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Danaei B, McPhee J. Optimal Implant Positioning Following Total Knee Arthroplasty Using Predictive Dynamic Simulation. J Biomech Eng 2024; 146:111003. [PMID: 38959084 DOI: 10.1115/1.4065879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 07/01/2024] [Indexed: 07/05/2024]
Abstract
In this paper, a novel method is proposed for the determination of the optimal subject-specific placement of knee implants based on predictive dynamic simulations of human movement following total knee arthroplasty (TKA). Two knee implant models are introduced. The first model is a comprehensive 12-degree-of-freedom (DoF) representation that incorporates volumetric contact between femoral and tibial implants, as well as patellofemoral contact. The second model employs a single-degree-of-freedom equivalent kinematic (SEK) approach for the knee joint. A cosimulation framework is proposed to leverage both knee models in our simulations. The knee model is calibrated and validated using patient-specific data, including knee kinematics and ground reaction forces. Additionally, quantitative indices are introduced to evaluate the optimality of implant positioning based on three criteria: balancing medial and lateral load distributions, ligament balancing, and varus/valgus alignment. The knee implant placement is optimized by minimizing the deviation of the indices from their user-defined desired values during predicted sit-to-stand motion. The method presented in this paper has the potential to enhance the results of knee arthroplasty and serve as a valuable instrument for surgeons when planning and performing this procedure.
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Affiliation(s)
- Behzad Danaei
- Department of Systems Design Engineering, University of Waterloo, Waterloo, ON N2L 3G1, Canada
| | - John McPhee
- Department of Systems Design Engineering, University of Waterloo, Waterloo, ON N2L 3G1, Canada
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Loi I, Zacharaki EI, Moustakas K. Machine Learning Approaches for 3D Motion Synthesis and Musculoskeletal Dynamics Estimation: A Survey. IEEE TRANSACTIONS ON VISUALIZATION AND COMPUTER GRAPHICS 2024; 30:5810-5829. [PMID: 37624722 DOI: 10.1109/tvcg.2023.3308753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/27/2023]
Abstract
The inference of 3D motion and dynamics of the human musculoskeletal system has traditionally been solved using physics-based methods that exploit physical parameters to provide realistic simulations. Yet, such methods suffer from computational complexity and reduced stability, hindering their use in computer graphics applications that require real-time performance. With the recent explosion of data capture (mocap, video) machine learning (ML) has started to become popular as it is able to create surrogate models harnessing the huge amount of data stemming from various sources, minimizing computational time (instead of resource usage), and most importantly, approximate real-time solutions. The main purpose of this paper is to provide a review and classification of the most recent works regarding motion prediction, motion synthesis as well as musculoskeletal dynamics estimation problems using ML techniques, in order to offer sufficient insight into the state-of-the-art and draw new research directions. While the study of motion may appear distinct to musculoskeletal dynamics, these application domains provide jointly the link for more natural computer graphics character animation, since ML-based musculoskeletal dynamics estimation enables modeling of more long-term, temporally evolving, ergonomic effects, while offering automated and fast solutions. Overall, our review offers an in-depth presentation and classification of ML applications in human motion analysis, unlike previous survey articles focusing on specific aspects of motion prediction.
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Syrett ED, Peterson CL, Darter BJ. The effect of impaired unilateral ankle propulsion on contralateral knee joint loading. Gait Posture 2024; 113:302-308. [PMID: 38986171 DOI: 10.1016/j.gaitpost.2024.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 05/07/2024] [Accepted: 07/02/2024] [Indexed: 07/12/2024]
Abstract
BACKGROUND Impairments in unilateral ankle propulsion may result from restriction by an external device or pathology such as lower limb amputation. Models of gait suggest this reduction may lead to increased collisional force on the contralateral side, potentially increasing force through the knee and increasing the risk of knee pain or osteoarthritis. RESEARCH QUESTION How do restrictions in unilateral ankle propulsive force affect contralateral knee joint loading in otherwise healthy individuals? METHODS 18 individuals without impairment walked on a treadmill at 1.5 m/s for two conditions: one free of restrictions, and one where a randomized limb's ankle propulsive force was restricted using an off-the-shelf ankle-foot orthosis (AFO). Ankle propulsive power, lower extremity joint work, and ground reaction force variables were calculated for the final 3 gait cycles of each condition. Tibiofemoral joint contact force (TJCF) for the limb contralateral to the AFO was calculated through a standard OpenSim workflow utilizing the gait2392 model. Intra-limb pair-wise comparisons were made between conditions. RESULTS Compared to walking unrestricted, the limb wearing the AFO demonstrated a significant reduction in peak ankle propulsive power and positive ankle work by approximately 50 % each (p<0.01). With ankle restriction, the ipsilateral knee significantly increased positive work (p<0.01). The overall propulsion produced by that limb did not change between conditions, demonstrated by a lack of change in anterior ground reaction force impulse (p=0.11). The knee of the limb contralateral to the AFO did not display differences in any TJCF variable between conditions (all p>0.07). SIGNIFICANCE These results suggest a unilateral deficit in ankle propulsion will not increase contralateral knee joint forces in individuals who are able to use other joints of the limb to compensate for the loss of ankle function. However, further research should investigate this relationship in those who display pathologies that may prevent more proximal compensations.
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Affiliation(s)
- E Daniel Syrett
- Department of Physical Therapy, Virginia Commonwealth University, Richmond, VA 23298, USA.
| | - Carrie L Peterson
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Benjamin J Darter
- Department of Physical Therapy, Virginia Commonwealth University, Richmond, VA 23298, USA; Department of Research, Hunter Holmes McGuire Veteran Affairs Medical Center, Richmond, VA 23249, USA
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Wearing SC, Hooper SL, Langton CM, Keiner M, Horstmann T, Crevier-Denoix N, Pourcelot P. The Biomechanics of Musculoskeletal Tissues during Activities of Daily Living: Dynamic Assessment Using Quantitative Transmission-Mode Ultrasound Techniques. Healthcare (Basel) 2024; 12:1254. [PMID: 38998789 PMCID: PMC11241410 DOI: 10.3390/healthcare12131254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 06/18/2024] [Accepted: 06/19/2024] [Indexed: 07/14/2024] Open
Abstract
The measurement of musculoskeletal tissue properties and loading patterns during physical activity is important for understanding the adaptation mechanisms of tissues such as bone, tendon, and muscle tissues, particularly with injury and repair. Although the properties and loading of these connective tissues have been quantified using direct measurement techniques, these methods are highly invasive and often prevent or interfere with normal activity patterns. Indirect biomechanical methods, such as estimates based on electromyography, ultrasound, and inverse dynamics, are used more widely but are known to yield different parameter values than direct measurements. Through a series of literature searches of electronic databases, including Pubmed, Embase, Web of Science, and IEEE Explore, this paper reviews current methods used for the in vivo measurement of human musculoskeletal tissue and describes the operating principals, application, and emerging research findings gained from the use of quantitative transmission-mode ultrasound measurement techniques to non-invasively characterize human bone, tendon, and muscle properties at rest and during activities of daily living. In contrast to standard ultrasound imaging approaches, these techniques assess the interaction between ultrasound compression waves and connective tissues to provide quantifiable parameters associated with the structure, instantaneous elastic modulus, and density of tissues. By taking advantage of the physical relationship between the axial velocity of ultrasound compression waves and the instantaneous modulus of the propagation material, these techniques can also be used to estimate the in vivo loading environment of relatively superficial soft connective tissues during sports and activities of daily living. This paper highlights key findings from clinical studies in which quantitative transmission-mode ultrasound has been used to measure the properties and loading of bone, tendon, and muscle tissue during common physical activities in healthy and pathological populations.
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Affiliation(s)
- Scott C. Wearing
- School of Medicine and Health, Technical University of Munich, 80992 Munich, Bavaria, Germany
| | - Sue L. Hooper
- School of Health, University of the Sunshine Coast, Sippy Downs, QLD 4556, Australia
| | - Christian M. Langton
- Griffith Centre of Rehabilitation Engineering, Griffith University, Southport, QLD 4222, Australia
| | - Michael Keiner
- Department of Exercise and Training Science, German University of Health and Sport, 85737 Ismaning, Bavaria, Germany
| | - Thomas Horstmann
- School of Medicine and Health, Technical University of Munich, 80992 Munich, Bavaria, Germany
| | | | - Philippe Pourcelot
- INRAE, BPLC Unit, Ecole Nationale Vétérinaire d’Alfort, 94700 Maisons-Alfort, France
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Xia Z, Cornish BM, Devaprakash D, Barrett RS, Lloyd DG, Hams AH, Pizzolato C. Prediction of Achilles Tendon Force During Common Motor Tasks From Markerless Video. IEEE Trans Neural Syst Rehabil Eng 2024; 32:2070-2077. [PMID: 38787676 DOI: 10.1109/tnsre.2024.3403092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2024]
Abstract
Remodeling of the Achilles tendon (AT) is partly driven by its mechanical environment. AT force can be estimated with neuromusculoskeletal (NMSK) modeling; however, the complex experimental setup required to perform the analyses confines use to the laboratory. We developed task-specific long short-term memory (LSTM) neural networks that employ markerless video data to predict the AT force during walking, running, countermovement jump, single-leg landing, and single-leg heel rise. The task-specific LSTM models were trained on pose estimation keypoints and corresponding AT force data from 16 subjects, calculated via an established NMSK modeling pipeline, and cross-validated using a leave-one-subject-out approach. As proof-of-concept, new motion data of one participant was collected with two smartphones and used to predict AT forces. The task-specific LSTM models predicted the time-series AT force using synthesized pose estimation data with root mean square error (RMSE) ≤ 526 N, normalized RMSE (nRMSE) ≤ 0.21 , R 2 ≥ 0.81 . Walking task resulted the most accurate with RMSE = 189±62 N; nRMSE = 0.11±0.03 , R 2 = 0.92±0.04 . AT force predicted with smartphones video data was physiologically plausible, agreeing in timing and magnitude with established force profiles. This study demonstrated the feasibility of using low-cost solutions to deploy complex biomechanical analyses outside the laboratory.
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Li H, Rong Q. Cost function criteria using muscle synergies: Exploring the potential of muscle synergy hypothesis. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2024; 250:108170. [PMID: 38614025 DOI: 10.1016/j.cmpb.2024.108170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 03/14/2024] [Accepted: 04/08/2024] [Indexed: 04/15/2024]
Abstract
BACKGROUND AND OBJECTIVE Solving the redundant optimization problem for human muscles depends on the cost function. Choosing the appropriate cost function helps to address a specific problem. Muscle synergies are currently limited to those obtained by electromyography. Furthermore, debate continues regarding whether muscle synergy is derived or real. This study proposes new cost functions based on the muscle synergy hypothesis for solving the optimal muscle force output problem through musculoskeletal modeling. METHODS We propose two new computational cost functions involving muscle synergies, which are extracted from muscle activations predicted by musculoskeletal modelling rather than electromyography. In this study, we constructed a musculoskeletal model for simulation using the "Grand Challenge Competition to Predict In Vivo Knee Loads" dataset. Muscle synergies were obtained using non-negative matrix factorization. Two cost functions with muscle synergies were constructed by integrating the polynomial and min/max criterion. Two new functions were verified and validated in normal, smooth, and bouncy gaits. RESULTS The muscle synergies based on normal gaits were classified into four modules. The cosine similarities of the first three modules were all >0.9. In the normal and smooth gaits, the forces in most muscles predicted using the two new functions were within three standard deviations of the root mean square error for electromyographic comparisons. Predicted muscle force curves using the four methods as well as characteristic points (i.e., time points in the gait cycle when the significant difference was observed between normal and bouncy gaits) were obtained to validate their predictive capabilities. CONCLUSIONS This study constructed two new cost functions involving muscle synergies, verified and validated the ability, and explored the potential of muscle synergy hypothesis.
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Affiliation(s)
- Haoran Li
- Department of Mechanics and Engineering Science, College of Engineering, Peking University, Beijing 100871, China
| | - Qiguo Rong
- Department of Mechanics and Engineering Science, College of Engineering, Peking University, Beijing 100871, China.
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Di Pietro A, Bersani A, Curreli C, Di Puccio F. AST: An OpenSim-based tool for the automatic scaling of generic musculoskeletal models. Comput Biol Med 2024; 175:108524. [PMID: 38688126 DOI: 10.1016/j.compbiomed.2024.108524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 04/22/2024] [Accepted: 04/24/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND AND OBJECTIVES The paper introduces a tool called Automatic Scaling Tool (AST) designed for improving and expediting musculoskeletal (MSK) simulations based on generic models in OpenSim. Scaling is a crucial initial step in MSK analyses, involving the correction of virtual marker locations on a model to align with actual experimental markers. METHODS The AST automates this process by iteratively adjusting virtual markers using scaling and inverse kinematics on a static trial. It evaluates the root mean square error (RMSE) and maximum marker error, implementing corrective actions until achieving the desired accuracy level. The tool determines whether to scale a segment with a marker-based or constant scaling factor based on checks on RMSE and segment scaling factors. RESULTS Testing on three generic MSK models demonstrated that the AST significantly outperformed manual scaling by an expert operator. The RMSE for static trials was one order of magnitude lower, and for gait tasks, it was five times lower (8.5 ± 0.76 mm vs. 44.5 ± 7.5 mm). The AST consistently achieved the desired level of accuracy in less than 100 iterations, providing reliable scaled MSK models within a relatively brief timeframe, ranging from minutes to hours depending on model complexity. CONCLUSIONS The paper concludes that AST can greatly benefit the biomechanical community by quickly and accurately scaling generic models, a critical first step in MSK analyses. Further validation through additional experimental datasets and generic models is proposed for future tests.
