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Intra-operative femoral condylar stress during arthroscopy : an in vivo biomechanical assessment

Schmid, Rahel B. and Wirz, Dieter and Göpfert, Beat and Arnold, Markus P. and Friederich, Niklaus F. and Hirschmann, Michael T.. (2010) Intra-operative femoral condylar stress during arthroscopy : an in vivo biomechanical assessment. Knee surgery, sports traumatology, arthroscopy, Vol. 19, H. 5. pp. 747-752.

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Official URL: http://edoc.unibas.ch/dok/A5841577

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Abstract

PURPOSE: Excessive varus and valgus stress forces during arthroscopy might exceed minimal compressive strength of cancellous bone. In extreme cases, this could lead to post-arthroscopic osteonecrosis. It was our purpose to measure the valgus and varus stress forces during arthroscopy and draw conclusions on the development of osteonecrosis. METHODS: On 24 consecutive patients undergoing arthroscopy, the maximum varus and valgus stress forces (N) were measured in vivo using a strain gauge mounted to a leg holder. The forces (N) and contact stresses (kPa) on the femoral condyles were calculated based on the measured acting lateral force at the femur fixation based on the lever principle. RESULTS: The maximum contact stress during varus on the medial condyle was significantly lower in patients with intact meniscus (mean ± standard error of the mean: 243 ± 29 kPa) than in patients with meniscus-deficient knees (520 ± 61 kPa; P > 0.01). A similar finding was obtained for the maximum contact stress during valgus on the lateral condyle: 630 ± 72 kPa in patients with intact meniscus compared to 2,173 ± 159 kPa in patients with meniscus-deficient knees (P > 0.01). In 19 patients (79%), the maximum contact stress was higher during valgus than during varus. The maximum contact stress on the lateral condyle during valgus was significantly higher for more experienced surgeons (P = 0.01). CONCLUSION: The maximum contact stresses in knees with intact menisci did not exceed the critical threshold of the compressive strength in cancellous bone. However, the maximum contact stresses in meniscus-deficient knees were frequently higher than the threshold. However, these stresses were much lower than those during daily activities and therefore unlikely to lead to post-arthroscopic osteonecrosis. LEVEL OF EVIDENCE: Diagnostic study, Level II.
Faculties and Departments:03 Faculty of Medicine > Bereich Operative Fächer (Klinik) > Bewegungsapparat und Integument
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Operative Fächer (Klinik) > Bewegungsapparat und Integument
03 Faculty of Medicine > Bereich Operative Fächer (Klinik) > Ehemalige Einheiten Operative Fächer (Klinik) > Orthopädie (Valderrabano)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Operative Fächer (Klinik) > Ehemalige Einheiten Operative Fächer (Klinik) > Orthopädie (Valderrabano)
03 Faculty of Medicine
UniBasel Contributors:Friederich, Niklaus F. and Arnold, Markus P. and Göpfert, Beat
Item Type:Article, refereed
Article Subtype:Research Article
Bibsysno:Link to catalogue
Publisher:Springer
ISSN:0942-2056
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:07 Jun 2018 14:07
Deposited On:04 Jan 2013 08:34

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