Skip to main content
Erschienen in: Archives of Orthopaedic and Trauma Surgery 3/2011

01.03.2011 | Basic Science

Effects of a surface matching articular resurfacing device on tibiofemoral contact pressure: results from continuous dynamic flexion–extension cycles

verfasst von: Christoph Becher, Roland Huber, Hajo Thermann, Lavinia Ezechieli, Sven Ostermeier, Matthias Wellmann, Gobert von Skrbensky

Erschienen in: Archives of Orthopaedic and Trauma Surgery | Ausgabe 3/2011

Einloggen, um Zugang zu erhalten

Abstract

Introduction

The application of a defect-size metal implant for the treatment of focal articular cartilage lesions of the femoral condyle is of potential concern resulting in cartilage damage to opposing biological structures. This in vitro study aims to determine the tibiofemoral contact pressure with a contoured articular partial femoral resurfacing device under continuous dynamic pressure loads.

Methods

Peak and area contact pressures were determined in eight fresh-frozen cadaveric specimens using a pressure-sensitive sensor placed in the medial compartment above the menisci. All knees were tested in the untreated condition and after implantation of the prosthetic device in the weight-bearing area of the medial femoral condyle. A robotic knee simulator was used to test each knee under continuous pressure load for 400 s during 40 dynamic knee bending cycles (5°–45° flexion) with body weight ground reaction force (GRF). The GRF was adjusted to the living body weight of the cadaver donor and maintained throughout all cycles.

Results

Comparison of the untreated condition to focal inlay resurfacing showed no statistically significant differences (P ≤ 0.05) between all testing conditions. The average maximum peak contact pressure across all 40 flexion cycles increased by 5.1% after resurfacing compared to the untreated knees. The average area contact pressure essentially stayed the same (+0.9%).

