Effect of cartilage thickness mismatch in osteochondral grafting from knee to talus on articular contact pressures: A finite element analysis

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Abstract

Objectives

The aim of this study was to investigate the effect of cartilage thickness mismatch on tibiotalar articular contact pressure in osteochondral grafting from femoral condyles to medial talar dome using a finite element analysis (FEA).

Materials and methods

Flush-implanted osteochondral grafting was performed on the talar centromedial aspect of the dome using osteochondral plugs with two different cartilage thicknesses. One of the plugs had an equal cartilage thickness with the recipient talar cartilage and the second plug had a thicker cartilage representing a plug harvested from the knee. The ankle joint was loaded during a single-leg stance phase of gait. Tibiotalar contact pressure, frictional stress, equivalent stress (von Mises values), and deformation were analyzed.

Results

In both osteochondral grafting simulations, tibiotalar contact pressure, frictional stress, equivalent stress (von Mises values) on both tibial and talar cartilage surfaces were restored to near-normal values.

Conclusion

Cartilage thickness mismatch does not significantly change the tibiotalar contact biomechanics, when the graft is inserted flush with the talar cartilage surface.

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Most cited references 40

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Osteochondral lesions of the talus: localization and morphologic data from 424 patients using a novel anatomical grid scheme.

Adam C Zoga, W Morrison, Carrie Schweitzer … (2007)

The primary aim of this study was to evaluate the true incidence of osteochondral lesions on the talar dome by location and by morphologic characteristics on MRI. Because no universally accepted localization system for talar dome osteochondral lesions currently exists, we established a novel, nine-zone anatomical grid system on the talar dome for an accurate depiction of lesion location. We assigned nine zones to the talar dome articular surface in an equal 3 x 3 grid configuration. Zone 1 was the most anterior and medial, zone 3 was anterior and lateral, zone 7 was most posterior and medial, and zone 9 was the most posterior and lateral. The grid was designed with all nine zones being equal in surface area. Two observers reviewed MRI examinations of 428 ankles in 424 patients (211 males and 213 females; mean age 43 years; age range 6 to 85 years) with reported osteochondral talar lesions. We recorded the frequency of involvement and size of lesion for each zone. Statistical analyses were performed using ANOVA and Scheffe tests. Four hundred and twenty-eight lesions were identified on MRI. The medial talar dome was more frequently involved (n = 269, 62%) than the lateral talar dome (n = 143, 34%). In the AP direction, the mid talar dome (equator) was much more frequently involved (n = 345, 80%) than the anterior (n = 25, 6%) or posterior (n = 58, 14%) thirds of the talar dome. Zone 4 (medial and mid) was most frequently involved (n = 227, 53%), and zone 6 (lateral and mid) was second most frequently involved (n=110, 26%). Lesions in the medial third of the talar dome were significantly larger in surface area involvement and deeper than those at the lateral talar dome. Our established nine-grid scheme is a useful tool for localizing and characterizing osteochondral talar lesions, which are most frequently located in zone 4 at the medial talar dome, and second most in zone 6 at the lateral talar dome near its equator. Medial talar dome lesions are not only more common but are larger in surface area and in depth than lateral lesions. Posteromedial and anterolateral lesions rarely were found.

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Osteochondral lesion of the talus: is there a critical defect size for poor outcome?

Woo Choi, Kwan-Kyu Park, Bom Soo Kim … (2009)

Identifying factors associated with favorable or unfavorable outcomes would provide patients with accurate expectations of the arthroscopic marrow stimulation techniques.

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Comparison of biomechanical and biochemical properties of cartilage from human knee and ankle pairs.

