Knee Joint Line Obliquity Causes Tibiofemoral Subluxation That Alters Contact Areas and Meniscal Loading
dc.contributor.author | Wang, D | |
dc.contributor.author | Willinger, L | |
dc.contributor.author | Athwal, KK | |
dc.contributor.author | Williams, A | |
dc.contributor.author | Amis, AA | |
dc.date.accessioned | 2021-06-21T10:10:25Z | |
dc.date.issued | 2021-06-14 | |
dc.description.abstract | Background: Little scientific evidence is available regarding the effect of knee joint line obliquity (JLO) before and after coronal realignment osteotomy. Hypotheses: Higher JLO would lead to abnormal relative position of the femur on the tibia, a shift of the joint contact areas, and elevated joint contact pressures. Study Design: Descriptive laboratory study. Methods: 10 fresh-frozen human cadaveric knees (age, 59 ± 5 years) were axially loaded to 1500 N in a materials testing machine with the joint line tilted 0°, 4°, 8°, and 12° varus (“downhill” medially) and valgus, at 0° and 20° of knee flexion. The mechanical compression axis was aligned to the center of the tibial plateau. Contact pressure and contact area were recorded by pressure sensors inserted between the tibia and femur below the menisci. Changes in relative femoral and tibial position in the coronal plane were obtained by an optical tracking system. Results: Both medial and lateral JLO caused significant tibiofemoral subluxation and pressure distribution changes. Medial (varus) JLO caused the femur to subluxate medially down the coronal slope of the tibial plateau, and vice versa for lateral (valgus) downslopes ( P < .01), giving a 6-mm range of subluxation. The areas of peak pressure moved 12 mm and 8 mm across the medial and lateral condyles, onto the downhill meniscus and the “uphill” tibial spine. Changes in JLO had only small effects on maximum contact pressures. Conclusion: A 4° change of JLO during load bearing caused significant mediolateral tibiofemoral subluxation. The femur slid down the slope of the tibial plateau to abut the tibial eminence and also to rest on the downhill meniscus. This caused large movements of the tibiofemoral contact pressures across each compartment. Clinical Relevance: These results provide important information for understanding the consequences of creating coronal JLO and for clinical practice in terms of osteotomy planning regarding the effect on JLO. This information provides guidance regarding the choice of single- or double-level osteotomy. Excessive JLO alteration may cause abnormal tibiofemoral joint articulation and chondral or meniscal loading. | en_GB |
dc.identifier.citation | Published online 14 June 2021 | en_GB |
dc.identifier.doi | 10.1177/03635465211020478 | |
dc.identifier.uri | http://hdl.handle.net/10871/126119 | |
dc.language.iso | en | en_GB |
dc.publisher | SAGE Publications / American Orthopaedic Society for Sports Medicine | en_GB |
dc.rights | © 2021 The Author(s). This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (https://creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage). | en_GB |
dc.subject | knee osteotomy | en_GB |
dc.subject | biomechanics | en_GB |
dc.subject | cartilage contact pressure | en_GB |
dc.subject | joint line obliquity | en_GB |
dc.subject | coronal slope | en_GB |
dc.subject | meniscus loading | en_GB |
dc.subject | tibiofemoral subluxation | en_GB |
dc.title | Knee Joint Line Obliquity Causes Tibiofemoral Subluxation That Alters Contact Areas and Meniscal Loading | en_GB |
dc.type | Article | en_GB |
dc.date.available | 2021-06-21T10:10:25Z | |
dc.identifier.issn | 0363-5465 | |
dc.description | This is the final version. Available from SAGE Publications / American Orthopaedic Society for Sports Medicine via the DOI in this record. | en_GB |
dc.identifier.journal | The American Journal of Sports Medicine | en_GB |
dc.rights.uri | https://creativecommons.org/licenses/by-nc-nd/4.0/ | en_GB |
rioxxterms.version | VoR | en_GB |
rioxxterms.licenseref.startdate | 2021-06-14 | |
rioxxterms.type | Journal Article/Review | en_GB |
refterms.dateFCD | 2021-06-21T10:00:08Z | |
refterms.versionFCD | VoR | |
refterms.dateFOA | 2021-06-21T10:10:39Z | |
refterms.panel | B | en_GB |
refterms.depositException | publishedGoldOA |
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Except where otherwise noted, this item's licence is described as © 2021 The Author(s). This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (https://creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).