Conclusion

The data suggest that resurfacing with the contoured articular prosthetic device does not pose any immediate deleterious effects to the opposing surfaces based on peak and area contact pressure in a continuous dynamic in vitro application. However, long-term in vivo effects remain to be evaluated.
Literatur
1.
Zurück zum Zitat Becher C, Heyse TJ, Kron N, Ostermeier S, Hurschler C, Schofer MD, Fuchs-Winkelmann S, Tibesku CO (2009) Posterior stabilized TKA reduce patellofemoral contact pressure compared with cruciate retaining TKA in vitro. Knee Surg Sports Traumatol Arthrosc 17:1159–1165CrossRefPubMed Becher C, Heyse TJ, Kron N, Ostermeier S, Hurschler C, Schofer MD, Fuchs-Winkelmann S, Tibesku CO (2009) Posterior stabilized TKA reduce patellofemoral contact pressure compared with cruciate retaining TKA in vitro. Knee Surg Sports Traumatol Arthrosc 17:1159–1165CrossRefPubMed
2.
Zurück zum Zitat Becher C, Huber R, Thermann H, Paessler HH, Skrbensky G (2008) Effects of a contoured articular prosthetic device on tibiofemoral peak contact pressure: a biomechanical study. Knee Surg Sports Traumatol Arthrosc 16:56–63CrossRefPubMed Becher C, Huber R, Thermann H, Paessler HH, Skrbensky G (2008) Effects of a contoured articular prosthetic device on tibiofemoral peak contact pressure: a biomechanical study. Knee Surg Sports Traumatol Arthrosc 16:56–63CrossRefPubMed
3.
Zurück zum Zitat Beck PR, Thomas AL, Farr J, Lewis PB, Cole BJ (2005) Trochlear contact pressures after anteromedialization of the tibial tubercle. Am J Sports Med 33:1710–1715CrossRefPubMed Beck PR, Thomas AL, Farr J, Lewis PB, Cole BJ (2005) Trochlear contact pressures after anteromedialization of the tibial tubercle. Am J Sports Med 33:1710–1715CrossRefPubMed
4.
Zurück zum Zitat Bingham JT, Papannagari R, Van de Velde SK, Gross C, Gill TJ, Felson DT, Rubash HE, Li G (2008) In vivo cartilage contact deformation in the healthy human tibiofemoral joint. Rheumatology (Oxford) 47:1622–1627CrossRef Bingham JT, Papannagari R, Van de Velde SK, Gross C, Gill TJ, Felson DT, Rubash HE, Li G (2008) In vivo cartilage contact deformation in the healthy human tibiofemoral joint. Rheumatology (Oxford) 47:1622–1627CrossRef
5.
Zurück zum Zitat Bobic V (1996) Arthroscopic osteochondral autograft transplantation in anterior cruciate ligament reconstruction: a preliminary clinical study. Knee Surg Sports Traumatol Arthrosc 3:262–264CrossRefPubMed Bobic V (1996) Arthroscopic osteochondral autograft transplantation in anterior cruciate ligament reconstruction: a preliminary clinical study. Knee Surg Sports Traumatol Arthrosc 3:262–264CrossRefPubMed
6.
Zurück zum Zitat Brittberg M, Lindahl A, Nilsson A, Ohlsson C, Isaksson O, Peterson L (1994) Treatment of deep cartilage defects in the knee with autologous chondrocyte transplantation. N Engl J Med 331:889–895CrossRefPubMed Brittberg M, Lindahl A, Nilsson A, Ohlsson C, Isaksson O, Peterson L (1994) Treatment of deep cartilage defects in the knee with autologous chondrocyte transplantation. N Engl J Med 331:889–895CrossRefPubMed
7.
Zurück zum Zitat Brown TD, Pope DF, Hale JE, Buckwalter JA, Brand RA (1991) Effects of osteochondral defect size on cartilage contact stress. J Orthop Res 9:559–567CrossRefPubMed Brown TD, Pope DF, Hale JE, Buckwalter JA, Brand RA (1991) Effects of osteochondral defect size on cartilage contact stress. J Orthop Res 9:559–567CrossRefPubMed
8.
Zurück zum Zitat Cicuttini F, Ding C, Wluka A, Davis S, Ebeling PR, Jones G (2005) Association of cartilage defects with loss of knee cartilage in healthy, middle-age adults: a prospective study. Arthritis Rheum 52:2033–2039CrossRefPubMed Cicuttini F, Ding C, Wluka A, Davis S, Ebeling PR, Jones G (2005) Association of cartilage defects with loss of knee cartilage in healthy, middle-age adults: a prospective study. Arthritis Rheum 52:2033–2039CrossRefPubMed
9.
Zurück zum Zitat Curl WW, Krome J, Gordon ES, Rushing J, Smith BP, Poehling GG (1997) Cartilage injuries: a review of 31, 516 knee arthroscopies. Arthroscopy 13:456–460CrossRefPubMed Curl WW, Krome J, Gordon ES, Rushing J, Smith BP, Poehling GG (1997) Cartilage injuries: a review of 31, 516 knee arthroscopies. Arthroscopy 13:456–460CrossRefPubMed
10.
Zurück zum Zitat Custers RJ, Creemers LB, van Rijen MH, Verbout AJ, Saris DB, Dhert WJ (2009) Cartilage damage caused by metal implants applied for the treatment of established localized cartilage defects in a rabbit model. J Orthop Res 27:84–90CrossRefPubMed Custers RJ, Creemers LB, van Rijen MH, Verbout AJ, Saris DB, Dhert WJ (2009) Cartilage damage caused by metal implants applied for the treatment of established localized cartilage defects in a rabbit model. J Orthop Res 27:84–90CrossRefPubMed
11.
