This content is not included in
your SAE MOBILUS subscription, or you are not logged in.
Insult to the Human Cadaver Patellofemoral Joint: Effects of Age on Fracture Tolerance and Occult Injury
Annotation ability available
Sector:
Language:
English
Abstract
Lower extremity (knee) trauma is currently based on a bone fracture criterion derived from impacts of aged specimens. Recent clinical studies, however, indicate that a chronic disease (post-traumatic osteoarthritis), may be precipitated after mechanical insult without obvious bone fracture(1). It is hypothesized this is due to microcracking of subchondral bone under cartilage. This hard tissue layer is known to change with age and pathology. Ten ‘aged’ (71 years) and ten ‘young’ (47 years) cadaver knee joints were impacted to study the influence of age and pathology on the fracture load, and incidents of occult injury. Our results indicate that fracture load, per se, was independent of specimen age. On the other hand, severely pathological specimens required significantly higher loads to fracture bone. Occult microcraking was also observed in subfracture experiments, however, fewer incidents were recorded for the ‘aged’ specimens. This type of injury has been associated with knee pain and the development of disease in the chronic setting. These data suggest that a bone fracture criterion based largely on pathological specimens would not provide a conservative measure of tolerance for the normal driving population.
Recommended Content
Citation
Haut, R. and Atkinson, P., "Insult to the Human Cadaver Patellofemoral Joint: Effects of Age on Fracture Tolerance and Occult Injury," SAE Technical Paper 952729, 1995, https://doi.org/10.4271/952729.Also In
References
- Shelp D Newberry W Li X Dalimonte R Decamp C Altiero N Haut R Tissue damage resulting from blunt impact on the knee: animal and cadaver studies 4th Inj Prevention Through Biomech Symp 4 43 62 1994
- Rice D MacKenzie E et al Cost of Injury in the United States: A Report to Congress 1989 Atlanta, GA 1989
- Lund A Ferguson S Driver Fatalities in 1985-1993 Cars with Airbags J. Trauma 38 469 475 1995
- Viano D Restraint Effectiveness, Availability and Use in Fatal Crashes: Implications to Injury Control J. Trauma 38 538 546 1995
- Dischinger P Cushing B Kerns T Lower extremity fractures in motor vehicle collisions: influence of direction of impact and seatbelt use Proc 36th Conf AAAM Portland, OR 319 326 1992
- Burgess A Dischinger P O'Quinn T Schmindhauser C Lower Extremity Injuries in Drivers of Airbag-Equipped Automobiles: Clinical and Crash Reconstruction Correlations J. Trauma 38 509 516 1995
- States J Adult Occupant Injuries of the Lower Limb 30th Stapp Car Crash Conf 30 97 107 1986
- MacKenzie EJ Siegel JH Shapiro S et al Functional recovery and medical costs of trauma: An analysis by type and severity of injury J Trauma 28 281 298 1988
- States J Traumatic arthritis--a medical and legal dilemma Ann Conf of the AAAM 14 21 28 1970
- Chapchal G Posttraumatic osteoarthritis after injury of the knee and hip joint Reconstr Surg Trauma 16 87 94 1978
- Pritsch M Comba D Frank G Noroszowski H Articular Cartilage Fractures of the Knee J Sports Medicine 24 299 302 1984
- Kapelov R Teresi L Bradley WG Bucciarelli NR Murakami DM Mullin WJ Jordan JE Bone contusions of the knee; increased lesion detection with fast spin-echo MR imaging with spectroscope fat saturation Radiology 901 904 1993
- Arnoldi C Patellar Pain Acta Orthop Scand 62 1 29 1991
- Engebretsen L Arendt E Fritts HM Osteochondral lesions and cruciate ligament injuries Acta Orthop Scand 64 434 436 1993
