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This study showed that subfracture impact loading to a joint creates stresses in cartilage and bone which can initiate a chronic osteoarthrosis. The magnitude and location of the impact induced stresses are dependent on the orientation and the intensity of loading. Impact loading produced lesions on retro-patellar cartilage and their depths increased as the thickness of subchondral bone increased with time post-impact. Mechanical tests of cartilage indicated significant softening twelve months post-impact. These alterations are similar to those documented clinically as early OA. In vitro impacts of isolated limbs, together with mathematical models, showed that high mean stress generated during impact may help protect joint tissues from acute injury. This study and others are being used to develop stress-based tissue failure criteria for predicting an osteoarthrosis following subfracture impact loading.

Lower extremity injuries due to automobile accidents are often overlooked, but can have a profound societal cost. Knee injuries, for example, account for approximately 10% of the total injuries. Fracture of the knee is not only an acute issue but may also have chronic, or long term, consequences. The criterion currently used for evaluation of knee injuries in new automobiles, however, is based on experimental impact data from the 70''s using seated human cadavers. These studies involved various padded and rigid impact interfaces that slightly alter the duration of contact. Based on these data and a simple mathematical model of the femur, it appears fracture tolerance increases as contact duration shortens. In contrast, more recent studies have shown mitigation of gross fractures of the knee itself using padded interfaces. The use of padded interfaces, however, result in coincidental changes in contact duration and knee contact area.