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Affiliation(s)
- Andrea Di Pietro
- Department of Civil and Industrial Engineering, University of Pisa, Italy.
| | - Alex Bersani
- Department of Industrial Engineering, Alma Mater Studiorum - University of Bologna, Italy; Medical Technology Lab, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Cristina Curreli
- Medical Technology Lab, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Francesca Di Puccio
- Department of Civil and Industrial Engineering, University of Pisa, Italy; Center for Rehabilitative Medicine "Sport and Anatomy", University of Pisa, Italy
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Li G, Ao D, Vega MM, Zandiyeh P, Chang SH, Penny AN, Lewis VO, Fregly BJ. Changes in walking function and neural control following pelvic cancer surgery with reconstruction. Front Bioeng Biotechnol 2024; 12:1389031. [PMID: 38827035 PMCID: PMC11140731 DOI: 10.3389/fbioe.2024.1389031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 04/15/2024] [Indexed: 06/04/2024] Open
Abstract
Introduction: Surgical planning and custom prosthesis design for pelvic cancer patients are challenging due to the unique clinical characteristics of each patient and the significant amount of pelvic bone and hip musculature often removed. Limb-sparing internal hemipelvectomy surgery with custom prosthesis reconstruction has become a viable option for this patient population. However, little is known about how post-surgery walking function and neural control change from pre-surgery conditions. Methods: This case study combined comprehensive walking data (video motion capture, ground reaction, and electromyography) with personalized neuromusculoskeletal computer models to provide a thorough assessment of pre- to post-surgery changes in walking function (ground reactions, joint motions, and joint moments) and neural control (muscle synergies) for a single pelvic sarcoma patient who received internal hemipelvectomy surgery with custom prosthesis reconstruction. Pre- and post-surgery walking function and neural control were quantified using pre- and post-surgery neuromusculoskeletal models, respectively, whose pelvic anatomy, joint functional axes, muscle-tendon properties, and muscle synergy controls were personalized using the participant's pre-and post-surgery walking and imaging data. For the post-surgery model, virtual surgery was performed to emulate the implemented surgical decisions, including removal of hip muscles and implantation of a custom prosthesis with total hip replacement. Results: The participant's post-surgery walking function was marked by a slower self-selected walking speed coupled with several compensatory mechanisms necessitated by lost or impaired hip muscle function, while the participant's post-surgery neural control demonstrated a dramatic change in coordination strategy (as evidenced by modified time-invariant synergy vectors) with little change in recruitment timing (as evidenced by conserved time-varying synergy activations). Furthermore, the participant's post-surgery muscle activations were fitted accurately using his pre-surgery synergy activations but fitted poorly using his pre-surgery synergy vectors. Discussion: These results provide valuable information about which aspects of post-surgery walking function could potentially be improved through modifications to surgical decisions, custom prosthesis design, or rehabilitation protocol, as well as how computational simulations could be formulated to predict post-surgery walking function reliably given a patient's pre-surgery walking data and the planned surgical decisions and custom prosthesis design.
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Affiliation(s)
- Geng Li
- Rice Computational Neuromechanics Laboratory, Department of Mechanical Engineering, Rice University, Houston, TX, United States
| | - Di Ao
- Rice Computational Neuromechanics Laboratory, Department of Mechanical Engineering, Rice University, Houston, TX, United States
| | - Marleny M. Vega
- Rice Computational Neuromechanics Laboratory, Department of Mechanical Engineering, Rice University, Houston, TX, United States
| | - Payam Zandiyeh
- Biomotion Laboratory, Department of Orthopedic Surgery, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Shuo-Hsiu Chang
- Department of Physical Medicine and Rehabilitation, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Alexander. N. Penny
- Department of Orthopedic Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Valerae O. Lewis
- Department of Orthopedic Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Benjamin J. Fregly
- Rice Computational Neuromechanics Laboratory, Department of Mechanical Engineering, Rice University, Houston, TX, United States
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Michaud F, Mouzo F, Dopico D, Cuadrado J. A Sensorized 3D-Printed Knee Test Rig for Preliminary Experimental Validation of Patellar Tracking and Contact Simulation. SENSORS (BASEL, SWITZERLAND) 2024; 24:3042. [PMID: 38793897 PMCID: PMC11125272 DOI: 10.3390/s24103042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 05/03/2024] [Accepted: 05/08/2024] [Indexed: 05/26/2024]
Abstract
Experimental validation of computational simulations is important because it provides empirical evidence to verify the accuracy and reliability of the simulated results. This validation ensures that the simulation accurately represents real-world phenomena, increasing confidence in the model's predictive capabilities and its applicability to practical scenarios. The use of musculoskeletal models in orthopedic surgery allows for objective prediction of postoperative function and optimization of results for each patient. To ensure that simulations are trustworthy and can be used for predictive purposes, comparing simulation results with experimental data is crucial. Although progress has been made in obtaining 3D bone geometry and estimating contact forces, validation of these predictions has been limited due to the lack of direct in vivo measurements and the economic and ethical constraints associated with available alternatives. In this study, an existing commercial surgical training station was transformed into a sensorized test bench to replicate a knee subject to a total knee replacement. The original knee inserts of the training station were replaced with personalized 3D-printed bones incorporating their corresponding implants, and multiple sensors with their respective supports were added. The recorded movement of the patella was used in combination with the forces recorded by the pressure sensor and the load cells, to validate the results obtained from the simulation, which was performed by means of a multibody dynamics formulation implemented in a custom-developed library. The utilization of 3D-printed models and sensors facilitated cost-effective and replicable experimental validation of computational simulations, thereby advancing orthopedic surgery while circumventing ethical concerns.
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Affiliation(s)
- Florian Michaud
- Laboratory of Mechanical Engineering, Centro de Investigación en Tecnologías Navales e Industriales (CITENI), Campus Industrial de Ferrol, University of La Coruña, 15403 Ferrol, Spain; (F.M.); (D.D.); (J.C.)
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10
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Zou J, Zhang X, Zhang Y, Jin Z. Prediction of medial knee contact force using multisource fusion recurrent neural network and transfer learning. Med Biol Eng Comput 2024; 62:1333-1346. [PMID: 38182944 DOI: 10.1007/s11517-023-03011-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 12/27/2023] [Indexed: 01/07/2024]
Abstract
Estimation of knee contact force (KCF) during gait provides essential information to evaluate knee joint function. Machine learning has been employed to estimate KCF because of the advantages of low computational cost and real-time. However, the existing machine learning models do not adequately consider gait-related data's temporal-dependent, multidimensional, and highly heterogeneous nature. This study is aimed at developing a multisource fusion recurrent neural network to predict the medial condyle KCF. First, a multisource fusion long short-term memory (MF-LSTM) model was established. Then, we developed a transfer learning strategy based on the MF-LSTM model for subject-specific medial KCF prediction. Four subjects with instrumented tibial prostheses were obtained from the literature. The results showed that the MF-LSTM model could predict medial KCF to a certain high level of accuracy (the mean of ρ = 0.970). The transfer learning model improved the prediction accuracy (the mean of ρ = 0.987). This study shows that the MF-LSTM model is a powerful and accurate computational tool for medial KCF prediction. Introducing transfer learning techniques could further improve the prediction performance for the target subject. This coupling strategy can help clinicians accurately estimate and track joint contact forces in real time.
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Affiliation(s)
- Jianjun Zou
- School of Mechanical Engineering, Southwest Jiaotong University, Chengdu, 610031, China
| | - Xiaogang Zhang
- School of Mechanical Engineering, Southwest Jiaotong University, Chengdu, 610031, China.
| | - Yali Zhang
- School of Mechanical Engineering, Southwest Jiaotong University, Chengdu, 610031, China
| | - Zhongmin Jin
- School of Mechanical Engineering, Southwest Jiaotong University, Chengdu, 610031, China
- School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, 710049, China
- School of Mechanical Engineering, University of Leeds, Leeds, LS2 9JT, UK
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11
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Crossley CB, Diamond LE, Saxby DJ, de Sousa A, Lloyd DG, Che Fornusek, Pizzolato C. Joint contact forces during semi-recumbent seated cycling. J Biomech 2024; 168:112094. [PMID: 38640830 DOI: 10.1016/j.jbiomech.2024.112094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 03/07/2024] [Accepted: 04/14/2024] [Indexed: 04/21/2024]
Abstract
Semi-recumbent cycling performed from a wheelchair is a popular rehabilitation exercise following spinal cord injury (SCI) and is often paired with functional electrical stimulation. However, biomechanical assessment of this cycling modality is lacking, even in unimpaired populations, hindering the development of personalised and safe rehabilitation programs for those with SCI. This study developed a computational pipeline to determine lower limb kinematics, kinetics, and joint contact forces (JCF) in 11 unimpaired participants during voluntary semi-recumbent cycling using a rehabilitation ergometer. Two cadences (40 and 60 revolutions per minute) and three crank powers (15 W, 30 W, and 45 W) were assessed. A rigid body model of a rehabilitation ergometer was combined with a calibrated electromyogram-informed neuromusculoskeletal model to determine JCF at the hip, knee, and ankle. Joint excursions remained consistent across all cadence and powers, but joint moments and JCF differed between 40 and 60 revolutions per minute, with peak JCF force significantly greater at 40 compared to 60 revolutions per minute for all crank powers. Poor correlations were found between mean crank power and peak JCF across all joints. This study provides foundation data and computational methods to enable further evaluation and optimisation of semi-recumbent cycling for application in rehabilitation after SCI and other neurological disorders.
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Affiliation(s)
- Claire B Crossley
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Griffith University, Australia; School of Health Sciences and Social Work, Griffith University, Australia
| | - Laura E Diamond
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Griffith University, Australia; School of Health Sciences and Social Work, Griffith University, Australia
| | - David J Saxby
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Griffith University, Australia; School of Health Sciences and Social Work, Griffith University, Australia
| | - Ana de Sousa
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Griffith University, Australia; Research Centre for Biomedical Engineering (CREB) at the Universitat Politècnica de Catalunya (UPC), Barcelona, Spain
| | - David G Lloyd
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Griffith University, Australia; School of Health Sciences and Social Work, Griffith University, Australia
| | - Che Fornusek
- Exercise & Sports Science, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Australia
| | - Claudio Pizzolato
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Griffith University, Australia; School of Health Sciences and Social Work, Griffith University, Australia.
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12
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Li J, Xu J, Chen Z, Lu Y, Hua X, Jin Z. Computational modelling of articular joints with biphasic cartilage: recent advances, challenges and opportunities. Med Eng Phys 2024; 126:104130. [PMID: 38621832 DOI: 10.1016/j.medengphy.2024.104130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 02/16/2024] [Accepted: 02/25/2024] [Indexed: 04/17/2024]
Abstract
Biphasic models have been widely used to simulate the time-dependent biomechanical response of soft tissues. Modelling techniques of joints with biphasic weight-bearing soft tissues have been markedly improved over the last decade, enhancing our understanding of the function, degenerative mechanism and outcomes of interventions of joints. This paper reviews the recent advances, challenges and opportunities in computational models of joints with biphasic weight-bearing soft tissues. The review begins with an introduction of the function and degeneration of joints from a biomechanical aspect. Different constitutive models of articular cartilage, in particular biphasic materials, are illustrated in the context of the study of contact mechanics in joints. Approaches, advances and major findings of biphasic models of the hip and knee are presented, followed by a discussion of the challenges awaiting to be addressed, including the convergence issue, high computational cost and inadequate validation. Finally, opportunities and clinical insights in the areas of subject-specific modeling and tissue engineering are provided and discussed.
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Affiliation(s)
- Junyan Li
- Tribology Research Institute, School of Mechanical Engineering, Southwest Jiaotong University, Chengdu, PR China.
| | - Jinghao Xu
- Tribology Research Institute, School of Mechanical Engineering, Southwest Jiaotong University, Chengdu, PR China
| | - Zhenxian Chen
- Key Laboratory of Road Construction Technology and Equipment (Ministry of Education), Chang'an University, Xi'an, PR China
| | - Yongtao Lu
- Department of Engineering Mechanics, Dalian University of Technology, Dalian, PR China
| | - Xijin Hua
- Faculty of Environment, Science and Economy, University of Exeter, Exeter, United Kingdom
| | - Zhongmin Jin
- Tribology Research Institute, School of Mechanical Engineering, Southwest Jiaotong University, Chengdu, PR China; Sate Key Laboratory for Manufacturing System Engineering, School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, PR China; Institute of Medical and Biological Engineering, School of Mechanical Engineering, University of Leeds, Leeds, United Kingdom
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13
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Sass JO, Johnson K, Darques JB, Buerstenbinder L, Soodmand I, Bader R, Kebbach M. Influence of posterior cruciate ligament tension on tibiofemoral and patellofemoral joint contact mechanics in cruciate-retaining total knee replacement: a combined musculoskeletal multibody and finite-element simulation. Comput Methods Biomech Biomed Engin 2024:1-13. [PMID: 38511844 DOI: 10.1080/10255842.2024.2329946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 03/08/2024] [Indexed: 03/22/2024]
Abstract
The influence of posterior cruciate ligament (PCL) tension on the clinical outcome of cruciate-retaining total knee replacement (CR-TKR) remains controversial. Various numerical approaches have been used to study this influence systematically, but the models used are limited by certain assumptions and simplifications. Therefore, the objective of this computational study was to develop a combined musculoskeletal multibody and finite-element simulation during a squat motion to 90° knee flexion with a CR-TKR design to overcome previous limitations regarding model inputs. In addition, different PCL tensions (tight, lax, resected) were modeled and the influence on tibiofemoral and resurfaced patellofemoral joint dynamics and contact stresses was evaluated. The effect of the PCL on knee joint dynamics and contact stresses was more pronounced at higher flexion angles. Tibiofemoral joint dynamics were influenced and a tight PCL induced increased posterior femoral translation during flexion. The maximum contact stress in the tibial insert increased from 20.6 MPa to 22.5 MPa for the resected and tightest PCL at 90° knee flexion. Patellofemoral joint dynamics were only slightly affected by PCL tension. However, the maximum contact stress in the patellar component decreased from 58.0 MPa to 53.7 MPa for the resected and tightest PCL at 90° knee flexion. The combination of musculoskeletal multibody and finite-element simulation is a sufficient method to comprehensively investigate knee joint dynamics and contact stresses in CR-TKR. The PCL tension after CR-TKR affects joint dynamics and contact stresses at the articulating implant surfaces.
