Effects of a surface matching articular resurfacing device on tibiofemoral contact pressure: results from continuous dynamic flexion–extension cycles
- Christoph BecherAffiliated withOrthopaedic Department, Hannover Medical School Email author
- , Roland HuberAffiliated withBone and Joint Biomechanic Laboratory, Medical University of Vienna
- , Hajo ThermannAffiliated withCenter for Knee and Foot Surgery/Sports Trauma, ATOS Clinic Center
- , Lavinia EzechieliAffiliated withOrthopaedic Department, Hannover Medical School
- , Sven OstermeierAffiliated withOrthopaedic Department, Hannover Medical School
- , Matthias WellmannAffiliated withOrthopaedic Department, Hannover Medical School
- , Gobert von SkrbenskyAffiliated withBone and Joint Biomechanic Laboratory, Medical University of Vienna
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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.
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.
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%).
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.
KeywordsKnee Articular cartilage defect Tibiofemoral joint Articular prosthetic device Contact pressure Dynamic loading
- Effects of a surface matching articular resurfacing device on tibiofemoral contact pressure: results from continuous dynamic flexion–extension cycles
Archives of Orthopaedic and Trauma Surgery
Volume 131, Issue 3 , pp 413-419
- Cover Date
- Print ISSN
- Online ISSN
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- Articular cartilage defect
- Tibiofemoral joint
- Articular prosthetic device
- Contact pressure
- Dynamic loading
- Industry Sectors
- Author Affiliations
- 1. Orthopaedic Department, Hannover Medical School, Anna-von-Borries-Str. 1-7, 30625, Hannover, Germany
- 2. Bone and Joint Biomechanic Laboratory, Medical University of Vienna, Waehringergürtel 18-20, 1090, Wien, Austria
- 3. Center for Knee and Foot Surgery/Sports Trauma, ATOS Clinic Center, Bismarckstr. 9-15, 69115, Heidelberg, Germany