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The effect of simulated fracture-angulations of the tibia on cartilage pressures in the knee joint.

The effects of angular deformities of the tibia on the contact areas and pressures on cartilage in the knee were measured with use of pressure-sensitive film. Six cadaver knees were mounted in a test-frame, such that the offset and tilt of the knee relative to the load-axis simulated that due to angular deformities of the tibia of 5, 10, 15, or 20 degrees of varus or valgus at the levels of the proximal, middle, and distal thirds. Angulation had little effect on the contact area. The change in pressure was least for fractures of the distal third and greatest for fractures of the proximal third. For example, a 20-degree angulation of the distal third increased the maximum contact pressure by an average of 26 per cent in the compartment toward the load-axis and reduced it by 32 per cent in the opposite compartment. With an angulation of 20 degrees at the level of the proximal third of the tibia, the increase in pressure averaged 106 per cent and the decrease averaged 89 per cent. The changes in pressure with fractures at the middle third were between these extremes.