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Affiliation(s)
- Jan-Oliver Sass
- Biomechanics and Implant Technology Research Laboratory, Department of Orthopedics, Rostock University Medical Center, Rostock, Germany
| | - Kurt Johnson
- Biomechanics and Implant Technology Research Laboratory, Department of Orthopedics, Rostock University Medical Center, Rostock, Germany
| | - Jean-Baptiste Darques
- Biomechanics and Implant Technology Research Laboratory, Department of Orthopedics, Rostock University Medical Center, Rostock, Germany
- Polytech Marseille, école d'ingénieurs d'Aix Marseille Université, Marseille, France
| | - Lucas Buerstenbinder
- Biomechanics and Implant Technology Research Laboratory, Department of Orthopedics, Rostock University Medical Center, Rostock, Germany
| | - Iman Soodmand
- Biomechanics and Implant Technology Research Laboratory, Department of Orthopedics, Rostock University Medical Center, Rostock, Germany
| | - Rainer Bader
- Biomechanics and Implant Technology Research Laboratory, Department of Orthopedics, Rostock University Medical Center, Rostock, Germany
| | - Maeruan Kebbach
- Biomechanics and Implant Technology Research Laboratory, Department of Orthopedics, Rostock University Medical Center, Rostock, Germany
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14
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Bennett HJ, Weinhandl JT, Sievert ZA. Musculoskeletal model degrees of Freedom: Frontal plane constraints are hindering our understanding of human movement. J Biomech 2024; 165:112026. [PMID: 38417193 DOI: 10.1016/j.jbiomech.2024.112026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 01/16/2024] [Accepted: 02/22/2024] [Indexed: 03/01/2024]
Abstract
Induced acceleration analyses have expanded our understanding on the contributions of muscle forces to center of mass and segmental kinematics during a myriad of tasks. While these techniques have identified a subset of major muscle that contribute to locomotion, most analyses have included models with only one frontal plane degree of freedom (dof) actuated by the hip joint. The purpose of this study was to define the impact of including knee and subtalar joint frontal plane dof on model superposition accuracy and muscle specific contributions to mediolateral accelerations. Induced acceleration analyses were performed using OpenSim with the Lai model on a freely available dataset of one subject running at 4 m/s. Analyses were performed on four models (standard, with subtalar joint, with frontal plane knee, and combined frontal plane knee with subtalar) with the kinematic constraint and perturbation analyses. Root mean square error and correlations were computed against experimental kinematics. Adding frontal plane dofs improved mediolateral acceleration correlations on average by > 0.25 while only minimally impacting errors. The constraints method performed better than the perturbation method for mediolateral accelerations. Including frontal plane knee dof resulted in muscle and method specific responses. All muscles presented with a complete flip of polarity for constraint method, imparted by allowing the medial/lateral muscles to contribute according to their anatomical function. Only the gluteus medius flipped for the perturbation method. This study provides significant support for the inclusion of frontal plane knee and subtalar dof and the need for reevaluation of muscle contributions via induced acceleration.
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Affiliation(s)
- Hunter J Bennett
- Neuromechanics Laboratory, Old Dominion University, Norfolk, VA, 23529, USA.
| | - Joshua T Weinhandl
- Department of Kinesiology, Recreation, & Sport Studies, University of Tennessee, Knoxville, TN, 37996, USA.
| | - Zachary A Sievert
- Department of Rehabilitation, Exercise, and Nutritional Sciences, University of Cincinnati, Cincinnati, OH, 45220, USA
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15
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Kobayashi T, Jor A, He Y, Hu M, Koh MWP, Hisano G, Hara T, Hobara H. Transfemoral prosthetic simulators versus amputees: ground reaction forces and spatio-temporal parameters in gait. ROYAL SOCIETY OPEN SCIENCE 2024; 11:231854. [PMID: 38545618 PMCID: PMC10966393 DOI: 10.1098/rsos.231854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 02/14/2024] [Accepted: 02/19/2024] [Indexed: 04/26/2024]
Abstract
This study aimed to compare the ground reaction forces (GRFs) and spatio-temporal parameters as well as their asymmetry ratios in gait between individuals wearing a transfemoral prosthetic simulator (TFSim) and individuals with unilateral transfemoral amputation (TFAmp) across a range of walking speeds (2.0-5.5 km h-1). The study recruited 10 non-disabled individuals using TFSim and 10 individuals with unilateral TFAmp using a transfemoral prosthesis. Data were collected using an instrumented treadmill with built-in force plates, and subsequently, the GRFs and spatio-temporal parameters, as well as their asymmetry ratios, were analysed. When comparing the TFSim and TFAmp groups, no significant differences were found among the gait parameters and asymmetry ratios of all tested metrics except the vertical GRFs. The TFSim may not realistically reproduce the vertical GRFs during the weight acceptance and push-off phases. The structural and functional variations in prosthetic limbs and components between the TFSim and TFAmp groups may be primary contributors to the difference in the vertical GRFs. These results suggest that TFSim might be able to emulate the gait of individuals with TFAmp regarding the majority of spatio-temporal and GRF parameters. However, the vertical GRFs of TFSim should be interpreted with caution.
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Affiliation(s)
- Toshiki Kobayashi
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, People's Republic of China
| | - Abu Jor
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, People's Republic of China
- Department of Leather Engineering, Faculty of Mechanical Engineering, Khulna University of Engineering & Technology, Khulna, Bangladesh
| | - Yufan He
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, People's Republic of China
| | - Mingyu Hu
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, People's Republic of China
| | - Mark W. P. Koh
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, People's Republic of China
| | - Genki Hisano
- Faculty of Advanced Engineering, Tokyo University of Science, Tokyo, Japan
- Japan Society for the Promotion of Science (JSPS), Tokyo, Japan
| | - Takeshi Hara
- Faculty of Advanced Engineering, Tokyo University of Science, Tokyo, Japan
| | - Hiroaki Hobara
- Faculty of Advanced Engineering, Tokyo University of Science, Tokyo, Japan
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16
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Michaud F, Luaces A, Mouzo F, Cuadrado J. Use of patellofemoral digital twins for patellar tracking and treatment prediction: comparison of 3D models and contact detection algorithms. Front Bioeng Biotechnol 2024; 12:1347720. [PMID: 38481569 PMCID: PMC10935559 DOI: 10.3389/fbioe.2024.1347720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 02/13/2024] [Indexed: 03/17/2024] Open
Abstract
Introduction: Poor patellar tracking can result in painful contact pressures, patella subluxation, or dislocation. The use of musculoskeletal models and simulations in orthopedic surgeries allows for objective predictions of post-treatment function, empowering clinicians to explore diverse treatment options for patients. Although a promising approach for managing knee surgeries, the high computational cost of the Finite Element Method hampers its clinical usability. In anticipation of minimal elastic deformations in the involved bodies, the exploration of the Multibody Dynamics approach emerged as a viable solution, providing a computationally efficient methodology to address clinical concerns related to the knee joint. Methods: This work, with a focus on high-performance computing, achieved the simulation of the patellofemoral joint through rigid-body multibody dynamics formulations. A comparison was made between two collision detection algorithms employed in the simulation of contact between the patellar and femoral implants: a generic mesh-to-mesh collision detection algorithm, which identifies potential collisions between bodies by checking for proximity or overlap between their discretized mesh surface elements, and an analytical contact algorithm, which uses a mathematical model to provide closed-form solutions for specific contact problems, but cannot handle arbitrary geometries. In addition, different digital twins (3D model geometries) of the femoral implant were compared. Results: Computational efficiency was considered, and histories of position, orientation, and contact force of the patella during the motion were compared with experimental measurements obtained from a sensorized 3D-printed test bench under pathological and treatment scenarios. The best results were achieved through a purely analytical contact detection algorithm, allowing for clinical usability and optimization of clinical outcomes.
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Affiliation(s)
- Florian Michaud
- Laboratory of Mechanical Engineering, CITENI, Campus Industrial de Ferrol, University of La Coruña, Ferrol, Spain
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17
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Cashaback JGA, Allen JL, Chou AHY, Lin DJ, Price MA, Secerovic NK, Song S, Zhang H, Miller HL. NSF DARE-transforming modeling in neurorehabilitation: a patient-in-the-loop framework. J Neuroeng Rehabil 2024; 21:23. [PMID: 38347597 PMCID: PMC10863253 DOI: 10.1186/s12984-024-01318-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 01/25/2024] [Indexed: 02/15/2024] Open
Abstract
In 2023, the National Science Foundation (NSF) and the National Institute of Health (NIH) brought together engineers, scientists, and clinicians by sponsoring a conference on computational modelling in neurorehabiilitation. To facilitate multidisciplinary collaborations and improve patient care, in this perspective piece we identify where and how computational modelling can support neurorehabilitation. To address the where, we developed a patient-in-the-loop framework that uses multiple and/or continual measurements to update diagnostic and treatment model parameters, treatment type, and treatment prescription, with the goal of maximizing clinically-relevant functional outcomes. This patient-in-the-loop framework has several key features: (i) it includes diagnostic and treatment models, (ii) it is clinically-grounded with the International Classification of Functioning, Disability and Health (ICF) and patient involvement, (iii) it uses multiple or continual data measurements over time, and (iv) it is applicable to a range of neurological and neurodevelopmental conditions. To address the how, we identify state-of-the-art and highlight promising avenues of future research across the realms of sensorimotor adaptation, neuroplasticity, musculoskeletal, and sensory & pain computational modelling. We also discuss both the importance of and how to perform model validation, as well as challenges to overcome when implementing computational models within a clinical setting. The patient-in-the-loop approach offers a unifying framework to guide multidisciplinary collaboration between computational and clinical stakeholders in the field of neurorehabilitation.
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Affiliation(s)
- Joshua G A Cashaback
- Biomedical Engineering, Mechanical Engineering, Kinesiology and Applied Physiology, Biome chanics and Movement Science Program, Interdisciplinary Neuroscience Graduate Program, University of Delaware, 540 S College Ave, Newark, DE, 19711, USA.
| | - Jessica L Allen
- Department of Mechanical Engineering, University of Florida, Gainesville, USA
| | | | - David J Lin
- Division of Neurocritical Care and Stroke Service, Department of Neurology, Center for Neurotechnology and Neurorecovery, Massachusetts General Hospital, Harvard Medical School, Boston, USA
- Department of Veterans Affairs, Center for Neurorestoration and Neurotechnology, Rehabilitation Research and Development Service, Providence, USA
| | - Mark A Price
- Department of Mechanical and Industrial Engineering, Department of Kinesiology, University of Massachusetts Amherst, Amherst, USA
| | - Natalija K Secerovic
- School of Electrical Engineering, The Mihajlo Pupin Institute, University of Belgrade, Belgrade, Serbia
- Laboratory for Neuroengineering, Institute for Robotics and Intelligent Systems ETH Zürich, Zurich, Switzerland
| | - Seungmoon Song
- Mechanical and Industrial Engineering, Northeastern University, Boston, USA
| | - Haohan Zhang
- Department of Mechanical Engineering, University of Utah, Salt Lake City, USA
| | - Haylie L Miller
- School of Kinesiology, University of Michigan, 830 N University Ave, Ann Arbor, MI, 48109, USA.
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18
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Glenday JD, Vigdorchik JM, Sculco PK, Kahlenberg CA, Mayman DJ, Debbi EM, Lipman JD, Wright TM, González FJQ. A novel computational workflow to holistically assess total knee arthroplasty biomechanics identifies subject-specific effects of joint mechanics on implant fixation. J Biomech 2024; 164:111973. [PMID: 38325192 DOI: 10.1016/j.jbiomech.2024.111973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 12/04/2023] [Accepted: 01/29/2024] [Indexed: 02/09/2024]
Abstract
Computational studies of total knee arthroplasty (TKA) often focus on either joint mechanics (kinematics and forces) or implant fixation mechanics. However, such disconnect between joint and fixation mechanics hinders our understanding of overall TKA biomechanical function by preventing identification of key relationships between these two levels of TKA mechanics. We developed a computational workflow to holistically assess TKA biomechanics by integrating musculoskeletal and finite element (FE) models. For our initial study using the workflow, we investigated how tibiofemoral contact mechanics affected the risk of failure due to debonding at the implant-cement interface using the four available subjects from the Grand Challenge Competitions to Predict In Vivo Knee Loads. We used a musculoskeletal model with a 12 degrees-of-freedom knee joint to simulate the stance phase of gait for each subject. The computed tibiofemoral joint forces at each node in contact were direct inputs to FE simulations of the same subjects. We found that the peak risk of failure did not coincide with the peak joint forces or the extreme tibiofemoral contact positions. Moreover, despite the consistency of joint forces across subjects, we observed important variability in the profile of the risk of failure during gait. Thus, by a combined evaluation of the joint and implant fixation mechanics of TKA, we could identify subject-specific effects of joint kinematics and forces on implant fixation that would otherwise have gone unnoticed. We intend to apply our workflow to evaluate the impact of implant alignment and design on TKA biomechanics.