Zurück zum Zitat Custers RJ, Dhert WJ, van Rijen MH, Verbout AJ, Creemers LB, Saris DB (2007) Articular damage caused by metal plugs in a rabbit model for treatment of localized cartilage defects. Osteoarthr Cartil 15:937–945CrossRefPubMed Custers RJ, Dhert WJ, van Rijen MH, Verbout AJ, Creemers LB, Saris DB (2007) Articular damage caused by metal plugs in a rabbit model for treatment of localized cartilage defects. Osteoarthr Cartil 15:937–945CrossRefPubMed
12.
Zurück zum Zitat Custers RJ, Saris DB, Dhert WJ, Verbout AJ, van Rijen MH, Mastbergen SC, Lafeber FP, Creemers LB (2009) Articular cartilage degeneration following the treatment of focal cartilage defects with ceramic metal implants and compared with microfracture. J Bone Joint Surg Am 91:900–910CrossRefPubMed Custers RJ, Saris DB, Dhert WJ, Verbout AJ, van Rijen MH, Mastbergen SC, Lafeber FP, Creemers LB (2009) Articular cartilage degeneration following the treatment of focal cartilage defects with ceramic metal implants and compared with microfracture. J Bone Joint Surg Am 91:900–910CrossRefPubMed
13.
Zurück zum Zitat Eckstein F, Lemberger B, Gratzke C, Hudelmaier M, Glaser C, Englmeier KH, Reiser M (2005) In vivo cartilage deformation after different types of activity and its dependence on physical training status. Ann Rheum Dis 64:291–295CrossRefPubMed Eckstein F, Lemberger B, Gratzke C, Hudelmaier M, Glaser C, Englmeier KH, Reiser M (2005) In vivo cartilage deformation after different types of activity and its dependence on physical training status. Ann Rheum Dis 64:291–295CrossRefPubMed
14.
Zurück zum Zitat Guettler JH, Demetropoulos CK, Yang KH, Jurist KA (2004) Osteochondral defects in the human knee: influence of defect size on cartilage rim stress and load redistribution to surrounding cartilage. Am J Sports Med 32:1451–1458CrossRefPubMed Guettler JH, Demetropoulos CK, Yang KH, Jurist KA (2004) Osteochondral defects in the human knee: influence of defect size on cartilage rim stress and load redistribution to surrounding cartilage. Am J Sports Med 32:1451–1458CrossRefPubMed
15.
Zurück zum Zitat Hangody L, Fules P (2003) Autologous osteochondral mosaicplasty for the treatment of full-thickness defects of weight-bearing joints: ten years of experimental and clinical experience. J Bone Joint Surg Am A 85(Suppl 2):25–32 Hangody L, Fules P (2003) Autologous osteochondral mosaicplasty for the treatment of full-thickness defects of weight-bearing joints: ten years of experimental and clinical experience. J Bone Joint Surg Am A 85(Suppl 2):25–32
16.
Zurück zum Zitat Hangody L, Kish G, Karpati Z, Udvarhelyi I, Szigeti I, Bely M (1998) Mosaicplasty for the treatment of articular cartilage defects: application in clinical practice. Orthopedics 21:751–756PubMed Hangody L, Kish G, Karpati Z, Udvarhelyi I, Szigeti I, Bely M (1998) Mosaicplasty for the treatment of articular cartilage defects: application in clinical practice. Orthopedics 21:751–756PubMed
17.
Zurück zum Zitat Herberhold C, Stammberger T, Faber S, Putz R, Englmeier KH, Reiser M, Eckstein F (1998) An MR-based technique for quantifying the deformation of articular cartilage during mechanical loading in an intact cadaver joint. Magn Reson Med 39:843–850CrossRefPubMed Herberhold C, Stammberger T, Faber S, Putz R, Englmeier KH, Reiser M, Eckstein F (1998) An MR-based technique for quantifying the deformation of articular cartilage during mechanical loading in an intact cadaver joint. Magn Reson Med 39:843–850CrossRefPubMed
18.
Zurück zum Zitat Hjelle K, Solheim E, Strand T, Muri R, Brittberg M (2002) Articular cartilage defects in 1,000 knee arthroscopies. Arthroscopy 18:730–734CrossRefPubMed Hjelle K, Solheim E, Strand T, Muri R, Brittberg M (2002) Articular cartilage defects in 1,000 knee arthroscopies. Arthroscopy 18:730–734CrossRefPubMed
19.
Zurück zum Zitat Jackson DW, Lalor PA, Aberman HM, Simon TM (2001) Spontaneous repair of full-thickness defects of articular cartilage in a goat model. A preliminary study. J Bone Joint Surg Am 83-A:53–64PubMed Jackson DW, Lalor PA, Aberman HM, Simon TM (2001) Spontaneous repair of full-thickness defects of articular cartilage in a goat model. A preliminary study. J Bone Joint Surg Am 83-A:53–64PubMed
20.
Zurück zum Zitat Kirker-Head CA, Van Sickle DC, Ek SW, McCool JC (2006) Safety of, and biological and functional response to, a novel metallic implant for the management of focal full-thickness cartilage defects: preliminary assessment in an animal model out to 1 year. J Orthop Res 24:1095–1108CrossRefPubMed Kirker-Head CA, Van Sickle DC, Ek SW, McCool JC (2006) Safety of, and biological and functional response to, a novel metallic implant for the management of focal full-thickness cartilage defects: preliminary assessment in an animal model out to 1 year. J Orthop Res 24:1095–1108CrossRefPubMed
21.
