metal implant for full-thickness cartilage defects of various sizes: a finite element study
Open this publication in new window or tab >>Time-dependent behavior of cartilage surrounding a metal implant for full-thickness cartilage defects of various sizes: a finite element study
2012 (English)In: Biomechanics and Modeling in Mechanobiology, ISSN 1617-7959, E-ISSN 1617-7940, Vol. 11, no 5, 731-742 p.Article in journal (Refereed) Published
Abstract [en]

Recently, physiological and biomechanical studies on animal models with metal implants filling full-thickness cartilage defects have resulted in good clinical outcomes. The knowledge of the time-dependent macroscopic behavior of cartilage surrounding the metal implant is essential for understanding the joint function after treating such defects. We developed a model to investigate the in vivo time-dependent behavior of the tibiofemoral cartilages surrounding the metal implant, when the joint is subjected to an axial load for various defect sizes. Results show that time-dependent effects on cartilage behavior are significant, and can be simulated. These effects should be considered when evaluating the results from an implant. In particular, the depth into the cartilage where an implant is positioned and the mechanical sealing due to solidification of the poroelastic material need a time aspect. We found the maximal deformations, contact pressures and contact forces in the joint with time for the implant positioned in flush and sunk 0.3 mm into the cartilage. The latter position gives the better joint performance. The results after 60 s may be treated as the primary results, reflecting the effect of accumulation in the joint due to repeated short-time loadings. The wedge-shaped implant showed beneficial in providing mechanical sealing of cartilages surrounding the implant with time.

Keyword
Cartilage defects, Finite element modeling, Knee, Metal implant, Poroelastic, Sheep
National Category
Other Materials Engineering
Identifiers
urn:nbn:se:kth:diva-26502 (URN)10.1007/s10237-011-0346-7 (DOI)000303378200012 ()2-s2.0-84861096730 (Scopus ID)
Note
QC 20120628Available from: 2010-11-25 Created: 2010-11-25 Last updated: 2017-12-12Bibliographically approved
3. Modeling of articular cartilage growth around localized defect-filling metal implant
Open this publication in new window or tab >>Modeling of articular cartilage growth around localized defect-filling metal implant
(English)In: Journal of Biomechanical Engineering, ISSN 0148-0731, E-ISSN 1528-8951Article in journal (Other academic) Submitted
National Category
Applied Mechanics
Identifiers
urn:nbn:se:kth:diva-121569 (URN)
Note

QCR 20161212

Available from: 2013-05-02 Created: 2013-05-02 Last updated: 2017-12-06Bibliographically approved
4. Modeling of constrained articular cartilage growth in an intact knee with focal knee resurfacing metal implant
Open this publication in new window or tab >>Modeling of constrained articular cartilage growth in an intact knee with focal knee resurfacing metal implant
2014 (English)In: Biomechanics and Modeling in Mechanobiology, ISSN 1617-7959, E-ISSN 1617-7940, Vol. 13, no 3, 599-613 p.Article in journal (Refereed) Published
Abstract [en]

The purpose of the present study was to develop a model to simulate the articular cartilage growth in an intact knee model with a metal implant replacing a degenerated portion of the femoral cartilage. The human knee joint was approximated with a simplified axisymmetric shape of the femoral condyle along with the cartilage, meniscus and bones. Two individually growing constituents (proteoglycans and collagen) bound to solid matrix were considered in the solid phase of the cartilage. The cartilage behavior was modeled with a nonlinear biphasic porohyperelastic material model, and meniscus with a transversely isotropic linear biphasic poroelastic material model. Two criteria (permeation and shear), both driven by mechanical loading, were considered to trigger the growth in the solid constituents. Mechanical loading with sixty heavy cycles was considered to represent daily walking activity. The growth algorithm was implemented for 90 days after implantation. The results from simulations show that both cartilage layers were more stimulated near the implant which lead to more growth of the cartilage near the defect. The method developed in the present work could be a powerful technique if more accurate material data and growth laws were available.

Keyword
Biphasic porohyperelastic, Finite element model, Cartilage growth, Cartilage defects, Metal implant, Knee resurfacing
National Category
Applied Mechanics
Identifiers
urn:nbn:se:kth:diva-121572 (URN)10.1007/s10237-013-0521-0 (DOI)000335722900010 ()2-s2.0-84905583151 (Scopus ID)
Note

QC 20140609

Available from: 2013-05-02 Created: 2013-05-02 Last updated: 2017-12-06Bibliographically approved

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