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Affiliation(s)
- Jonathan D Glenday
- Hospital for Special Surgery, 535 East 71st Street, New York 10021, NY, USA
| | | | - Peter K Sculco
- Hospital for Special Surgery, 535 East 71st Street, New York 10021, NY, USA
| | | | - David J Mayman
- Hospital for Special Surgery, 535 East 71st Street, New York 10021, NY, USA
| | - Eytan M Debbi
- Hospital for Special Surgery, 535 East 71st Street, New York 10021, NY, USA
| | - Joseph D Lipman
- Hospital for Special Surgery, 535 East 71st Street, New York 10021, NY, USA
| | - Timothy M Wright
- Hospital for Special Surgery, 535 East 71st Street, New York 10021, NY, USA
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19
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Esrafilian A, Halonen KS, Dzialo CM, Mannisi M, Mononen ME, Tanska P, Woodburn J, Korhonen RK, Andersen MS. Effects of gait modifications on tissue-level knee mechanics in individuals with medial tibiofemoral osteoarthritis: A proof-of-concept study towards personalized interventions. J Orthop Res 2024; 42:326-338. [PMID: 37644668 PMCID: PMC10952410 DOI: 10.1002/jor.25686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 06/19/2023] [Accepted: 08/24/2023] [Indexed: 08/31/2023]
Abstract
Gait modification is a common nonsurgical approach to alter the mediolateral distribution of knee contact forces, intending to decelerate or postpone the progression of mechanically induced knee osteoarthritis (KOA). Nevertheless, the success rate of these approaches is controversial, with no studies conducted to assess alterations in tissue-level knee mechanics governing cartilage degradation response in KOA patients undertaking gait modifications. Thus, here we investigated the effect of different conventional gait conditions and modifications on tissue-level knee mechanics previously suggested as indicators of collagen network damage, cell death, and loss of proteoglycans in knee cartilage. Five participants with medial KOA were recruited and musculoskeletal finite element analyses were conducted to estimate subject-specific tissue mechanics of knee cartilages during two gait conditions (i.e., barefoot and shod) and six gait modifications (i.e., 0°, 5°, and 10° lateral wedge insoles, toe-in, toe-out, and wide stance). Based on our results, the optimal gait modification varied across the participants. Overall, toe-in, toe-out, and wide stance showed the greatest reduction in tissue mechanics within medial tibial and femoral cartilages. Gait modifications could effectually alter maximum principal stress (~20 ± 7%) and shear strain (~9 ± 4%) within the medial tibial cartilage. Nevertheless, lateral wedge insoles did not reduce joint- and tissue-level mechanics considerably. Significance: This proof-of-concept study emphasizes the importance of the personalized design of gait modifications to account for biomechanical risk factors associated with cartilage degradation.
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Affiliation(s)
- Amir Esrafilian
- Department of Technical PhysicsUniversity of Eastern FinlandKuopioFinland
| | - Kimmo S. Halonen
- Central hospital of Päijät‐HämeLahtiFinland
- Department of Materials and ProductionAalborg UniversityAalborgDenmark
| | | | | | - Mika E. Mononen
- Department of Technical PhysicsUniversity of Eastern FinlandKuopioFinland
| | - Petri Tanska
- Department of Technical PhysicsUniversity of Eastern FinlandKuopioFinland
| | - Jim Woodburn
- Griffith Centre of Biomedical and Rehabilitation Engineering, Menzies Health Institute QueenslandGriffith UniversityGold CoastQLDAustralia
| | - Rami K. Korhonen
- Department of Technical PhysicsUniversity of Eastern FinlandKuopioFinland
| | - Michael S. Andersen
- Department of Materials and ProductionAalborg UniversityAalborgDenmark
- Center for Mathematical Modeling of Knee Osteoarthritis (MathKOA), Department of Materials and ProductionAalborg UniversityAalborgDenmark
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20
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Zhang Q, Li Z, Chen Z, Peng Y, Jin Z, Qin L. Prediction of knee biomechanics with different tibial component malrotations after total knee arthroplasty: conventional machine learning vs. deep learning. Front Bioeng Biotechnol 2024; 11:1255625. [PMID: 38260731 PMCID: PMC10800660 DOI: 10.3389/fbioe.2023.1255625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 12/21/2023] [Indexed: 01/24/2024] Open
Abstract
The precise alignment of tibiofemoral components in total knee arthroplasty is a crucial factor in enhancing the longevity and functionality of the knee. However, it is a substantial challenge to quickly predict the biomechanical response to malrotation of tibiofemoral components after total knee arthroplasty using musculoskeletal multibody dynamics models. The objective of the present study was to conduct a comparative analysis between a deep learning method and four conventional machine learning methods for predicting knee biomechanics with different tibial component malrotation during a walking gait after total knee arthroplasty. First, the knee contact forces and kinematics with different tibial component malrotation in the range of ±5° in the three directions of anterior/posterior slope, internal/external rotation, and varus/valgus rotation during a walking gait after total knee arthroplasty were calculated based on the developed musculoskeletal multibody dynamics model. Subsequently, deep learning and four conventional machine learning methods were developed using the above 343 sets of biomechanical data as the dataset. Finally, the results predicted by the deep learning method were compared to the results predicted by four conventional machine learning methods. The findings indicated that the deep learning method was more accurate than four conventional machine learning methods in predicting knee contact forces and kinematics with different tibial component malrotation during a walking gait after total knee arthroplasty. The deep learning method developed in this study enabled quickly determine the biomechanical response with different tibial component malrotation during a walking gait after total knee arthroplasty. The proposed method offered surgeons and surgical robots the ability to establish a calibration safety zone, which was essential for achieving precise alignment in both preoperative surgical planning and intraoperative robotic-assisted surgical navigation.
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Affiliation(s)
- Qida Zhang
- Musculoskeletal Research Laboratory, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Zhuhuan Li
- State Key Laboratory for Manufacturing System Engineering, School of Mechanical Engineering, Xi’an Jiaotong University, Xi’an, China
| | - Zhenxian Chen
- Key Laboratory of Road Construction Technology and Equipment (Ministry of Education), School of Mechanical Engineering, Chang’an University, Xi’an, China
| | - Yinghu Peng
- CAS Key Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen Institutes of Advanced Technology Chinese Academy of Sciences, Shenzhen, China
| | - Zhongmin Jin
- Tribology Research Institute, School of Mechanical Engineering, Southwest Jiaotong University, Chengdu, China
- Institute of Medical and Biological Engineering, School of Mechanical Engineering, University of Leeds, Leeds, United Kingdom
| | - Ling Qin
- Musculoskeletal Research Laboratory, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
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21
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Jang J, Franz JR, Pietrosimone BG, Wikstrom EA. Muscle contributions to reduced ankle joint contact force during drop vertical jumps in patients with chronic ankle instability. J Biomech 2024; 163:111926. [PMID: 38183761 DOI: 10.1016/j.jbiomech.2024.111926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 12/05/2023] [Accepted: 01/02/2024] [Indexed: 01/08/2024]
Abstract
Chronic ankle instability is a condition linked to progressive early ankle joint degeneration. Patients with chronic ankle instability exhibit altered biomechanics during gait and jump landings and these alterations are believed to contribute to aberrant joint loading and subsequent joint degeneration. Musculoskeletal modeling has the capacity to estimate joint loads from individual muscle forces. However, the influence of chronic ankle instability on joint contact forces remains largely unknown. The objective of this study was to compare tri-axial (i.e., compressive, anterior-posterior, and medial-lateral) ankle joint contact forces between those with and without chronic ankle instability during the ground contact phase of a drop vertical jump. Fifteen individuals with and 15 individuals without chronic ankle instability completed drop vertical jump maneuvers in a research laboratory. We used those data to drive three-dimensional musculoskeletal simulations and estimate muscle forces and tri-axial joint contact force variables (i.e., peak and impulse). Compared to those without chronic ankle instability, the ankles of patients with chronic ankle instability underwent lower compressive ankle joint contact forces as well as lower anterior-posterior and medial-lateral shearing forces during the weight acceptance phase of landing (p <.05). These findings suggest that patients with chronic ankle instability exhibit lower ankle joint loading patterns than uninjured individuals during a drop vertical jump, which may be considered in rehabilitation to potentially reduce the risk of early onset of ankle joint degeneration.
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Affiliation(s)
- Jaeho Jang
- Department of Kinesiology, University of Texas at El Paso, El Paso, TX, United States.
| | - Jason R Franz
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Chapel Hill, NC, United States
| | - Brian G Pietrosimone
- MOTION Science Institute, Department of Exercise & Sport Science, University of North Carolina at Chapel Hill, NC, United States
| | - Erik A Wikstrom
- MOTION Science Institute, Department of Exercise & Sport Science, University of North Carolina at Chapel Hill, NC, United States
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22
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Zhou S, Bender A, Kutzner I, Dymke J, Maleitzke T, Perka C, Duda GN, Winkler T, Damm P. Loading of the Hip and Knee During Swimming: An in Vivo Load Study. J Bone Joint Surg Am 2023; 105:1962-1971. [PMID: 38079507 DOI: 10.2106/jbjs.23.00218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
BACKGROUND Swimming is commonly recommended as postoperative rehabilitation following total hip arthroplasty (THA) and total knee arthroplasty (TKA). So far, in vivo hip and knee joint loads during swimming remain undescribed. METHODS In vivo hip and knee joint loads were measured in 6 patients who underwent THA and 5 patients who underwent TKA with instrumented joint implants. Joint loads, including the resultant joint contact force (F Res ), torsional moment around the femoral shaft axis or the tibial axis (M Tors ), bending moment at the middle of the femoral neck (M Bend ), torsional moment around the femoral neck axis (M Tne ), and medial force ratio (MFR) in the knee, were measured during breaststroke swimming at 0.5, 0.6, and 0.7 m/s and the breaststroke and crawl kicks at 0.5 and 1.0 m/s. RESULTS The ranges of the median maximal F Res were 157% to 193% of body weight for the hip and 93% to 145% of body weight for the knee during breaststroke swimming. Greater maxima of F Res (hip and knee), M Tors (hip and knee), M Bend (hip), and M Tne (hip) were observed with higher breaststroke swimming velocities, but significance was only identified between 0.5 and 0.6 m/s in F Res (p = 0.028), M Tors (p = 0.028), and M Bend (p = 0.028) and between 0.5 and 0.7 m/s in F Res (p = 0.045) in hips. No difference was found in maximal MFR between different breaststroke swimming velocities. The maximal F Res was significantly positively correlated with the breaststroke swimming velocity (hip: r = 0.541; p < 0.05; and knee: r = 0.414; p < 0.001). The maximal F Res (hip and knee) and moments (hip) were higher in the crawl kick than in the breaststroke kick, and a significant difference was recognized in F Res Max for the hip: median, 179% versus 118% of body weight (p = 0.028) for 0.5 m/s and 166% versus 133% of body weight (p = 0.028) for 1.0 m/s. CONCLUSIONS Swimming is a safe and low-impact activity, particularly recommended for patients who undergo THA or TKA. Hip and knee joint loads are greater with higher swimming velocities and can be influenced by swimming styles. Nevertheless, concrete suggestions to patients who undergo arthroplasty on swimming should involve individual considerations. LEVEL OF EVIDENCE Therapeutic Level IV . See Instructions for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Sijia Zhou
- Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Julius Wolff Institute for Biomechanics and Musculoskeletal Regeneration, Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
- Berlin Brandenburg Center for Regenerative Therapies, Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Alwina Bender
- Julius Wolff Institute for Biomechanics and Musculoskeletal Regeneration, Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Ines Kutzner
- Julius Wolff Institute for Biomechanics and Musculoskeletal Regeneration, Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Jörn Dymke
- Julius Wolff Institute for Biomechanics and Musculoskeletal Regeneration, Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Tazio Maleitzke
- Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Julius Wolff Institute for Biomechanics and Musculoskeletal Regeneration, Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
- Berlin Institute of Health Charité Clinician Scientist Program, BIH Biomedical Innovation Academy, Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Carsten Perka
- Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Georg N Duda
- Julius Wolff Institute for Biomechanics and Musculoskeletal Regeneration, Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
- Berlin Brandenburg Center for Regenerative Therapies, Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Tobias Winkler
- Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Julius Wolff Institute for Biomechanics and Musculoskeletal Regeneration, Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
- Berlin Brandenburg Center for Regenerative Therapies, Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Philipp Damm
- Julius Wolff Institute for Biomechanics and Musculoskeletal Regeneration, Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
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23
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Febrer-Nafría M, Dreyer MJ, Maas A, Taylor WR, Smith CR, Hosseini Nasab SH. Knee kinematics are primarily determined by implant alignment but knee kinetics are mainly influenced by muscle coordination strategy. J Biomech 2023; 161:111851. [PMID: 37907050 DOI: 10.1016/j.jbiomech.2023.111851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 10/19/2023] [Accepted: 10/22/2023] [Indexed: 11/02/2023]
Abstract
Implant malalignment has been reported to be a primary reason for revision total knee arthroplasty (TKA). In addition, altered muscle coordination patterns are commonly observed in TKA patients, which is thought to alter knee contact loads. A comprehensive understanding of the influence of surgical implantation and muscle recruitment strategies on joint contact mechanics is crucial to improve surgical techniques, increase implant longevity, and inform rehabilitation protocols. In this study, a detailed musculoskeletal model with a 12 degrees of freedom knee was developed to represent a TKA subject from the CAMS-Knee datasets. Using motion capture and ground reaction force data, a level walking cycle was simulated and the joint movement and loading patterns were estimated using a novel technique for concurrent optimization of muscle activations and joint kinematics. In addition, over 12'000 Monte Carlo simulations were performed to predict knee contact mechanics during walking, considering numerous combinations of implant alignment and muscle activation scenarios. Validation of our baseline simulation showed good agreement between the model kinematics and loading patterns against the in vivo data. Our analyses reveal a considerable impact of implant alignment on the joint kinematics, while variation in muscle activation strategies mainly affects knee contact loading. Moreover, our results indicate that high knee compressive forces do not necessarily originate from extreme kinematics and vice versa. This study provides an improved understanding of the complex inter-relationships between loading and movement patterns resulting from different surgical implantation and muscle coordination strategies and presents a validated framework towards population-based modelling in TKA.
