Despite all the efforts to optimize the meniscus prosthesis system (geometry, material, and fixation type), the success of the prosthesis in clinical practice will depend on surgical factors such as intra-operative positioning of the prosthesis. In this study, the aim was therefore to assess the implications of positional changes of the medial meniscus prosthesis for knee biomechanics. A detailed validated finite element (FE) model of human intact and meniscal implanted knees was developed based on a series of in vitro experiments. Different non-anatomical prosthesis positions were applied in the FE model, and the biomechanical response during the gait stance phase compared with an anatomically positioned prosthesis, as well as meniscectomized and also the intact knee model. The results showed that an anatomical positioning of the medial meniscus prosthesis could better recover the intact knee biomechanics, while a non-anatomical positioning of the prosthesis to a limited extent alters the knee kinematics and articular contact pressure and increases the implantation failure risk. The outcomes indicate that a medial or anterior positioning of the meniscus prosthesis may be more forgiving than a posteriorly or laterally positioned prosthesis. The outcome of this study may provide a better insight into the possible consequences of meniscus prosthesis positioning errors for the patient and the prosthesis functionality. Graphical abstract.

中文翻译：

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半月板假体的非解剖定位对预测的人类膝关节生物力学的影响。

尽管尽了所有努力来优化半月板假体系统（几何形状，材料和固定类型），但假体在临床实践中的成功将取决于手术因素，例如术中假体的位置。因此，在这项研究中，目的是评估内侧半月板假体的位置变化对膝关节生物力学的影响。基于一系列体外实验，开发了详细的经过验证的完整无缺和半月板植入的膝盖的有限元（FE）模型。在FE模型中应用了不同的非解剖假体位置，并且在步态姿态阶段的生物力学响应与解剖假体，半月板切除术和完整的膝盖模型相比。结果表明，内侧半月板假体的解剖定位可以更好地恢复完整的膝盖生物力学，而假体的非解剖定位在一定程度上改变了膝盖的运动学和关节接触压力，并增加了植入失败的风险。结果表明，半月板假体的内侧或前侧定位可能比后侧或外侧定位的假体更宽容。这项研究的结果可能会更好地了解弯月面假体对患者的定位错误以及假体功能的可能后果。图形概要。而假体的非解剖定位在有限的范围内会改变膝盖的运动学和关节接触压力，并增加植入失败的风险。结果表明，半月板假体的内侧或前侧定位可能比后侧或外侧定位的假体更宽容。这项研究的结果可能会更好地了解弯月面假体对患者的定位错误和假体功能的可能后果。图形概要。而假体的非解剖定位在有限的范围内会改变膝盖的运动学和关节接触压力，并增加植入失败的风险。结果表明，半月板假体的内侧或前侧定位可能比后侧或外侧定位的假体更宽容。这项研究的结果可能会更好地了解弯月面假体对患者的定位错误和假体功能的可能后果。图形概要。这项研究的结果可能会更好地了解弯月面假体对患者的定位错误和假体功能的可能后果。图形概要。这项研究的结果可能会更好地了解弯月面假体对患者的定位错误和假体功能的可能后果。图形概要。