Zurück zum Zitat Kreuz PC, Erggelet C, Steinwachs MR, Krause SJ, Lahm A, Niemeyer P, Ghanem N, Uhl M, Sudkamp N (2006) Is microfracture of chondral defects in the knee associated with different results in patients aged 40 years or younger? Arthroscopy 22:1180–1186CrossRefPubMed Kreuz PC, Erggelet C, Steinwachs MR, Krause SJ, Lahm A, Niemeyer P, Ghanem N, Uhl M, Sudkamp N (2006) Is microfracture of chondral defects in the knee associated with different results in patients aged 40 years or younger? Arthroscopy 22:1180–1186CrossRefPubMed
22.
Zurück zum Zitat Lee SJ, Aadalen KJ, Malaviya P, Lorenz EP, Hayden JK, Farr J, Kang RW, Cole BJ (2006) Tibiofemoral contact mechanics after serial medial meniscectomies in the human cadaveric knee. Am J Sports Med 34:1334–1344CrossRefPubMed Lee SJ, Aadalen KJ, Malaviya P, Lorenz EP, Hayden JK, Farr J, Kang RW, Cole BJ (2006) Tibiofemoral contact mechanics after serial medial meniscectomies in the human cadaveric knee. Am J Sports Med 34:1334–1344CrossRefPubMed
23.
Zurück zum Zitat Mithoefer K, Williams RJ 3rd, Warren RF, Potter HG, Spock CR, Jones EC, Wickiewicz TL, Marx RG (2005) The microfracture technique for the treatment of articular cartilage lesions in the knee. A prospective cohort study. J Bone Joint Surg Am 87:1911–1920CrossRefPubMed Mithoefer K, Williams RJ 3rd, Warren RF, Potter HG, Spock CR, Jones EC, Wickiewicz TL, Marx RG (2005) The microfracture technique for the treatment of articular cartilage lesions in the knee. A prospective cohort study. J Bone Joint Surg Am 87:1911–1920CrossRefPubMed
24.
Zurück zum Zitat Nehrer S, Domayer S, Dorotka R, Schatz K, Bindreiter U, Kotz R (2006) Three-year clinical outcome after chondrocyte transplantation using a hyaluronan matrix for cartilage repair. Eur J Radiol 57:3–8CrossRefPubMed Nehrer S, Domayer S, Dorotka R, Schatz K, Bindreiter U, Kotz R (2006) Three-year clinical outcome after chondrocyte transplantation using a hyaluronan matrix for cartilage repair. Eur J Radiol 57:3–8CrossRefPubMed
25.
Zurück zum Zitat O’Driscoll SW (1998) The healing and regeneration of articular cartilage. J Bone Joint Surg Am 80:1795–1812PubMed O’Driscoll SW (1998) The healing and regeneration of articular cartilage. J Bone Joint Surg Am 80:1795–1812PubMed
26.
Zurück zum Zitat Pena E, Calvo B, Martinez MA, Doblare M (2007) Effect of the size and location of osteochondral defects in degenerative arthritis. A finite element simulation. Comput Biol Med 37:376–387CrossRefPubMed Pena E, Calvo B, Martinez MA, Doblare M (2007) Effect of the size and location of osteochondral defects in degenerative arthritis. A finite element simulation. Comput Biol Med 37:376–387CrossRefPubMed
27.
Zurück zum Zitat Peterson L, Brittberg M, Kiviranta I, Akerlund EL, Lindahl A (2002) Autologous chondrocyte transplantation. Biomechanics and long-term durability. Am J Sports Med 30:2–12PubMed Peterson L, Brittberg M, Kiviranta I, Akerlund EL, Lindahl A (2002) Autologous chondrocyte transplantation. Biomechanics and long-term durability. Am J Sports Med 30:2–12PubMed
28.
Zurück zum Zitat Steadman JR, Rodkey WG, Rodrigo JJ (2001) Microfracture: surgical technique and rehabilitation to treat chondral defects. Clin Orthop 391:S362–S369CrossRefPubMed Steadman JR, Rodkey WG, Rodrigo JJ (2001) Microfracture: surgical technique and rehabilitation to treat chondral defects. Clin Orthop 391:S362–S369CrossRefPubMed
29.
Zurück zum Zitat Tondu B, Lopez P (2000) Modeling and control of McKibben artificial muscle robot actuators. IEEE Control Syst 20:15–38CrossRef Tondu B, Lopez P (2000) Modeling and control of McKibben artificial muscle robot actuators. IEEE Control Syst 20:15–38CrossRef
30.
Zurück zum Zitat von Skrbensky G, Huber R (2006) Vienna 2.2 knee joint simulator for long-term in vitro testing. J Biomech 39:S50 von Skrbensky G, Huber R (2006) Vienna 2.2 knee joint simulator for long-term in vitro testing. J Biomech 39:S50
31.
Zurück zum Zitat Wang Y, Ding C, Wluka AE, Davis S, Ebeling PR, Jones G, Cicuttini FM (2006) Factors affecting progression of knee cartilage defects in normal subjects over 2 years. Rheumatology (Oxf) 45:79–84CrossRef Wang Y, Ding C, Wluka AE, Davis S, Ebeling PR, Jones G, Cicuttini FM (2006) Factors affecting progression of knee cartilage defects in normal subjects over 2 years. Rheumatology (Oxf) 45:79–84CrossRef
Metadaten
Titel
Effects of a surface matching articular resurfacing device on tibiofemoral contact pressure: results from continuous dynamic flexion–extension cycles
verfasst von
Christoph Becher
Roland Huber
Hajo Thermann
Lavinia Ezechieli
Sven Ostermeier
Matthias Wellmann
Gobert von Skrbensky
Publikationsdatum
01.03.2011
Verlag
Springer-Verlag
Erschienen in
Archives of Orthopaedic and Trauma Surgery / Ausgabe 3/2011
Print ISSN: 0936-8051
Elektronische ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-010-1201-5

Weitere Artikel der Ausgabe 3/2011

Archives of Orthopaedic and Trauma Surgery 3/2011 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.