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Affiliation(s)
- Míriam Febrer-Nafría
- Institute for Biomechanics, ETH Zürich, Switzerland; Department of Mechanical Engineering, Universitat Politècnica de Catalunya, Spain
| | - Michael J Dreyer
- Institute for Biomechanics, ETH Zürich, Switzerland; Laboratory for Mechanical Systems Engineering, Empa, Dübendorf, Switzerland
| | - Allan Maas
- Department of Orthopaedic and Trauma Surgery, Ludwig Maximilians University Munich, Musculoskeletal University Center Munich (MUM), Campus Grosshadern, Munich, Germany; Research and Development, Aesculap AG, Tuttlingen, Germany
| | | | - Colin R Smith
- Institute for Biomechanics, ETH Zürich, Switzerland; Steadman Philippon Research Institute, Vail, USA
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24
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Jones BW, Willson JD, DeVita P, Wedge RD. Tibiofemoral Load Magnitude and Distribution During Load Carriage. J Appl Biomech 2023; 39:432-439. [PMID: 37739402 DOI: 10.1123/jab.2022-0257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 07/26/2023] [Accepted: 08/02/2023] [Indexed: 09/24/2023]
Abstract
Chronic exposure to high tibiofemoral joint (TFJ) contact forces can be detrimental to knee joint health. Load carriage increases TFJ contact forces, but it is unclear whether medial and lateral tibiofemoral compartments respond similarly to incremental load carriage. The purpose of our study was to compare TFJ contact forces when walking with 15% and 30% added body weight. Young healthy adults (n = 24) walked for 5 minutes with no load, 15% load, and 30% load on an instrumented treadmill. Total, medial, and lateral TFJ contact peak forces and impulses were calculated via an inverse dynamics informed musculoskeletal model. Results of 1-way repeated measures analyses of variance (α = .05) demonstrated total, medial, and lateral TFJ first peak contact forces and impulses increased significantly with increasing load. Orthogonal polynomial trends demonstrated that the 30% loading condition led to a curvilinear increase in total and lateral TFJ impulses, whereas medial first peak TFJ contact forces and impulses responded linearly to increasing load. The total and lateral compartment impulse increased disproportionally with load carriage, while the medial did not. The medial and lateral compartments responded differently to increasing load during walking, warranting further investigation because it may relate to risk of osteoarthritis.
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Affiliation(s)
- Blake W Jones
- Department of Kinesiology, East Carolina University, Greenville, NC,USA
- Department of Physical Therapy, East Carolina University, Greenville, NC,USA
| | - John D Willson
- Department of Physical Therapy, East Carolina University, Greenville, NC,USA
| | - Paul DeVita
- Department of Kinesiology, East Carolina University, Greenville, NC,USA
| | - Ryan D Wedge
- Department of Physical Therapy, East Carolina University, Greenville, NC,USA
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25
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Imhauser CW, Baumann AP, Liu XC, Bischoff JE, Verdonschot N, Fregly BJ, Elmasry SS, Abdollahi NN, Hume DR, Rooks NB, Schneider MTY, Zaylor W, Besier TF, Halloran JP, Shelburne KB, Erdemir A. Reproducibility in modeling and simulation of the knee: Academic, industry, and regulatory perspectives. J Orthop Res 2023; 41:2569-2578. [PMID: 37350016 DOI: 10.1002/jor.25652] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 04/23/2023] [Accepted: 05/30/2023] [Indexed: 06/24/2023]
Abstract
Stakeholders in the modeling and simulation (M&S) community organized a workshop at the 2019 Annual Meeting of the Orthopaedic Research Society (ORS) entitled "Reproducibility in Modeling and Simulation of the Knee: Academic, Industry, and Regulatory Perspectives." The goal was to discuss efforts among these stakeholders to address irreproducibility in M&S focusing on the knee joint. An academic representative from a leading orthopedic hospital in the United States described a multi-institutional, open effort funded by the National Institutes of Health to assess model reproducibility in computational knee biomechanics. A regulatory representative from the United States Food and Drug Administration indicated the necessity of standards for reproducibility to increase utility of M&S in the regulatory setting. An industry representative from a major orthopedic implant company emphasized improving reproducibility by addressing indeterminacy in personalized modeling through sensitivity analyses, thereby enhancing preclinical evaluation of joint replacement technology. Thought leaders in the M&S community stressed the importance of data sharing to minimize duplication of efforts. A survey comprised 103 attendees revealed strong support for the workshop and for increasing emphasis on computational modeling at future ORS meetings. Nearly all survey respondents (97%) considered reproducibility to be an important issue. Almost half of respondents (45%) tried and failed to reproduce the work of others. Two-thirds of respondents (67%) declared that individual laboratories are most responsible for ensuring reproducible research whereas 44% thought that journals are most responsible. Thought leaders and survey respondents emphasized that computational models must be reproducible and credible to advance knee M&S.
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Affiliation(s)
- Carl W Imhauser
- Department of Biomechanics, Hospital for Special Surgery, New York, New York, USA
| | - Andrew P Baumann
- US Food and Drug Administration, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, Division of Applied Mechanics, Silver Spring, Maryland, USA
| | | | | | - Nico Verdonschot
- Department of Biomechanical Engineering, Technical Medical Institute at University of Twente, Enschede, The Netherlands
- Orthopaedic Research Lab, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Benjamin J Fregly
- Department of Mechanical Engineering, Rice University, Houston, Texas, USA
| | - Shady S Elmasry
- Department of Biomechanics, Hospital for Special Surgery, New York, New York, USA
- Department of Mechanical Design and Production, Faculty of Engineering, Cairo University, Cairo, Egypt
| | - Neda N Abdollahi
- Center for Human Machine Systems, Cleveland State University, Cleveland, Ohio, USA
- Department of Mechanical Engineering, Cleveland State University, Cleveland, Ohio, USA
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Donald R Hume
- Department of Mechanical and Materials Engineering, University of Denver, Denver, Colorado, USA
- Center for Orthopaedic Biomechanics, University of Denver, Denver, Colorado, USA
| | - Nynke B Rooks
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - Marco T-Y Schneider
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - William Zaylor
- Center for Human Machine Systems, Cleveland State University, Cleveland, Ohio, USA
- Department of Mechanical Engineering, Cleveland State University, Cleveland, Ohio, USA
| | - Thor F Besier
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
- Department of Engineering Science, Faculty of Engineering, University of Auckland, Auckland, New Zealand
| | - Jason P Halloran
- Applied Sciences Laboratory, Institute for Shock Physics, Washington State University, Spokane, Washington, USA
| | - Kevin B Shelburne
- Department of Mechanical and Materials Engineering, University of Denver, Denver, Colorado, USA
- Center for Orthopaedic Biomechanics, University of Denver, Denver, Colorado, USA
| | - Ahmet Erdemir
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA
- Computational Biomodeling (CoBi) Core, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA
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26
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Gill HS. CORR Insights®: Are Abnormal Muscle Biomechanics and Patient-reported Outcomes Associated in Patients With Hip Dysplasia? Clin Orthop Relat Res 2023; 481:2390-2391. [PMID: 37498284 PMCID: PMC10642880 DOI: 10.1097/corr.0000000000002787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 06/29/2023] [Indexed: 07/28/2023]
Affiliation(s)
- Harinderjit S Gill
- Professor of Mechanical Engineering, University of Bath - Claverton Down, Bath, UK
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27
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Werling K, Bianco NA, Raitor M, Stingel J, Hicks JL, Collins SH, Delp SL, Liu CK. AddBiomechanics: Automating model scaling, inverse kinematics, and inverse dynamics from human motion data through sequential optimization. PLoS One 2023; 18:e0295152. [PMID: 38033114 PMCID: PMC10688959 DOI: 10.1371/journal.pone.0295152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 11/14/2023] [Indexed: 12/02/2023] Open
Abstract
Creating large-scale public datasets of human motion biomechanics could unlock data-driven breakthroughs in our understanding of human motion, neuromuscular diseases, and assistive devices. However, the manual effort currently required to process motion capture data and quantify the kinematics and dynamics of movement is costly and limits the collection and sharing of large-scale biomechanical datasets. We present a method, called AddBiomechanics, to automate and standardize the quantification of human movement dynamics from motion capture data. We use linear methods followed by a non-convex bilevel optimization to scale the body segments of a musculoskeletal model, register the locations of optical markers placed on an experimental subject to the markers on a musculoskeletal model, and compute body segment kinematics given trajectories of experimental markers during a motion. We then apply a linear method followed by another non-convex optimization to find body segment masses and fine tune kinematics to minimize residual forces given corresponding trajectories of ground reaction forces. The optimization approach requires approximately 3-5 minutes to determine a subject's skeleton dimensions and motion kinematics, and less than 30 minutes of computation to also determine dynamically consistent skeleton inertia properties and fine-tuned kinematics and kinetics, compared with about one day of manual work for a human expert. We used AddBiomechanics to automatically reconstruct joint angle and torque trajectories from previously published multi-activity datasets, achieving close correspondence to expert-calculated values, marker root-mean-square errors less than 2 cm, and residual force magnitudes smaller than 2% of peak external force. Finally, we confirmed that AddBiomechanics accurately reproduced joint kinematics and kinetics from synthetic walking data with low marker error and residual loads. We have published the algorithm as an open source cloud service at AddBiomechanics.org, which is available at no cost and asks that users agree to share processed and de-identified data with the community. As of this writing, hundreds of researchers have used the prototype tool to process and share about ten thousand motion files from about one thousand experimental subjects. Reducing the barriers to processing and sharing high-quality human motion biomechanics data will enable more people to use state-of-the-art biomechanical analysis, do so at lower cost, and share larger and more accurate datasets.
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Affiliation(s)
- Keenon Werling
- Department of Computer Science, Stanford University, Stanford, California, United States of America
| | - Nicholas A. Bianco
- Department of Mechanical Engineering, Stanford University, Stanford, California, United States of America
| | - Michael Raitor
- Department of Mechanical Engineering, Stanford University, Stanford, California, United States of America
| | - Jon Stingel
- Department of Mechanical Engineering, Stanford University, Stanford, California, United States of America
| | - Jennifer L. Hicks
- Department of Bioengineering, Stanford University, Stanford, California, United States of America
| | - Steven H. Collins
- Department of Mechanical Engineering, Stanford University, Stanford, California, United States of America
| | - Scott L. Delp
- Department of Mechanical Engineering, Stanford University, Stanford, California, United States of America
- Department of Bioengineering, Stanford University, Stanford, California, United States of America
| | - C. Karen Liu
- Department of Computer Science, Stanford University, Stanford, California, United States of America
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28
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Lavikainen J, Stenroth L, Alkjær T, Karjalainen PA, Korhonen RK, Mononen ME. Prediction of Knee Joint Compartmental Loading Maxima Utilizing Simple Subject Characteristics and Neural Networks. Ann Biomed Eng 2023; 51:2479-2489. [PMID: 37335376 PMCID: PMC10598099 DOI: 10.1007/s10439-023-03278-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 06/07/2023] [Indexed: 06/21/2023]
Abstract
Joint loading may affect the development of osteoarthritis, but patient-specific load estimation requires cumbersome motion laboratory equipment. This reliance could be eliminated using artificial neural networks (ANNs) to predict loading from simple input predictors. We used subject-specific musculoskeletal simulations to estimate knee joint contact forces for 290 subjects during over 5000 stance phases of walking and then extracted compartmental and total joint loading maxima from the first and second peaks of the stance phase. We then trained ANN models to predict the loading maxima from predictors that can be measured without motion laboratory equipment (subject mass, height, age, gender, knee abduction-adduction angle, and walking speed). When compared to the target data, our trained models had NRMSEs (RMSEs normalized to the mean of the response variable) between 0.14 and 0.42 and Pearson correlation coefficients between 0.42 and 0.84. The loading maxima were predicted most accurately using the models trained with all predictors. We demonstrated that prediction of knee joint loading maxima may be possible without laboratory-measured motion capture data. This is a promising step in facilitating knee joint loading predictions in simple environments, such as a physician's appointment. In future, the rapid measurement and analysis setup could be utilized to guide patients in rehabilitation to slow development of joint disorders, such as osteoarthritis.
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Affiliation(s)
- Jere Lavikainen
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
| | - Lauri Stenroth
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
| | - Tine Alkjær
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
- Parker Institute, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - Pasi A. Karjalainen
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
| | - Rami K. Korhonen
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
| | - Mika E. Mononen
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
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29
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Liu S, Amiri P, McGregor AH, Bull AMJ. Bilateral Asymmetry in Knee and Hip Musculoskeletal Loading During Stair Ascending/Descending in Individuals with Unilateral Mild-to-Moderate Medial Knee Osteoarthritis. Ann Biomed Eng 2023; 51:2490-2503. [PMID: 37482575 PMCID: PMC10598163 DOI: 10.1007/s10439-023-03289-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 06/19/2023] [Indexed: 07/25/2023]
Abstract
Most cases of unilateral knee osteoarthritis (OA) progress to bilateral OA within 10 years. Biomechanical asymmetries have been implicated in contralateral OA development; however, gait analysis alone does not consistently detect asymmetries in OA patient gait. Stair ambulation is a more demanding activity that may be more suited to reveal between-leg asymmetries in OA patients. The objective of this study was to investigate the between-leg biomechanical differences in patients with unilateral mild-to-moderate knee OA. Sixteen unilateral mild-to-moderate medial knee OA patients and 16 healthy individuals underwent kinematic and kinetic analysis of stair ascent and descent. Stair ascent produced higher loading and muscle forces in the unaffected limb compared to the OA limb, and stair descent produced lower loading on the OA limb compared to healthy subjects. These biomechanical differences were apparent in the ankle, knee, and hip joints. The implications of these findings are that OA patients rely more heavily on their unaffected sides than the affected side in stair ascent, a strategy that may be detrimental to the unaffected joint health. The reduction in affected limb loading in stair descent is thought to be related to minimizing pain.
