Effect of the size and location of osteochondral defects in degenerative arthritis. A finite element simulation.

Physiological studies have shown that focal articular surface defects in the human knee may progress to degenerative arthritis. Although the risk of this evolutive process is multifactorial, defect size is one of the most important factors. In order to determine the influence of osteochondral defect size and location on the stress and strain concentrations around the defect rim, a finite element model of the human knee was developed. From our results, it became clear that the size and location of cartilage defects drastically affect to those variables. No stress concentration appeared around the rim of small defects, being the stress distribution mainly controlled by the meniscus contact. On the contrary, important rim stress concentration was found for large osteochondral defects. This alteration of the stress distribution has important clinical implications regarding the long-term integrity of the cartilage adjacent to osteochondral defects.