Abstract
BackgroundA three-dimensional finite element model (FEM) of the knee joint was established to analyze the biomechanical functions of the superficial and deep medial collateral ligaments (MCLs) of knee joints and to investigate the treatment of the knee medial collateral ligament injury.MethodsThe right knee joint of a healthy male volunteer was subjected to CT and MRI scans in the extended position. The scanned data were imported into MIMICS, Geomagic, and ANSYS software to establish a three-dimensional FEM of the human knee joint. The anterior-posterior translation, valgus-varus rotation, and internal-external rotation of knee joints were simulated to observe tibial displacement or valgus angle. In addition, the magnitude and distribution of valgus stress in the superficial and deep layers of the intact MCL as well as the superficial, deep, and overall deficiencies of the MCL were investigated.ResultsIn the extended position, the superficial medial collateral ligament (SMCL) would withstand maximum stresses of 48.63, 16.08, 17.23, and 16.08 MPa in resisting the valgus of knee joints, tibial forward displacement, internal rotation, and external rotation, respectively. Meanwhile, the maximum stress tolerated by the SMCL in various ranges of motion mainly focused on the femoral end point, which was located at the anterior and posterior parts of the femur in resisting valgus motion and external rotation, respectively. However, the deep medial collateral ligament could tolerate only minimum stress, which was mainly focused at the femoral start and end points.ConclusionsThis model can effectively analyze the biomechanical functions of the superficial and deep layers of the MCLs of knee joints. The results show that the knee MCL II° injury is the indication of surgical repair.
Highlights
A three-dimensional finite element model (FEM) of the knee joint was established to analyze the biomechanical functions of the superficial and deep medial collateral ligaments (MCLs) of knee joints and to investigate the treatment of the knee medial collateral ligament injury
Under the load of the 134-N forward force, the tibial displacement changed from 4.89 mm at intact MCL to 5.17, 5.04, and 5.17 mm at superficial medial collateral ligament (SMCL) deficiency, deep MCL (DMCL) deficiency, and overall MCL deficiency, respectively
The peak stress was maximum at SMCL and gradually decreased at DMCL, anterior cruciate ligament (ACL), and posterior cruciate ligament (PCL) (Table 4); it was mainly located at the femoral end point and anterior part at SMCL and at the femoral start and end points at DMCL (Fig. 5)
Summary
A three-dimensional finite element model (FEM) of the knee joint was established to analyze the biomechanical functions of the superficial and deep medial collateral ligaments (MCLs) of knee joints and to investigate the treatment of the knee medial collateral ligament injury. There is a high incidence of injury to the knee MCL in sports activities such as ice hockey, skiing, and soccer [2], accounting for approximately 40% of all severe knee joint injuries, 50% of which involve partial fracture while 30% involve complete fracture and injury of the knee MCL [3]. These injuries may lead to medial laxity and instability of the knee joints, as well as secondary long-term complications. This study is to evaluate the function in detail within MCL maintaining the stability of the knee joint and expects to provide evidence on how to treat the knee MCL II° injury
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