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Affiliation(s)
- Sirui Liu
- Department of Bioengineering, Imperial College London, Sir Michael Uren Hub, Imperial College London White City Campus, 86 Wood Ln, London, W12 0BZ, UK.
| | - Pouya Amiri
- Department of Bioengineering, Imperial College London, Sir Michael Uren Hub, Imperial College London White City Campus, 86 Wood Ln, London, W12 0BZ, UK
| | - Alison H McGregor
- Department of Surgery and Cancer, Imperial College London, Sir Michael Uren Hub, Imperial College London White City Campus, 86 Wood Ln, London, W12 0BZ, UK
| | - Anthony M J Bull
- Department of Bioengineering, Imperial College London, Sir Michael Uren Hub, Imperial College London White City Campus, 86 Wood Ln, London, W12 0BZ, UK
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30
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Ao D, Li G, Shourijeh MS, Patten C, Fregly BJ. EMG-Driven Musculoskeletal Model Calibration With Wrapping Surface Personalization. IEEE Trans Neural Syst Rehabil Eng 2023; 31:4235-4244. [PMID: 37831559 PMCID: PMC10644710 DOI: 10.1109/tnsre.2023.3323516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2023]
Abstract
Muscle forces and joint moments estimated by electromyography (EMG)-driven musculoskeletal models are sensitive to the wrapping surface geometry defining muscle-tendon lengths and moment arms. Despite this sensitivity, wrapping surface properties are typically not personalized to subject movement data. This study developed a novel method for personalizing OpenSim cylindrical wrapping surfaces during EMG-driven model calibration. To avoid the high computational cost of repeated OpenSim muscle analyses, the method uses two-level polynomial surrogate models. Outer-level models specify time-varying muscle-tendon lengths and moment arms as functions of joint angles, while inner-level models specify time-invariant outer-level polynomial coefficients as functions of wrapping surface parameters. To evaluate the method, we used walking data collected from two individuals post-stroke and performed four variations of EMG-driven lower extremity model calibration: 1) no calibration of scaled generic wrapping surfaces (NGA), 2) calibration of outer-level polynomial coefficients for all muscles (SGA), 3) calibration of outer-level polynomial coefficients only for muscles with wrapping surfaces (LSGA), and 4) calibration of cylindrical wrapping surface parameters for muscles with wrapping surfaces (PGA). On average compared to NGA, SGA reduced lower extremity joint moment matching errors by 31%, LSGA by 24%, and PGA by 12%, with the largest reductions occurring at the hip. Furthermore, PGA reduced peak hip joint contact force by 47% bodyweight, which was the most consistent with published in vivo measurements. The proposed method for EMG-driven model calibration with wrapping surface personalization produces physically realistic OpenSim models that reduce joint moment matching errors while improving prediction of hip joint contact force.
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31
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Konrath JM, Killen BA, Saxby DJ, Pizzolato C, Kennedy BA, Vertullo CJ, Barrett RS, Lloyd DG. Hamstring harvest results in significantly reduced knee muscular protection during side-step cutting two years after anterior cruciate ligament reconstruction. PLoS One 2023; 18:e0292867. [PMID: 37824493 PMCID: PMC10569629 DOI: 10.1371/journal.pone.0292867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 10/02/2023] [Indexed: 10/14/2023] Open
Abstract
The purpose of this study was to determine the effect of donor muscle morphology following tendon harvest in anterior cruciate ligament (ACL) reconstruction on muscular support of the tibiofemoral joint during sidestep cutting. Magnetic resonance imaging (MRI) was used to measure peak cross-sectional area (CSA) and volume of the semitendinosus (ST) and gracilis (GR) muscles and tendons (bilaterally) in 18 individuals following ACL reconstruction. Participants performed sidestep cutting tasks in a biomechanics laboratory during which lower-limb electromyography, ground reaction loads, whole-body motions were recorded. An EMG driven neuro-musculoskeletal model was subsequently used to determine force from 34 musculotendinous units of the lower limb and the contribution of the ST and GR to muscular support of the tibiofemoral joint based on a normal muscle-tendon model (Standard model). Then, differences in peak CSA and volume between the ipsilateral/contralateral ST and GR were used to adjust their muscle-tendon parameters in the model followed by a recalibration to determine muscle force for 34 musculotendinous units (Adjusted model). The combined contribution of the donor muscles to muscular support about the medial and lateral compartments were reduced by 52% and 42%, respectively, in the adjusted compared to standard model. While the semimembranosus (SM) increased its contribution to muscular stabilisation about the medial and lateral compartment by 23% and 30%, respectively. This computer simulation study demonstrated the muscles harvested for ACL reconstruction reduced their support of the tibiofemoral joint during sidestep cutting, while the SM may have the potential to partially offset these reductions. This suggests donor muscle impairment could be a factor that contributes to ipsilateral re-injury rates to the ACL following return to sport.
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Affiliation(s)
- Jason M. Konrath
- School of Allied Health Sciences and Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
- Principia Technology, Crawley, Western Australia, Australia
| | - Bryce A. Killen
- School of Allied Health Sciences and Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - David J. Saxby
- School of Allied Health Sciences and Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Claudio Pizzolato
- School of Allied Health Sciences and Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | | | - Christopher J. Vertullo
- School of Allied Health Sciences and Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
- Knee Research Australia, Gold Coast, Queensland, Australia
| | - Rod S. Barrett
- School of Allied Health Sciences and Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - David G. Lloyd
- School of Allied Health Sciences and Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
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32
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Dandois F, Taylan O, Müller JH, Scheys L. Sensitivity of Model-Based Predictions of Post-TKA Kinematic Behavior to Residual Errors in Ultrasound-Based Knee Collateral Ligament Strain Assessment. SENSORS (BASEL, SWITZERLAND) 2023; 23:8268. [PMID: 37837097 PMCID: PMC10574986 DOI: 10.3390/s23198268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 09/25/2023] [Accepted: 09/30/2023] [Indexed: 10/15/2023]
Abstract
Ultrasound-based ligament strain estimation shows promise in non-invasively assessing knee joint collateral ligament behavior and improving ligament balancing procedures. However, the impact of ultrasound-based strain estimation residual errors on in-silico arthroplasty predictions remains unexplored. We investigated the sensitivity of post-arthroplasty kinematic predictions to ultrasound-based strain estimation errors compared to clinical inaccuracies in implant positioning.Two cadaveric legs were submitted to active squatting, and specimen-specific rigid computer models were formulated. Mechanical properties of the ligament model were optimized to reproduce experimentally obtained tibiofemoral kinematics and loads with minimal error. Resulting remaining errors were comparable to the current state-of-the-art. Ultrasound-derived strain residual errors were then introduced by perturbing lateral collateral ligament (LCL) and medial collateral ligament (MCL) stiffness. Afterwards, the implant position was perturbed to match with the current clinical inaccuracies reported in the literature. Finally, the impact on simulated post-arthroplasty tibiofemoral kinematics was compared for both perturbation scenarios. Ultrasound-based errors minimally affected kinematic outcomes (mean differences < 0.73° in rotations, 0.1 mm in translations). Greatest differences occurred in external tibial rotations (-0.61° to 0.73° for MCL, -0.28° to 0.27° for LCL). Comparatively, changes in implant position had larger effects, with mean differences up to 1.95° in external tibial rotation and 0.7 mm in mediolateral translation. In conclusion, our study demonstrated that the ultrasound-based assessment of collateral ligament strains has the potential to enhance current computer-based pre-operative knee arthroplasty planning.
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Affiliation(s)
- Félix Dandois
- Institute for Orthopaedic Research and Training (IORT), Development and Regeneration Department, KU Leuven, 49 Herestraat, 3000 Leuven, Belgium (O.T.)
| | - Orçun Taylan
- Institute for Orthopaedic Research and Training (IORT), Development and Regeneration Department, KU Leuven, 49 Herestraat, 3000 Leuven, Belgium (O.T.)
| | | | - Lennart Scheys
- Institute for Orthopaedic Research and Training (IORT), Development and Regeneration Department, KU Leuven, 49 Herestraat, 3000 Leuven, Belgium (O.T.)
- Department of Orthopaedics, University Hospitals Leuven, 49 Herestraat, 3000 Leuven, Belgium
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33
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Princelle D, Davico G, Viceconti M. Comparative validation of two patient-specific modelling pipelines for predicting knee joint forces during level walking. J Biomech 2023; 159:111758. [PMID: 37659354 DOI: 10.1016/j.jbiomech.2023.111758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 07/28/2023] [Accepted: 08/07/2023] [Indexed: 09/04/2023]
Abstract
Over the past few years, the use of computer models and simulations tailored to the patient's physiology to assist clinical decision-making has increased enormously.While several pipelines to develop personalized models exist, their adoption on a large scale is still limited due to the required niche computational skillset and the lengthy operations required. Novel toolboxes, such as STAPLE, promise to streamline and expedite the development of image-based skeletal lower limb models. STAPLE-generated models can be rapidly generated, with minimal user input, and present similar joint kinematics and kinetics compared to models developed employing the established INSIGNEO pipeline. Yet, it is unclear how much the observed discrepancies scale up and affect joint contact force predictions. In this study, we compared image-based musculoskeletal models developed (i) with the INSIGNEO pipeline and (ii) with a semi-automated pipeline that combines STAPLE and nmsBuilder, and assessed their accuracy against experimental implant data.Our results showed that both pipelines predicted similar total knee joint contact forces between one another in terms of profiles and average values, characterized by a moderately high level of agreement with the experimental data. Nonetheless, the Student t-test revealed statistically significant differences between both pipelines. Of note, the STAPLE-based pipeline required considerably less time than the INSIGNEO pipeline to generate a musculoskeletal model (i.e., 60 vs 160 min). This is likely to open up opportunities for the use of personalized musculoskeletal models in clinical practice, where time is of the essence.
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Affiliation(s)
- Domitille Princelle
- Medical Technology Lab, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy; Department of Industrial Engineering, Alma Mater Studiorum - University of Bologna, Italy.
| | - Giorgio Davico
- Medical Technology Lab, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy; Department of Industrial Engineering, Alma Mater Studiorum - University of Bologna, Italy.
| | - Marco Viceconti
- Medical Technology Lab, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy; Department of Industrial Engineering, Alma Mater Studiorum - University of Bologna, Italy
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Lloyd DG, Jonkers I, Delp SL, Modenese L. The History and Future of Neuromusculoskeletal Biomechanics. J Appl Biomech 2023; 39:273-283. [PMID: 37751904 DOI: 10.1123/jab.2023-0165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 07/04/2023] [Accepted: 07/05/2023] [Indexed: 09/28/2023]
Abstract
The Executive Council of the International Society of Biomechanics has initiated and overseen the commemorations of the Society's 50th Anniversary in 2023. This included multiple series of lectures at the ninth World Congress of Biomechanics in 2022 and XXIXth Congress of the International Society of Biomechanics in 2023, all linked to special issues of International Society of Biomechanics' affiliated journals. This special issue of the Journal of Applied Biomechanics is dedicated to the biomechanics of the neuromusculoskeletal system. The reader is encouraged to explore this special issue which comprises 6 papers exploring the current state-of the-art, and future directions and roles for neuromusculoskeletal biomechanics. This editorial presents a very brief history of the science of the neuromusculoskeletal system's 4 main components: the central nervous system, musculotendon units, the musculoskeletal system, and joints, and how they biomechanically integrate to enable an understanding of the generation and control of human movement. This also entails a quick exploration of contemporary neuromusculoskeletal biomechanics and its future with new fields of application.
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Affiliation(s)
- David G Lloyd
- Griffith Centre of Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland and Advanced Design and Prototyping Technologies Institute, School of Health Science and Social Work, Griffith University, Gold Coast, QLD, Australia
| | - Ilse Jonkers
- Institute of Physics-Based Modeling for in Silico Health, Human Movement Science Department, KU Leuven, Leuven, Belgium
| | - Scott L Delp
- Bioengineering, Mechanical Engineering and Orthopedic Surgery, and Wu Tsai Human Performance Alliance at Stanford, Stanford University, Stanford, CA, USA
| | - Luca Modenese
- Graduate School of Biomedical Engineering, University of New South Wales, Sydney, NSW, Australia
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Fernandez J, Shim V, Schneider M, Choisne J, Handsfield G, Yeung T, Zhang J, Hunter P, Besier T. A Narrative Review of Personalized Musculoskeletal Modeling Using the Physiome and Musculoskeletal Atlas Projects. J Appl Biomech 2023; 39:304-317. [PMID: 37607721 DOI: 10.1123/jab.2023-0079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 07/02/2023] [Accepted: 07/24/2023] [Indexed: 08/24/2023]
Abstract
In this narrative review, we explore developments in the field of computational musculoskeletal model personalization using the Physiome and Musculoskeletal Atlas Projects. Model geometry personalization; statistical shape modeling; and its impact on segmentation, classification, and model creation are explored. Examples include the trapeziometacarpal and tibiofemoral joints, Achilles tendon, gastrocnemius muscle, and pediatric lower limb bones. Finally, a more general approach to model personalization is discussed based on the idea of multiscale personalization called scaffolds.
