The effect of distance between holes on the structural stability of subchondral bone in microfracture surgery: a finite element model study
| Autor: | Byoung-Hyun Min, Xiang Yun Yin, Do Young Park, Hye Jung Ahn, Young Jick Kim, Seung-Hyun Yoo |
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| Rok vydání: | 2020 |
| Předmět: |
Cartilage
Articular X-ray microtomography lcsh:Diseases of the musculoskeletal system Fractures Stress Arthroplasty Subchondral Finite Element Analysis Stress (mechanics) 03 medical and health sciences 0302 clinical medicine Rheumatology Medicine von Mises yield criterion Humans Orthopedics and Sports Medicine 030203 arthritis & rheumatology 030222 orthopedics business.industry Cartilage X-Ray Microtomography Finite element method medicine.anatomical_structure Subchondral bone Structural stability Fibrocartilage lcsh:RC925-935 business Biomedical engineering Research Article |
| Zdroj: | BMC Musculoskeletal Disorders BMC Musculoskeletal Disorders, Vol 21, Iss 1, Pp 1-7 (2020) |
| ISSN: | 1471-2474 |
| Popis: | Background Microfracture is a surgical technique that involves creating multiple holes of 3–4 mm depth in the subchondral bone to recruit stem cells in the bone marrow to the lesion, inducing fibrocartilage repair and knee cartilage regeneration. Recently, it has been reported that increasing the exposed area of the lower cartilaginous bone (drilling a lot of holes) increases the outflow of stem cells, which is expected to affect the physical properties of the subchondral bone when the exposed area is large. The purpose of this study was to analyse the effect of the distance between the holes in the microfracture procedure on the structural stability of the osteochondral bone using a finite element method. Methods In this study, lateral aspects of the femoral knee, which were removed during total knee arthroplasty were photographed using microtomography. The model was implemented using a solitary walks program, which is a three-dimensional simplified geometric representation based on the basic microtomography data. A microfracture model was created by drilling 4 mm-deep holes at 1, 1.5, 2, 2.5, 3, 4, and 5 mm intervals in a simplified three-dimensional (3D) geometric femoral model. The structural stability of these models was analysed with the ABAQUS program. We compared the finite element model (FEM) based on the microtomography image and the simplified geometric finite element model. Results Von Mises stress of the subchondral bone plate barely increased, even when the distance between holes was set to 1 mm. Altering the distance between the holes had little impact on the structural stability of the subchondral bone plate. Safety factors were all below 1. Conclusions Although we did not confirm an optimal distance between holes, this study does provide reference data and an epidemiological basis for determining the optimal distance between the holes used in the microfracture procedure. |
| Databáze: | OpenAIRE |
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