Load-bearing mode of the knee joint: physical behavior of the knee joint with or without menisci.

The load-bearing mode of the knee joint and the load-carrying capacity of the menisci were investigated by a load-deflection and load-contact study using stresses of as much as 3 times body weight on 14 freshly amputated knee specimens. A flection angle of 0 degrees was used. The average deflection and the average size of the contact area of the intact knees were 1.04 x 10(-1) cm and 14.1 cm2 respectively when the knees were loaded to 1,500 N. The elastic modulus of the entire joint was 2.7 x 10(2) MPa over the load of 1,500 N. At first, the knee joint was not congruous at a low load under about 500 N; the joint contacts both menisci in conjunction with some part of the exposed cartilage. However, the joint became markedly congruous at higher loads, around 1,000 N. The joint was in contact with the menisci and the exposed cartilage, and as more load was applied, the areas of contact widened to the peripheral areas of both the compartments. After menisci were removed, the deflection increased. The size of the contact areas decreased significantly by a third to a half. Consequently, the average stress increased 2 to 3 times that of the intact knee. The elastic modulus was increased over 2 fold after menisci were removed. The results of the energy study indicate that the menisci gave more elastic stability to the joint. After the menisci were removed, more energy was dissipated during cyclic loading. Thus, the menisci provide surface compliance and serve to transmit stresses across the wider areas to the periphery, and, therefore, help to avoid stress concentration both in the articular cartilage and in the subchondral bone, especially under high loads over 1,000 N.