A finite element exploration of cartilage stress near an articular incongruity during unstable motion

Both instability and residual articular incongruity are implicated in the development of post-traumatic osteoarthritis (OA) following intra-articular fracture, but currently no information exists regarding cartilage stresses for unstable residual incongruities. In this study, a transversely isotropic poroelastic cartilage finite element model was implemented and validated within physiologically relevant loading ranges. This material model was then used to simulate the loading of cartilage during stable and unstable motion accompanying a step-off incongruity residual from intra-articular fracture, using load data from previous cadaver tests of ankle instability. Peak solid-phase stresses and fluid pressure were found to increase markedly in the presence of instability. Solid-phase transients of normal stress increased from 2.00 to 13.8 MPa/s for stable compared to unstable motion, and tangential stress transients increased from 17.1 to 118.1 MPa/s. Corresponding fluid pressure transients increased from 15.1 to 117.9 MPa/s for unstable motion. In the most rapidly loaded sections of cartilage, the fluid was found to carry nearly all of the normal load, with the pressurization of the fluid resulting in high solid matrix tangential stresses.