Table Of ContentSPRINGER BRIEFS IN
APPLIED SCIENCES AND TECHNOLOGY
Zahra Trad
Abdelwahed Barkaoui
Moez Chafra
João Manuel R. S. Tavares
FEM Analysis of
the Human Knee
Joint
A Review
123
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Zahra Trad Abdelwahed Barkaoui
(cid:129)
ã
Moez Chafra Jo o Manuel R. S. Tavares
(cid:129)
FEM Analysis of the Human
Knee Joint
A Review
123
Zahra Trad MoezChafra
LR-11-ES19 Laboratoire deMécanique Laboratoire deSystèmes etdeMécanique
Appliquéeet Ingénierie (LR-MAI), Ecole Appliquée
Nationaled’IngénieursdeTunis EcolePolytechnique deTunis
UniversitédeTunisEl Manar Tunis
Tunis Tunisie
Tunisie
and
Abdelwahed Barkaoui
LR-11-ES19 Laboratoire deMécanique IPEIEM
Appliquéeet Ingénierie (LR-MAI), Ecole UniversitédeTunisEl Manar
Nationaled’IngénieursdeTunis Tunis
UniversitédeTunisEl Manar Tunisie
Tunis
Tunisie João Manuel R. S.Tavares
Instituto deCiência eInovação em
EngenhariaMecânica eEngenharia
Industrial, Departamento deEngenharia
Mecânica, FaculdadedeEngenharia
Universidade doPorto
Porto
Portugal
ISSN 2191-530X ISSN 2191-5318 (electronic)
SpringerBriefs inApplied SciencesandTechnology
ISBN978-3-319-74157-4 ISBN978-3-319-74158-1 (eBook)
https://doi.org/10.1007/978-3-319-74158-1
LibraryofCongressControlNumber:2017963858
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Without a curious mind, what would we be?
Such is the beauty and nobility
of science: an endless desire to push back
the frontiers of knowledge, to hunt down
the secrets of matter and life without
any preconceived idea of the possible
consequences.
Marie Curie
Everything I am or aspire to become, I owe it
to my mother, my angel.
These pages are a way to say thank you.
I will always thank you.
I will always love you.
With love,
Zahra Trad
Acknowledgements
The authors gratefully acknowledge the funding of Project NORTE-01-0145-
FEDER-000022—SciTech—Science and Technology for Competitive and
Sustainable Industries, co-financed by the “Programa Operacional Regional do
Norte” (NORTE2020), through the “Fundo Europeu de Desenvolvimento
Regional” (FEDER).
ix
Contents
1 Finite Element Models of the Knee Joint . . . . . . . . . . . . . . . . . . . . . 1
1.1 Knee Joint Model Geometries . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
1.2 Material Properties of Hard and Soft Tissues . . . . . . . . . . . . . . . . 6
1.2.1 Material Properties of Articular Cartilage . . . . . . . . . . . . . 7
1.2.2 Material Properties of Menisci . . . . . . . . . . . . . . . . . . . . . 10
1.2.3 Material Properties of Ligaments . . . . . . . . . . . . . . . . . . . 13
1.2.4 Material Properties of Bony Structure . . . . . . . . . . . . . . . . 19
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
2 Finite Element Analysis Applications in Biomechanical
Studies of the Knee Joint . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
2.1 Current FEA Applications on Ligament Injury . . . . . . . . . . . . . . . 35
2.2 Current FEA Applications on Meniscus Injury. . . . . . . . . . . . . . . 38
2.3 Current FEA Applications on Knee Joint Contact Analysis
and Cartilage Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
3 Overview of High Tibial Osteotomy and Optimization
of the Correction Angle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
3.1 High Tibial Osteotomy Definition . . . . . . . . . . . . . . . . . . . . . . . . 61
3.2 Current FEA Studies on the HTO Procedure . . . . . . . . . . . . . . . . 62
3.3 Current Clinical Studies on Optimizing the Correction
Angle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
3.4 Current Biomechanical Studies on Optimizing
the Correction Angle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73
4 Conclusions and Future Work . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
xi
Introduction
Biomechanicsisthestudyofthemechanicallaws relating tothemovementand/or
structureoflivingorganisms.Itoftenreferstothestudyofhumanbodyinteraction
with the environment under different conditions. Particularly, the knee joint is the
largestandmostcomplexandstressedjointinthehumanbody,comprisedofboth
thefemoro-patellarandtibiofemoraljoints.Theimportantstructureofthekneejoint
is divided into the following main tissues. The soft tissues include ligaments,
tendons,menisci,muscles,andarticularcartilages.Thebonystructure(hardtissues)
includes the femur, tibia, fibula, and patella. Owing to the bearing of very high
loads, the knee structure permits active movement for daily activities such as
walking, running, sitting, and kneeling, which produce complex mechanical
responsesundertheloadsthatoccurineverydaylife(MogloandShirazi-Adl2003;
SahuandKaviti2016;Gatcheletal.2007;Kiapouretal.2014;Biščevićetal.2005;
Zaffagnini et al. 2013).
However, excessive joint loading on the articular cartilage, as well as age,
weightbearing,meniscectomy,alignment,andjointinjury,maycausevarioustypes
of damage and lead to the initiation and progression of knee osteoarthritis (OA).
Clinical studies have revealed that an increased risk in knee OA progression with
abnormal tibiofemoral alignment most likely results from the increase of
mechanical loading at the knee joint (Andriacchi et al. 2004; Sharma et al. 2001;
Felson and Zhang 1998; Felson et al. 2000; Sowers 2001; Cooper et al. 2000;
Sharma2001;Cerejoetal.2002;EnglundandLohmander2004;Felsonetal.2004;
GriffinandGuilak2005;Krausetal.2013;Kuboetal.2009;Arokoskietal.2000).
The role of the loading axis in the progression of knee OA has been well
recognized.Clinically,theinterventionsthatmodifytheexcessiveforcesrelatedto
the position of the loading axis acting on damaged tissues, such as articular carti-
lage,havebeenappliedinrelievingOAsymptoms(Akizukietal.2008).Forknees
afflictedbymedialOAprogression,hightibialosteotomy(HTO)canbeaneffective
adjunct to conservative management of interruption of the disease’s progression
(Schallbergeretal.2011;EsenkayaandElmali2006).Bycorrectingthehip–knee–
ankle (HKA) angle, HTO shifts the mechanical load from the arthritic medial
compartment to the lateral compartment with relatively healthy cartilage.
xiii