- Wright V Post-Traumatic Osteoarthritis--A Medico- Legal Minefield Brit J Rheum 29 474 478 1990
- Donohue MJ Buss D Oegema T Thompson R The effects of indirect blunt trauma on adult canine articular cartilage J Bone Joint Surg 65-A 7 948 957 1983
- Thompson RC Oegema TR Lewis JL Wallace L Osteoarthritic changes after acute transarticular load J Bone Joint Surg 73-A 7 990 1001 1991
- Vener MJ Thompson RC Lewis JL Oegema TR Subchondral damage after acute transarticular loading: an in vitro model of joint injury J Orthop Res 10 759 765 1992
- Shimizu M Tsuji H Matsui H Katoh Y Sano A Morphometric analysis of subchondral bone of the tibia1 condyle in osteoarthrosis Clin Orthop 229 239 1993
- Vellet AD Marks PH Fowler PJ Munro TG Occult post-traumatic osteochondral lesions of the knee: prevalence, classification, and short-term sequelae evaluated with MR imaging Radiology 178 1 271 276 1991
- Thompson RC Vener MJ Griffiths HJ Lewis JL Oegema TR Wallace L Scanning Electron-Microscopic and Magnetic Resonance-Imaging Studies of Injuries to the Patellofemoral Joint after Acute Transarticular Loading J Bone and Joint Surg 75-A 5 704 713 1993
- Repo R Finlay J Survival of articular cartilage after controlled impact J Bone Joint Surg 59-A 8 1068 1076 1977
- Newberry W Atkinson P Li X DeCamp C Altiero N Haut R Tissue Injuries Resulting From Blunt Impact on the Knee 5th Injury Prevention Through Biomechanics Symposium 5 21 39 1995
- Nyquist G King A Lower extremities Rev Biomech Impact Res Inj Auto Env 6 163 201 1985
- Patrick L Kroell C Mertz H Forces on the human body in simulated Crashes 9th Stapp Car Crash Conf 9 237 259 1965
- Powell W Ojala S Advani S Marlin R Cadaver femur responses to longitudinal impacts 19th Stapp Car Crash Conf 19 561 579 1975
- Melvin J Stalnaker R Alem N Benson J Mohan D Impact response and tolerance of the lower extremities 19th Stapp Car Crash Conf 19 543 559 1975
- Haut R Contact pressures in the patello-femoral joint during impact loading on the human flexed knee J Orthop Res 7 272 280 1989
- Atkinson PJ Haut RC Subfracture insult to the human cadaver patellofemoral joint produces occult injury J Orthop Res In press
- Kelsey JL Epidemiology of musculoskeletal disorders New York Oxford University Press 1982 78 86
- Beckman DC Palmer MF Thoracic force-deflection studies in primates Proc 3rd Biomech Factors Conf ASME Ann Arbor, MI Paper 69-BHF-12 1969
- Huberti H Hayes W Patellofemoral contact pressure J Bone Joint Surg 66-A 5 715 724 1984
- Haut RC Ide TM DeCamp CW Impact-induced damage to articular cartilage of the patello-femoral joint First Injury Through Biomech Symp 13 26 1991
- Hering WE Patrick LM Response comparisons of the human cadaver knee and a part 572 dummy knee to impacts by crushable materials 21st Stapp Car Crash Conf 21 1015 1053 1977
- Tomatsu T Imai N Takeuchi N Takahashi K Kimura N Experimentally produced fractures of articular cartilage and bone J Bone Joint Surg 3 457 461 1992
- Haut R Dalimonte R Li X Altiero N Mechanical damage in the human P-F joint after blunt impact loading Proc Second World Conf Biomech 2 297 1994
- Radin E Parker H Pugh J Steinberg R Paul I Rose R Response of joints to impact loading-III relationship between trabecular microfractures and cartilage degeneration J Biomech 6 51 57 1973
- Li X Haut RC Altiero NJ An analytic model to study blunt impact response of the rabbit P-F joint J Biomech Eng 1995
- Hale JE Brown TD Contact stress gradient detection limits of pressensor film J Biomech Eng 114 352 358 1992