Computational modeling reveals thickness and stiffness mismatches amplify local interface strain in patellar allografts, highlighting the need to match donor and recipient biomechanics.
Patellar osteochondral allograft (OCA) transplantation treats focal cartilage defects, but donor-recipient cartilage thickness and mechanical compatibility are not routinely quantified during graft selection. This idealized computational study evaluated associations of donor-to-recipient (D/R) thickness ratio, absolute stiffness, stiffness contrast, and depth-dependent stiffness with interface-local strain. Two-dimensional axisymmetric finite element models were subjected to a spatially uniform nominal pressure of 1.00 MPa. Nine D/R ratios (0.33-3.25) and eleven homogeneous donor/recipient (DC/RC) Young's modulus combinations (2.50-7.00 MPa) yielded 99 homogeneous cases; nine functionally graded material (FGM) cases were evaluated. Primary outcomes were 95th percentile (P95) values of the nodewise compressive strain magnitude and tensor maximum shear strain within a fixed 0.25-mm local interface region of interest (ROI). This robust upper-tail measure is less sensitive than a single nodal maximum. In the matched homogeneous control, P95 values were 0.031 and 0.015. The largest homogeneous values were 0.412 and 0.347 at D/R=3.25 and DC/RC=7.0/2.5 MPa. Same-side concentration factors normalized local P95 to median strain in the same model's 0.75-1.00 mm far-field band. Pooled factors were 3.71 ± 2.04 for compression and 6.03 ± 3.79 for maximum shear in homogeneous cases (n = 198 model-sides), and 3.51 ± 2.17 and 5.69 ± 4.03 in FGM cases (n = 18). FGM values were lower than both extreme homogeneous mismatch references at every D/R ratio. Across formulations, thickness disparity remained associated with interface-local upper-tail strain. These results support evaluating donor-recipient cartilage thickness and material compatibility alongside surface congruity and osseous integration in future experimental and patient-specific modeling studies.
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Lamberty et al. (2026) studied this question.
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