Optimized Thickness of Meniscal Component in Partial Knee Replacement Analysed with Computer Simulation

Computer simulation with programming and Matlab graphics was used to analyse effects of meniscal component thickness on lengths of ligament fibres in partially replaced human knee with uni-compartmental arthroplasty. A circular femoral, a flat tibial and a matching meniscal component were modelled in the sagittal plane with four intact ligaments represented as fibres that showed non-linear elastic behaviour. Shapes of the prosthetic components, attachments of the ligament fibres and their material properties were from anatomical studies in the literature. The components when placed on respective bones with surgical guidelines and an optimized thickness of the meniscal insert achieved nearly fixed lengths of ligament fibres during motion. Changes in thickness of the insert either stretched or slackened the fibres with variable effects during flexion of the joint. For example, a 2 mm thicker insert stretched a fibre of anterior cruciate ligament by 4.7% at 30^o and 3.2% at 120^o flexion. Such variations in component selection are probable due to surgical judgments. Stretched ligaments could increase joint stiffness, while slack ligaments could increase joint laxity – either of these effects has potential for affecting the joint kinematics. Computer models of the replaced knee validated with anatomical studies allow insight in the mechanics of the replaced knee and effects of surgical errors.