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. 2025 Jan 9;20(1):26.
doi: 10.1186/s13018-024-05401-8.

Dynamic biomechanical effects of medial meniscus tears on the knee joint: a finite element analysis

Zuming Mao  1 , Qiang Yang  1 , Xiangyu Meng  2 , Dong Jiang  3 , Feng Zhao  4
Affiliations

Dynamic biomechanical effects of medial meniscus tears on the knee joint: a finite element analysis

Zuming Mao et al. J Orthop Surg Res. .

Abstract

Background: Meniscus tears can change the biomechanical environment of the knee joint and might accelerate the development of osteoarthritis. The aim of this study was to investigate the dynamic biomechanical effects of different medial meniscus tear positions and tear gaps on the knee during walking.

Methods: Seven finite element models of the knee joint were constructed, including the intact medial meniscus (IMM), radial stable tears in the anterior, middle, and posterior one-third regions of the medial meniscus (RSTA, RSTM, RSTP), and the corresponding unstable tears (RUTA, RUTM, RUTP). The seven models applied a 1000 N axial static load and a human walking load, as defined by the ISO14243-1 standard.

Results: Compared with the results under static loading, the axial load ratio of the medial and lateral compartments was redistributed (ranging from 0.7:1 to 2.9:1). The stress concentration was in the middle and posterior portions of the lateral compartment, not in the anterior and middle portions of the medial compartment under dynamic analysis. Compared with that of the IMM, the maximum von Mises stress on the medial meniscus increased by approximately 24.68-57.14% in the RUTA, RUTM, and RSTM models, with a greater difference observed in the hoop stress on both sides of the radial tear. The peak radial tear gap appeared at GC6 and GC44, and the tear gap remained at a high level from GC30-GC60.

Conclusions: Radial tears should be considered for repair, and reinforced sutures should be placed on the anterior or middle regions of the meniscus. Greater attention should be given to the dynamic biomechanical effects on the knee joint during preoperative diagnosis and postoperative rehabilitation.

Keywords: Biomechanics; Finite element analysis; Knee; Meniscal tear.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was approved by the board of the research ethics committee in Peking University Third Hospital (IRB00006761-M2019299). The volunteer involved in the study consent to participate in the study. Consent for publication: All individual data consent to publish. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
A Front view of the constructed knee joint. B Intact medial meniscus (IMM). C Radial tears of the medial meniscus including: stable radial tears in the anterior region (RSTA), in the middle region (RSTM), and in the posterior region (RSTP); unstable radial tears in the anterior region (RUTA), in the middle region (RUTM), and in the posterior region (RUTP)
Fig. 2
Fig. 2
Axial load distribution of the knee joint. A Static analysis. B 30% of the gait cycle in the dynamic analysis (GC30). Abbreviations: MM: medial meniscus. LM: lateral meniscus. MFC: medial femoral cartilage. MTC: medial tibial cartilage. LFC: lateral femoral cartilage. LTC: lateral tibial cartilage. MC: medial compartment. LC: lateral compartment
Fig. 3
Fig. 3
The von Mises stress distribution on the meniscus and tibial cartilage of the knee joint under static state and GC44. A Intact medial meniscus (IMM) under static state; B Radial tears of the medial meniscus including: stable radial tears in the anterior region (RSTA), in the middle region (RSTM), and in the posterior region (RSTP); unstable radial tears in the anterior region (RUTA), in the middle region (RUTM), and in the posterior region (RUTP) under static state; C IMM under GC44; D RSTA, RSTM, RSTP, RUTA, RUTM and RUTP under GC44
Fig. 4
Fig. 4
The variation trend of the maximum von Mises stress on the MM of each stable and unstable tears and intact meniscus during static state and the gait cycle. The trend of radial tears in A the anterior region, B the middle region, and C the posterior region, compared with IMM. The solid line represents the maximum von Mises stress under dynamic analysis, and the dotted line represents static analysis
Fig. 5
Fig. 5
Tensor plots of maximum principal stress on medial meniscus (MM) at GC44. A the stress in the posterior region of intact meniscus (IMM), stable tears (RSTP), and unstable tears (RUTP); B the stress in the middle region of intact meniscus (IMM), stable tears (RSTM), and unstable tears (RUTM); and C the stress in the anterior region of intact meniscus (IMM), stable tears (RSTA), and unstable tears (RUTA). The arrow direction indicated the hoop stress direction. The blue color represented the tensile stress, and the red color represented the compressive stress
Fig. 6
Fig. 6
A The comparison of the tear gap of each model under static and dynamic analysis. The solid line represented dynamic analysis and the dotted line represented static analysis. B The measure method of tear gap in radial tears
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