Accurate 3D reconstruction of subject-specific knee finite element model to simulate the articular cartilage defects

The biomechanical relationship between the articular cartilage defect and knee osteoarthritis (OA) has not been clearly defined. This study presents a 3D knee finite element model (FEM) to determine the effect of cartilage defects on the stress distribution around the defect rim. The complete knee FEM, which includes bones, articular cartilages, menisci and ligaments, is developed from computed tomography and magnetic resonance images. This FEM then is validated and used to simulate femoral cartilage defects. Based on the obtained results, it is confirmed that the 3D knee FEM is reconstructed with high-fidelity level and can faithfully predict the knee contact behavior. Cartilage defects drastically affect the stress distribution on articular cartilages. When the defect size was smaller than 1.00 cm², the stress elevation and redistribution were found undistinguishable. However, significant stress elevation and redistribution were detected due to the large defect sizes (⩾1.00 cm²). This alteration of stress distribution has important implications relating to the progression of cartilage defect to OA in the human knee joint.