title: The relationship between medial meniscal subluxation and stress distribution pattern of the knee joint: Finite element analysis.
abstract: BACKGROUND
  Degenerative changes of the knee joint and clinical follow-up after meniscal subluxation are well documented. In the current study three-dimensional (3D) finite element analysis (FEA) of human lower limb was used to investigate the effect medial meniscal subluxation on the loadings of the knee structures.
  
  
  METHODS
  Apart from the reference model, a total of ten 3D models were created, according to amount of medial meniscal subluxation. ANSYS® 14 was used to analyze the stress/load distribution, that is to say the maximum equivalent stress (MES) (von Mises stress) on bones, cartilages, ligaments and menisci. MES was expressed as Newton/mm(2) = Megapascal (MPa).
  
  
  RESULTS
  In a static and standing upright position the MES on all knee structures were evaluated in the reference model. Although MES increased in all structures with the increase of medial meniscal subluxation degree, tibia cartilage was found to be the most affected structure with an increase of 22.73-fold in the 10 mm subluxation model when compared with references values.
  
  
  CONCLUSIONS
  This study showed that medial meniscus subluxation is associated with increased loadings on all knee structures especially the tibia cartilage. Also the degree of the medial meniscal subluxation correlates with distribution and the amount of loadings on tibia cartilage which may be a prominent feature of knee osteoarthritis.
authors.affiliation: Antalya Memorial Hospital, Department of Orthopaedics and Traumatology, Antalya, Turkey. Electronic address: kgokkus@gmail.com.
authors.forename: Kemal
authors.initials: K
authors.lastname: Gokkus
authors.affiliation: Akdeniz University, School of Medicine, Department of Orthopaedics and Traumatology, Antalya, Turkey. Electronic address: drhalilatmaca@hotmail.com.
authors.forename: Halil
authors.initials: H
authors.lastname: Atmaca
authors.affiliation: Amasya University, Faculty of Technology, Department of Automotive Engineering, Amasya, Turkey. Electronic address: leventozge@gmail.com.
authors.forename: Levent
authors.initials: L
authors.lastname: Uğur
authors.affiliation: University of Duzce, Engineering Faculty, Department of Biomedical Engineering, Duzce, Turkey. Electronic address: ozkanarif@hotmail.com.
authors.forename: Arif
authors.initials: A
authors.lastname: Özkan
authors.affiliation: Antalya Memorial Hospital, Department of Orthopaedics and Traumatology, Antalya, Turkey. Electronic address: ataydin07@gmail.com.
authors.forename: Ahmet Turan
authors.initials: AT
authors.lastname: Aydin
mesh_terms: D001696:Biomechanical Phenomena; D020342:Finite Element Analysis; D006801:Humans; D021621:Imaging, Three-Dimensional; D004204:Joint Dislocations / Q000503:physiopathology*; D007719:Knee Joint / Q000502:physiology*; D008954:Models, Biological; D013314:Stress, Mechanical; D000070600:Tibial Meniscus Injuries / Q000503:physiopathology*