Biomechanical evaluation of bone marrow lesions in the knee

Osteoarthritis is a degenerative disease of the joint leading to pain and disability. The knee is the most common site for osteoarthritis. Bone marrow lesions (BMLs) have been associated with knee osteoarthritis symptoms and progression, however there has been limited investigation of the mechanical effects of BMLs on joint function. Subchondroplasty has been proposed as a minimally invasive surgical treatment for BMLs where the lesion site is augmented with bone substitute material in attempt to restore biomechanical function. However, it is not known how the presence of BMLs affect knee joint contact mechanics and whether augmentation of this area could address this.

The aim of the work presented in this thesis was to investigate the effect of BMLs on knee joint mechanics and to investigate the efficacy of augmentation of BML areas to restore knee joint mechanics. Computational methods were developed to model BMLs in the knee joint and augmentation cases using finite element (FE) models. Experimental methods were also developed to characterize the mechanical properties of bone in BML areas. The experimental and computational methods developed were combined to create specimen-specific models of human knee joints incorporating BMLs with derived mechanical properties.