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Affiliation(s)
- Justin Fernandez
- Auckland Bioengineering Institute, University of Auckland, Auckland,New Zealand
- Department of Engineering Science and Biomedical Engineering, University of Auckland, Auckland,New Zealand
| | - Vickie Shim
- Auckland Bioengineering Institute, University of Auckland, Auckland,New Zealand
| | - Marco Schneider
- Auckland Bioengineering Institute, University of Auckland, Auckland,New Zealand
| | - Julie Choisne
- Auckland Bioengineering Institute, University of Auckland, Auckland,New Zealand
| | - Geoff Handsfield
- Auckland Bioengineering Institute, University of Auckland, Auckland,New Zealand
| | - Ted Yeung
- Auckland Bioengineering Institute, University of Auckland, Auckland,New Zealand
| | - Ju Zhang
- Auckland Bioengineering Institute, University of Auckland, Auckland,New Zealand
| | - Peter Hunter
- Auckland Bioengineering Institute, University of Auckland, Auckland,New Zealand
| | - Thor Besier
- Auckland Bioengineering Institute, University of Auckland, Auckland,New Zealand
- Department of Engineering Science and Biomedical Engineering, University of Auckland, Auckland,New Zealand
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Werling K, Bianco NA, Raitor M, Stingel J, Hicks JL, Collins SH, Delp SL, Liu CK. AddBiomechanics: Automating model scaling, inverse kinematics, and inverse dynamics from human motion data through sequential optimization. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.06.15.545116. [PMID: 37398034 PMCID: PMC10312696 DOI: 10.1101/2023.06.15.545116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
Creating large-scale public datasets of human motion biomechanics could unlock data-driven breakthroughs in our understanding of human motion, neuromuscular diseases, and assistive devices. However, the manual effort currently required to process motion capture data and quantify the kinematics and dynamics of movement is costly and limits the collection and sharing of large-scale biomechanical datasets. We present a method, called AddBiomechanics, to automate and standardize the quantification of human movement dynamics from motion capture data. We use linear methods followed by a non-convex bilevel optimization to scale the body segments of a musculoskeletal model, register the locations of optical markers placed on an experimental subject to the markers on a musculoskeletal model, and compute body segment kinematics given trajectories of experimental markers during a motion. We then apply a linear method followed by another non-convex optimization to find body segment masses and fine tune kinematics to minimize residual forces given corresponding trajectories of ground reaction forces. The optimization approach requires approximately 3-5 minutes to determine a subjecťs skeleton dimensions and motion kinematics, and less than 30 minutes of computation to also determine dynamically consistent skeleton inertia properties and fine-tuned kinematics and kinetics, compared with about one day of manual work for a human expert. We used AddBiomechanics to automatically reconstruct joint angle and torque trajectories from previously published multi-activity datasets, achieving close correspondence to expert-calculated values, marker root-mean-square errors less than 2 c m , and residual force magnitudes smaller than 2 % of peak external force. Finally, we confirmed that AddBiomechanics accurately reproduced joint kinematics and kinetics from synthetic walking data with low marker error and residual loads. We have published the algorithm as an open source cloud service at AddBiomechanics.org, which is available at no cost and asks that users agree to share processed and de-identified data with the community. As of this writing, hundreds of researchers have used the prototype tool to process and share about ten thousand motion files from about one thousand experimental subjects. Reducing the barriers to processing and sharing high-quality human motion biomechanics data will enable more people to use state-of-the-art biomechanical analysis, do so at lower cost, and share larger and more accurate datasets.
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Affiliation(s)
- Keenon Werling
- Department of Computer Science, Stanford University, Stanford, California
| | - Nicholas A. Bianco
- Department of Mechanical Engineering, Stanford University, Stanford, California
| | - Michael Raitor
- Department of Mechanical Engineering, Stanford University, Stanford, California
| | - Jon Stingel
- Department of Mechanical Engineering, Stanford University, Stanford, California
| | - Jennifer L. Hicks
- Department of Bioengineering, Stanford University, Stanford, California
| | - Steven H. Collins
- Department of Mechanical Engineering, Stanford University, Stanford, California
| | - Scott L. Delp
- Department of Mechanical Engineering, Stanford University, Stanford, California
- Department of Bioengineering, Stanford University, Stanford, California
| | - C. Karen Liu
- Department of Computer Science, Stanford University, Stanford, California
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Valente G, Grenno G, Dal Fabbro G, Zaffagnini S, Taddei F. Medial and lateral knee contact forces during walking, stair ascent and stair descent are more affected by contact locations than tibiofemoral alignment in knee osteoarthritis patients with varus malalignment. Front Bioeng Biotechnol 2023; 11:1254661. [PMID: 37731759 PMCID: PMC10507691 DOI: 10.3389/fbioe.2023.1254661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 08/22/2023] [Indexed: 09/22/2023] Open
Abstract
Introduction: Knee OA progression is related to medial knee contact forces, which can be altered by anatomical parameters of tibiofemoral alignment and contact point locations. There is limited and controversial literature on medial-lateral force distribution and the effect of anatomical parameters, especially in motor activities different from walking. We analyzed the effect of tibiofemoral alignment and contact point locations on knee contact forces, and the medial-lateral force distribution in knee OA subjects with varus malalignment during walking, stair ascending and stair descending. Methods: Fifty-one knee OA subjects with varus malalignment underwent weight-bearing radiographs and motion capture during walking, stair ascending and stair descending. We created a set of four musculoskeletal models per subject with increasing level of personalization, and calculated medial and lateral knee contact forces. To analyze the effect of the anatomical parameters, statistically-significant differences in knee contact forces among models were evaluated. Then, to analyze the force distribution, the medial-to-total contact force ratios were calculated from the fully-informed models. In addition, a multiple regression analysis was performed to evaluate correlations between forces and anatomical parameters. Results: The anatomical parameters significantly affected the knee contact forces. However, the contact points decreased medial forces and increased lateral forces and led to more marked variations compared to tibiofemoral alignment, which produced an opposite effect. The forces were less medially-distributed during stair negotiation, with medial-to-total ratios below 50% at force peaks. The anatomical parameters explained 30%-67% of the variability in the knee forces, where the medial contact points were the best predictors of medial contact forces. Discussion: Including personalized locations of contact points is crucial when analyzing knee contact forces in subjects with varus malalignment, and especially the medial contact points have a major effect on the forces rather than tibiofemoral alignment. Remarkably, the medial-lateral force distribution depends on the motor activity, where stair ascending and descending show increased lateral forces that lead to less medially-distributed loads compared to walking.
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Affiliation(s)
- Giordano Valente
- Bioengineering and Computing Laboratory, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Giulia Grenno
- Bioengineering and Computing Laboratory, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Giacomo Dal Fabbro
- 2nd Orthopedics and Trauma Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Stefano Zaffagnini
- 2nd Orthopedics and Trauma Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Fulvia Taddei
- Bioengineering and Computing Laboratory, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
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Kim W, Vela EA, Kohles SS, Huayamave V, Gonzalez O. Validation of a Biomechanical Injury and Disease Assessment Platform Applying an Inertial-Based Biosensor and Axis Vector Computation. ELECTRONICS 2023; 12:3694. [PMID: 37974898 PMCID: PMC10653259 DOI: 10.3390/electronics12173694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
Inertial kinetics and kinematics have substantial influences on human biomechanical function. A new algorithm for Inertial Measurement Unit (IMU)-based motion tracking is presented in this work. The primary aims of this paper are to combine recent developments in improved biosensor technology with mainstream motion-tracking hardware to measure the overall performance of human movement based on joint axis-angle representations of limb rotation. This work describes an alternative approach to representing three-dimensional rotations using a normalized vector around which an identified joint angle defines the overall rotation, rather than a traditional Euler angle approach. Furthermore, IMUs allow for the direct measurement of joint angular velocities, offering the opportunity to increase the accuracy of instantaneous axis of rotation estimations. Although the axis-angle representation requires vector quotient algebra (quaternions) to define rotation, this approach may be preferred for many graphics, vision, and virtual reality software applications. The analytical method was validated with laboratory data gathered from an infant dummy leg's flexion and extension knee movements and applied to a living subject's upper limb movement. The results showed that the novel approach could reasonably handle a simple case and provide a detailed analysis of axis-angle migration. The described algorithm could play a notable role in the biomechanical analysis of human joints and offers a harbinger of IMU-based biosensors that may detect pathological patterns of joint disease and injury.
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Affiliation(s)
- Wangdo Kim
- Ingeniería Mecánica, Universidad de Ingenieria y Tecnologia—UTEC, Lima 15063, Peru
- Research Center in Bioengineering, Ingeniería Mecánica, Universidad de Ingenieria y Tecnologia—UTEC, Lima 15063, Peru
| | - Emir A. Vela
- Ingeniería Mecánica, Universidad de Ingenieria y Tecnologia—UTEC, Lima 15063, Peru
- Research Center in Bioengineering, Ingeniería Mecánica, Universidad de Ingenieria y Tecnologia—UTEC, Lima 15063, Peru
| | - Sean S. Kohles
- Kohles Bioengineering, Cape Meares, OR 97141, USA
- Division of Biomaterials & Biomechanics, School of Dentistry, Oregon Health & Science University, Portland, OR 97239, USA
- Department of Emergency Medicine, School of Medicine, Oregon Health & Science University, Portland, OR 97239, USA
- Department of Human Physiology and Knight Campus for Accelerating Scientific Impact, University of Oregon, Eugene, OR 97403, USA
| | - Victor Huayamave
- Department of Mechanical Engineering, Embry-Riddle Aeronautical University, Daytona Beach, FL 32114, USA
| | - Oscar Gonzalez
- Ingeniería Mecánica, Universidad de Ingenieria y Tecnologia—UTEC, Lima 15063, Peru
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Wilhelm N, von Deimling C, Haddadin S, Glowalla C, Burgkart R. Validation of a Robotic Testbench for Evaluating Biomechanical Effects of Implant Rotation in Total Knee Arthroplasty on a Cadaveric Specimen. SENSORS (BASEL, SWITZERLAND) 2023; 23:7459. [PMID: 37687914 PMCID: PMC10490644 DOI: 10.3390/s23177459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 08/23/2023] [Accepted: 08/25/2023] [Indexed: 09/10/2023]
Abstract
In this study, we developed and validated a robotic testbench to investigate the biomechanical compatibility of three total knee arthroplasty (TKA) configurations under different loading conditions, including varus-valgus and internal-external loading across defined flexion angles. The testbench captured force-torque data, position, and quaternion information of the knee joint. A cadaver study was conducted, encompassing a native knee joint assessment and successive TKA testing, featuring femoral component rotations at -5°, 0°, and +5° relative to the transepicondylar axis of the femur. The native knee showed enhanced stability in varus-valgus loading, with the +5° external rotation TKA displaying the smallest deviation, indicating biomechanical compatibility. The robotic testbench consistently demonstrated high precision across all loading conditions. The findings demonstrated that the TKA configuration with a +5° external rotation displayed the minimal mean deviation under internal-external loading, indicating superior joint stability. These results contribute meaningful understanding regarding the influence of different TKA configurations on knee joint biomechanics, potentially influencing surgical planning and implant positioning. We are making the collected dataset available for further biomechanical model development and plan to explore the 6 Degrees of Freedom (DOF) robotic platform for additional biomechanical analysis. This study highlights the versatility and usefulness of the robotic testbench as an instrumental tool for expanding our understanding of knee joint biomechanics.
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Affiliation(s)
- Nikolas Wilhelm
- Department of Orthopedics and Sports Orthopedics, Klinikum rechts der Isar, School of Medicine, 81675 Munich, Germany
- Munich Institute of Robotics and Machine Intelligence, Department of Electrical and Computer Engineering, Technical University of Munich, 80992 Munich, Germany
| | - Constantin von Deimling
- Department of Orthopedics and Sports Orthopedics, Klinikum rechts der Isar, School of Medicine, 81675 Munich, Germany
| | - Sami Haddadin
- Munich Institute of Robotics and Machine Intelligence, Department of Electrical and Computer Engineering, Technical University of Munich, 80992 Munich, Germany
| | - Claudio Glowalla
- Department of Orthopedics and Sports Orthopedics, Klinikum rechts der Isar, School of Medicine, 81675 Munich, Germany
- Department of Trauma and Orthopedic Surgery, Berufsgenossenschaftliche Unfallklinik Murnau, 82418 Murnau, Germany
| | - Rainer Burgkart
- Department of Orthopedics and Sports Orthopedics, Klinikum rechts der Isar, School of Medicine, 81675 Munich, Germany
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Liew BXW, Rügamer D, Mei Q, Altai Z, Zhu X, Zhai X, Cortes N. Smooth and accurate predictions of joint contact force time-series in gait using over parameterised deep neural networks. Front Bioeng Biotechnol 2023; 11:1208711. [PMID: 37465692 PMCID: PMC10350628 DOI: 10.3389/fbioe.2023.1208711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 06/25/2023] [Indexed: 07/20/2023] Open
Abstract
Alterations in joint contact forces (JCFs) are thought to be important mechanisms for the onset and progression of many musculoskeletal and orthopaedic pain disorders. Computational approaches to JCFs assessment represent the only non-invasive means of estimating in-vivo forces; but this cannot be undertaken in free-living environments. Here, we used deep neural networks to train models to predict JCFs, using only joint angles as predictors. Our neural network models were generally able to predict JCFs with errors within published minimal detectable change values. The errors ranged from the lowest value of 0.03 bodyweight (BW) (ankle medial-lateral JCF in walking) to a maximum of 0.65BW (knee VT JCF in running). Interestingly, we also found that over parametrised neural networks by training on longer epochs (>100) resulted in better and smoother waveform predictions. Our methods for predicting JCFs using only joint kinematics hold a lot of promise in allowing clinicians and coaches to continuously monitor tissue loading in free-living environments.