H Koepp, S Treppo, Shelley A. Cole … (2000)

Cartilage was obtained from eight matched knee (tibiofemoral and femoropatellar) and ankle (talocrural) joints of five different donors (both left and right from donors 14, 22, and 38 years of age, and left only from donors 31 and 45 years of age) within 24 hours of death. All cartilage was graded as normal by the macroscopic visual Collins' scale and the histological Mankin scale. Cylindrical disks of cartilage were harvested from 10 sites within the tibiofemoral and femoropatellar joint surfaces and four sites within the talocrural joint, and uniaxial confined compression measurements were performed to quantify a spectrum of physical properties including the equilibrium modulus, hydraulic permeability, dynamic stiffness, streaming potential, electrokinetic coupling coefficient, and electrical conductivity. Matched specimens from the same 14 sites were used for complementary measurements of biochemical composition and molecular interaction, including water content, hypotonic swelling behavior, and sulfated glycosaminoglycan and collagen contents. In comparison of the top 1-mm slices of talar cartilage with the top 1-mm of tibiofemoral cartilage, the talar cartilage appeared denser with a higher sulfated glycosaminoglycan content, lower water content, higher equilibrium modulus and dynamic stiffness, and lower hydraulic permeability. The equilibrium modulus increased with increasing sulfated glycosaminoglycans per wet weight and decreased with increasing water content for all joint surfaces. Multiple linear regression showed that greater than 80% of the variation in the equilibrium modulus could be accounted for by variations in the biochemical parameters (water content, sulfated glycosaminoglycans/wet weight, and hydroxyproline content/wet weight) for each joint surface. Nonhomogeneous depth-dependent changes in the physical properties and biochemical composition of full-thickness distal femoral cartilage were consistent with previous reports. Since the compressive deformation of cartilage during cyclic loading is confined to the more superficial regions, the differences in properties of the upper regions of the talar compared with tibiofemoral or femoropatellar cartilage may be important in the etiology of osteoarthritis.

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Author and article information

Journal

Journal ID (nlm-ta): Jt Dis Relat Surg

Journal ID (iso-abbrev): Jt Dis Relat Surg

Journal ID (pmc): jt_dis_relat_surg_pmc

Title: Joint Diseases and Related Surgery

Publisher: Bayçınar Medical Publishing

ISSN (Print): 2687-4784

ISSN (Electronic): 2687-4792

Publication date Collection: August 2021

Publication date (Electronic): 11 June 2021

Volume: 32

Issue: 2

Pages: 355-362

Affiliations

[1 ] Department of Orthopedics and Traumatology, HSU, Antalya Training and Research Hospital, Antalya, Turkey

[2 ] Department of Orthopedics and Traumatology, HSU, Şanlıurfa Mehmet Akif Inan Training and Research Hospital, Şanlıurfa, Turkey

[3 ] Department of Agricultural Machinery and Technology Engineering, Akdeniz University, Antalya, Turkey

[4 ] Department of Orthopedics and Traumatology, HSU, Ankara Keçiören Training and Research Hospital, Ankara, Turkey

[5 ] Department of Engineering, Lancaster University, Lancaster, United Kingdom

Author notes

Özkan Köse, MD. Sağlık Bilimleri Üniversitesi, Antalya Eğitim ve Araştırma Hastanesi Ortopedi ve Travmatoloji Kliniği, 07100 Muratpaşa, Antalya, Türkiye. drozkankose@ 123456hotmail.com .

Author information

Ömer Faruk Kılıçaslan http://orcid.org/0000-0001-6716-4542

Ali Levent http://orcid.org/0000-0002-3666-1084

Hüseyin Kürşat Çelik http://orcid.org/0000-0001-8154-6993

Mehmet Ali Tokgöz http://orcid.org/0000-0002-4056-3743

Özkan Köse http://orcid.org/0000-0002-7679-9635

Allan E. W. Rennie http://orcid.org/0000-0003-4568-316X

Article

DOI: 10.52312/jdrs.2021.41

PMC ID: 8343842

PubMed ID: 34145811

SO-VID: 2ca84ad6-c7e9-4758-b512-27d6b5b5b96b

License:

This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

History

Date received : 08 March 2021

Date accepted : 26 April 2021

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Effect of cartilage thickness mismatch in osteochondral grafting from knee to talus on articular contact pressures: A finite element analysis

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Abstract

Objectives

Materials and methods

Results

Conclusion

Related collections

Core Readings in Statistical Mediation Analysis

Most cited references 40

Osteochondral lesions of the talus: localization and morphologic data from 424 patients using a novel anatomical grid scheme.

Osteochondral lesion of the talus: is there a critical defect size for poor outcome?

Comparison of biomechanical and biochemical properties of cartilage from human knee and ankle pairs.

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