Knee joint contact mechanics in a malaligned limb: an integrated finite element and in vitro study

Excessive joint stress, often caused by knee malalignment, contributes to osteoarthritis (OA) progression. High tibial osteotomy (HTO) is a conservative surgery that corrects lower limb malalignment to relieve damaged tissues from excessive loading. However, HTO outcome has been highly variable and the relationship between the degree of malalignment correction and knee joint contact stresses is not known. If this were known, HTO could be tailored to each patient to best restore joint stresses to normal levels. Therefore, the aim of this work is to create a three-dimensional (3D) finite element (FE) model of the knee joint to predict the effect of different malalignment corrections on knee joint contact stresses. In this study, we present the verification of our subject-specific 3D FE model.