Numerical Modeling of Shockwave Treatment of Knee Joint

Overview

Journal Materials (Basel)

Publisher MDPI

Date 2021 Dec 24

PMID 34947273

Authors

Galina Eremina

Alexey Smolin

Affiliations

Soon will be listed here.

Abstract

Arthritis is a degenerative disease that primarily affects the cartilage and meniscus of the knee joint. External acoustic stimulation is used to treat this disease. This article presents a numerical model of the knee joint aimed at the computer-aided study of the regenerative effects of shockwave treatment. The presented model was verified and validated. A numerical analysis of the conditions for the regeneration of the tissues of the knee joint under shockwave action was conducted. The results allow us to conclude that to obtain the conditions required for the regeneration of cartilage tissues and meniscus (compressive stresses above the threshold value of 0.15 MPa to start the process of chondrogenesis; distortional strains above the threshold value of 0.05% characterized by the beginning of the differentiation of the tissues in large volumes; fluid pressure corresponding to the optimal level of 68 kPa to transfer tissue cells in large volumes), the energy flux density of therapeutic shockwave loading should exceed 0.3 mJ/mm.

References

Eremina G, Smolin A . Risk assessment of resurfacing implant loosening and femur fracture under low-energy impacts taking into account degenerative changes in bone tissues. Computer simulation. Comput Methods Programs Biomed. 2021; 200:105929. DOI: 10.1016/j.cmpb.2021.105929. View

Li J, Zheng S, Zhang J, Huang J, Liu X . [Effect of Acupuncture plus Different Frequency Shock-wave Interventions on Pain Reactions and Motor Function in Knee Osteoarthritis Patients]. Zhen Ci Yan Jiu. 2015; 40(4):300-3. View

Prendergast P, Huiskes R, Soballe K . ESB Research Award 1996. Biophysical stimuli on cells during tissue differentiation at implant interfaces. J Biomech. 1997; 30(6):539-48. DOI: 10.1016/s0021-9290(96)00140-6. View

Jones A, Wilcox R . Finite element analysis of the spine: towards a framework of verification, validation and sensitivity analysis. Med Eng Phys. 2008; 30(10):1287-304. DOI: 10.1016/j.medengphy.2008.09.006. View

Al-Abbad H, Allen S, Morris S, Reznik J, Biros E, Paulik B . The effects of shockwave therapy on musculoskeletal conditions based on changes in imaging: a systematic review and meta-analysis with meta-regression. BMC Musculoskelet Disord. 2020; 21(1):275. PMC: 7189454. DOI: 10.1186/s12891-020-03270-w. View

Ji Q, Wang P, He C . Extracorporeal shockwave therapy as a novel and potential treatment for degenerative cartilage and bone disease: Osteoarthritis. A qualitative analysis of the literature. Prog Biophys Mol Biol. 2016; 121(3):255-65. DOI: 10.1016/j.pbiomolbio.2016.07.001. View

Loboa E, Wren T, Beaupre G, Carter D . Mechanobiology of soft skeletal tissue differentiation--a computational approach of a fiber-reinforced poroelastic model based on homogeneous and isotropic simplifications. Biomech Model Mechanobiol. 2003; 2(2):83-96. DOI: 10.1007/s10237-003-0030-7. View

Simon U, Augat P, Utz M, Claes L . A numerical model of the fracture healing process that describes tissue development and revascularisation. Comput Methods Biomech Biomed Engin. 2010; 14(1):79-93. DOI: 10.1080/10255842.2010.499865. View

Townsend K, Thomas-Aitken H, Rudert M, Kern A, Willey M, Anderson D . Discrete element analysis is a valid method for computing joint contact stress in the hip before and after acetabular fracture. J Biomech. 2017; 67:9-17. PMC: 5767141. DOI: 10.1016/j.jbiomech.2017.11.014. View

10.

Whittaker J, Truong L, Dhiman K, Beck C . Osteoarthritis year in review 2020: rehabilitation and outcomes. Osteoarthritis Cartilage. 2020; 29(2):190-207. DOI: 10.1016/j.joca.2020.10.005. View

11.

Wang C, Cheng J, Chou W, Hsu S, Chen J, Huang C . Changes of articular cartilage and subchondral bone after extracorporeal shockwave therapy in osteoarthritis of the knee. Int J Med Sci. 2017; 14(3):213-223. PMC: 5370283. DOI: 10.7150/ijms.17469. View

12.

Shrive N, OConnor J, Goodfellow J . Load-bearing in the knee joint. Clin Orthop Relat Res. 1978; (131):279-87. View

13.

Veronick J, Assanah F, Piscopo N, Kutes Y, Vyas V, Nair L . Mechanically Loading Cell/Hydrogel Constructs with Low-Intensity Pulsed Ultrasound for Bone Repair. Tissue Eng Part A. 2017; 24(3-4):254-263. PMC: 5792249. DOI: 10.1089/ten.TEA.2016.0547. View

14.

Manlapaz D, Sole G, Jayakaran P, Chapple C . Risk Factors for Falls in Adults with Knee Osteoarthritis: A Systematic Review. PM R. 2019; 11(7):745-757. DOI: 10.1002/pmrj.12066. View

15.

Gaugler M, Wirz D, Ronken S, Hafner M, Gopfert B, Friederich N . Fibrous cartilage of human menisci is less shock-absorbing and energy-dissipating than hyaline cartilage. Knee Surg Sports Traumatol Arthrosc. 2014; 23(4):1141-6. DOI: 10.1007/s00167-014-2926-4. View

16.

Xie X, Zhu J, Zhang H . Effects of extracorporeal shock wave therapy in patients with knee osteoarthritis: A cohort study protocol. Medicine (Baltimore). 2020; 99(35):e21749. PMC: 7458224. DOI: 10.1097/MD.0000000000021749. View

17.

Saarakkala S, Julkunen P, Kiviranta P, Makitalo J, Jurvelin J, Korhonen R . Depth-wise progression of osteoarthritis in human articular cartilage: investigation of composition, structure and biomechanics. Osteoarthritis Cartilage. 2009; 18(1):73-81. DOI: 10.1016/j.joca.2009.08.003. View

18.

Anderson D, Woo S, Kwan M, Gershuni D . Viscoelastic shear properties of the equine medial meniscus. J Orthop Res. 1991; 9(4):550-8. DOI: 10.1002/jor.1100090411. View

19.

Park S, Krishnan R, Nicoll S, Ateshian G . Cartilage interstitial fluid load support in unconfined compression. J Biomech. 2003; 36(12):1785-96. PMC: 2833094. DOI: 10.1016/s0021-9290(03)00231-8. View

20.

Kim J, Kim J, Choi C, Lee J, Kee H, Jung K . The Dose-Related Effects of Extracorporeal Shock Wave Therapy for Knee Osteoarthritis. Ann Rehabil Med. 2015; 39(4):616-23. PMC: 4564710. DOI: 10.5535/arm.2015.39.4.616. View