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Affiliation(s)
- Bernard X. W. Liew
- School of Sport, Rehabilitation, and Exercise Sciences, University of Essex, Colchester, United Kingdom
| | - David Rügamer
- Department of Statistics, Ludwig-Maximilians-Universität München, Munich, Germany
- Munich Center for Machine Learning, Munich, Germany
| | - Qichang Mei
- Faculty of Sports Science, Ningbo University, Ningbo, China
- Research Academy of Grand Health, Ningbo University, Ningbo, China
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
| | - Zainab Altai
- School of Sport, Rehabilitation, and Exercise Sciences, University of Essex, Colchester, United Kingdom
| | - Xuqi Zhu
- School of Computer Science and Electrical Engineering, University of Essex, Colchester, United Kingdom
| | - Xiaojun Zhai
- School of Computer Science and Electrical Engineering, University of Essex, Colchester, United Kingdom
| | - Nelson Cortes
- School of Sport, Rehabilitation, and Exercise Sciences, University of Essex, Colchester, United Kingdom
- Department of Bioengineering, George Mason University, Fairfax, VA, United States
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Winter P, Rother S, Orth P, Fritsch E. [Innovative image-based planning in musculoskeletal surgery]. ORTHOPADIE (HEIDELBERG, GERMANY) 2023:10.1007/s00132-023-04393-3. [PMID: 37286621 DOI: 10.1007/s00132-023-04393-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/03/2023] [Indexed: 06/09/2023]
Abstract
BACKGROUND For the preparation of surgical procedures in orthopedics and trauma surgery, precise knowledge of imaging and the three-dimensional imagination of the surgeon are of outstanding importance. Image-based, preoperative two-dimensional planning is the gold standard in arthroplasty today. In complex cases, further imaging such as computed tomography (CT) or magnetic resonance imaging is also performed, generating a three-dimensional model of the body region and helping the surgeon in the planning of the surgical treatment. Four-dimensional, dynamic CT studies have also been reported and are available as a complementary tool. DIGITAL AIDS Furthermore, digital aids should generate an improved representation of the pathology to be treated and optimize the surgeon's imagination. The finite element method allows patient-specific and implant-specific parameters to be taken into account in preoperative surgical planning. Intraoperatively, relevant information can be provided by augmented reality without significantly influencing the surgical workflow.
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Affiliation(s)
- Philipp Winter
- Klinik für Orthopädie und Orthopädische Chirurgie, Universität des Saarlandes, Kirrberger Str. 100, 66421, Homburg, Deutschland.
| | - Stephan Rother
- Klinik für Orthopädie und Orthopädische Chirurgie, Universität des Saarlandes, Kirrberger Str. 100, 66421, Homburg, Deutschland
| | - Patrick Orth
- Klinik für Orthopädie und Orthopädische Chirurgie, Universität des Saarlandes, Kirrberger Str. 100, 66421, Homburg, Deutschland
| | - Ekkehard Fritsch
- Klinik für Orthopädie und Orthopädische Chirurgie, Universität des Saarlandes, Kirrberger Str. 100, 66421, Homburg, Deutschland
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Chen Z, Franklin DW. Musculotendon Parameters in Lower Limb Models: Simplifications, Uncertainties, and Muscle Force Estimation Sensitivity. Ann Biomed Eng 2023; 51:1147-1164. [PMID: 36913088 PMCID: PMC10172227 DOI: 10.1007/s10439-023-03166-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 02/08/2023] [Indexed: 03/14/2023]
Abstract
Musculotendon parameters are key factors in the Hill-type muscle contraction dynamics, determining the muscle force estimation accuracy of a musculoskeletal model. Their values are mostly derived from muscle architecture datasets, whose emergence has been a major impetus for model development. However, it is often not clear if such parameter update indeed improves simulation accuracy. Our goal is to explain to model users how these parameters are derived and how accurate they are, as well as to what extent errors in parameter values might influence force estimation. We examine in detail the derivation of musculotendon parameters in six muscle architecture datasets and four prominent OpenSim models of the lower limb, and then identify simplifications which could add uncertainties to the derived parameter values. Finally, we analyze the sensitivity of muscle force estimation to these parameters both numerically and analytically. Nine typical simplifications in parameter derivation are identified. Partial derivatives of the Hill-type contraction dynamics are derived. Tendon slack length is determined as the musculotendon parameter that muscle force estimation is most sensitive to, whereas pennation angle is the least impactful. Anatomical measurements alone are not enough to calibrate musculotendon parameters, and the improvement on muscle force estimation accuracy will be limited if the source muscle architecture datasets are the only main update. Model users may check if a dataset or model is free of concerning factors for their research or application requirements. The derived partial derivatives may be used as the gradient for musculotendon parameter calibration. For model development, we demonstrate that it is more promising to focus on other model parameters or components and seek alternative strategies to further increase simulation accuracy.
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Affiliation(s)
- Ziyu Chen
- Neuromuscular Diagnostics, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
- Munich Institute of Robotics and Machine Intelligence (MIRMI), Technical University of Munich, Munich, Germany
| | - David W Franklin
- Neuromuscular Diagnostics, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany.
- Munich Institute of Robotics and Machine Intelligence (MIRMI), Technical University of Munich, Munich, Germany.
- Munich Data Science Institute (MDSI), Technical University of Munich, Munich, Germany.
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Kothurkar R, Lekurwale R, Gad M, Rathod CM. Finite element analysis of a healthy knee joint at deep squatting for the study of tibiofemoral and patellofemoral contact. J Orthop 2023; 40:7-16. [PMID: 37143926 PMCID: PMC10151221 DOI: 10.1016/j.jor.2023.04.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 04/20/2023] [Accepted: 04/20/2023] [Indexed: 05/06/2023] Open
Abstract
Background In non-western countries, deep squatting is a daily activity, and prolonged deep squatting is common among occupational squatters. Household tasks, taking a bath, socializing, using toilets, and performing religious acts are among the activities frequently carried out while squatting by the Asian population. High knee loading is responsible for a knee injury and osteoarthritis. Finite element analysis is an effective tool to determine stresses on the knee joint. Methods Magnetic Resonance Imaging (MRI) and Computed Tomographic (CT) images were acquired of one adult without knee injuries. The CT images were acquired at the fully extended knee and one more set of images was acquired with the knee at a deeply flexed knee position. The MRI was acquired with the fully extended knee. 3-Dimensional models of bones were created using CT and soft tissue using MRI with the help of 3D Slicer software. Kinematics and finite element analysis of the knee was performed for standing and deep squatting posture using Ansys Workbench 2022. Results High peak stresses were observed at deep squatting compared to standing along with the reduction in the contact area. Peak von Mises stresses on femoral cartilage, tibial cartilage, patellar cartilage, and meniscus were increased from 3.3 MPa to 19.9 MPa, 2.9 MPa to 12.4 MPa, 1.5 MPa to 16.7 MPa and 15.8 MPa to 32.8 MPa respectively during deep squatting. Posterior translation of 7.01 mm, and 12.58 mm was observed for medial and lateral femoral condyle respectively from full extension to 153° knee flexion. Conclusions Increased stresses in the knee joint at deep squat posture may cause cartilage damage. A sustained deep squat posture should be avoided for healthy knee joints. More posterior translations of the medial femoral condyle at higher knee flexion angle warrant further investigation.
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Affiliation(s)
- Rohan Kothurkar
- Department of Mechanical Engineering, K. J. Somaiya College of Engineering, Mumbai, India
| | - Ramesh Lekurwale
- Department of Mechanical Engineering, K. J. Somaiya College of Engineering, Mumbai, India
| | - Mayuri Gad
- St. Xavier's Gait Lab, Xavier Institute of Engineering, Mumbai, India
| | - Chasanal M. Rathod
- St. Xavier's Gait Lab, Xavier Institute of Engineering, Mumbai, India
- Department of Orthopaedics, SRCC Children's Hospital, Haji Ali, Mumbai, India
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Uhlrich SD, Uchida TK, Lee MR, Delp SL. Ten steps to becoming a musculoskeletal simulation expert: A half-century of progress and outlook for the future. J Biomech 2023; 154:111623. [PMID: 37210923 PMCID: PMC10544733 DOI: 10.1016/j.jbiomech.2023.111623] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 05/05/2023] [Indexed: 05/23/2023]
Abstract
Over the past half-century, musculoskeletal simulations have deepened our knowledge of human and animal movement. This article outlines ten steps to becoming a musculoskeletal simulation expert so you can contribute to the next half-century of technical innovation and scientific discovery. We advocate looking to the past, present, and future to harness the power of simulations that seek to understand and improve mobility. Instead of presenting a comprehensive literature review, we articulate a set of ideas intended to help researchers use simulations effectively and responsibly by understanding the work on which today's musculoskeletal simulations are built, following established modeling and simulation principles, and branching out in new directions.
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Affiliation(s)
- Scott D Uhlrich
- Department of Bioengineering, Stanford University, 318 Campus Drive, Stanford, CA 94305, USA.
| | - Thomas K Uchida
- Department of Mechanical Engineering, University of Ottawa, 161 Louis-Pasteur, Ottawa, ON K1N 6N5, Canada.
| | - Marissa R Lee
- Department of Mechanical Engineering, Stanford University, 318 Campus Drive, Stanford, CA 94305, USA.
| | - Scott L Delp
- Department of Bioengineering, Stanford University, 318 Campus Drive, Stanford, CA 94305, USA; Department of Mechanical Engineering, Stanford University, 318 Campus Drive, Stanford, CA 94305, USA; Department of Orthopaedic Surgery, Stanford University, 318 Campus Drive, Stanford, CA 94305, USA.
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Michaud F, Pazos R, Lugrís U, Cuadrado J. The Use of Wearable Inertial Sensors and Workplace-Based Exercises to Reduce Lateral Epicondylitis in the Workstation of a Textile Logistics Center. SENSORS (BASEL, SWITZERLAND) 2023; 23:s23115116. [PMID: 37299843 DOI: 10.3390/s23115116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 05/19/2023] [Accepted: 05/25/2023] [Indexed: 06/12/2023]
Abstract
People whose jobs involve repetitive motions of the wrist and forearm can suffer from lateral epicondylitis, which is a significant burden on both the individual and the employer due to treatment costs, reduced productivity, and work absenteeism. This paper describes an ergonomic intervention to reduce lateral epicondylitis in the workstation of a textile logistics center. The intervention includes workplace-based exercise programs, evaluation of risk factors, and movement correction. An injury- and subject-specific score was calculated from the motion captured with wearable inertial sensors at the workplace to evaluate the risk factors of 93 workers. Then, a new working movement was adapted to the workplace, which limited the observed risk factors and took into account the subject-specific physical abilities. The movement was taught to the workers during personalized sessions. The risk factors of 27 workers were evaluated again after the intervention to validate the effectiveness of the movement correction. In addition, active warm-up and stretching programs were introduced as part of the workday to promote muscle endurance and improve resistance to repetitive stress. The present strategy offered good results at low cost, without any physical modification of the workplace and without any detriment to productivity.
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Affiliation(s)
- Florian Michaud
- Laboratory of Mechanical Engineering, Campus Industrial de Ferrol, Universidade da Coruña, 15403 Ferrol, Spain
| | | | - Urbano Lugrís
- Laboratory of Mechanical Engineering, Campus Industrial de Ferrol, Universidade da Coruña, 15403 Ferrol, Spain
| | - Javier Cuadrado
- Laboratory of Mechanical Engineering, Campus Industrial de Ferrol, Universidade da Coruña, 15403 Ferrol, Spain
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46
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Rothammer B, Wolf A, Winkler A, Schulte-Hubbert F, Bartz M, Wartzack S, Miehling J, Marian M. Subject-specific tribo-contact conditions in total knee replacements: a simulation framework across scales. Biomech Model Mechanobiol 2023:10.1007/s10237-023-01726-1. [PMID: 37210464 PMCID: PMC10366315 DOI: 10.1007/s10237-023-01726-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 05/09/2023] [Indexed: 05/22/2023]
Abstract
Fundamental knowledge about in vivo kinematics and contact conditions at the articulating interfaces of total knee replacements are essential for predicting and optimizing their behavior and durability. However, the prevailing motions and contact stresses in total knee replacements cannot be precisely determined using conventional in vivo measurement methods. In silico modeling, in turn, allows for a prediction of the loads, velocities, deformations, stress, and lubrication conditions across the scales during gait. Within the scope of this paper, we therefore combine musculoskeletal modeling with tribo-contact modeling. In the first step, we compute contact forces and sliding velocities by means of inverse dynamics approach and force-dependent kinematic solver based upon experimental gait data, revealing contact forces during healthy/physiological gait of young subjects. In a second step, the derived data are employed as input data for an elastohydrodynamic model based upon the finite element method full-system approach taking into account elastic deformation, the synovial fluid's hydrodynamics as well as mixed lubrication to predict and discuss the subject-specific pressure and lubrication conditions.
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Affiliation(s)
- Benedict Rothammer
- Engineering Design, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany.
| | - Alexander Wolf
- Engineering Design, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Andreas Winkler
- Engineering Design, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Felix Schulte-Hubbert
- Engineering Design, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Marcel Bartz
- Engineering Design, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Sandro Wartzack
- Engineering Design, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Jörg Miehling
- Engineering Design, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Max Marian
- Department of Mechanical and Metallurgical Engineering, School of Engineering, Pontificia Universidad Católica de Chile, Santiago, Chile.
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Kulkarni PG, Paudel N, Magar S, Santilli MF, Kashyap S, Baranwal AK, Zamboni P, Vasavada P, Katiyar A, Singh AV. Overcoming Challenges and Innovations in Orthopedic Prosthesis Design: An Interdisciplinary Perspective. BIOMEDICAL MATERIALS & DEVICES (NEW YORK, N.Y.) 2023:1-12. [PMID: 37363137 PMCID: PMC10180679 DOI: 10.1007/s44174-023-00087-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 04/29/2023] [Indexed: 06/28/2023]
Abstract
Recent advances in the orthopedic prostheses design have significantly improved the quality of life for individuals with orthopedic disabilities. However, there are still critical challenges that need to be addressed to further enhance the functionality of orthopedic prostheses improving biocompatibility to promote better integration with natural tissues, enhancing durability to withstand the demands of daily use, and improving sensory feedback for better control of movement are the most pressing issues. To address these challenges, promising emerging solutions such as smart prosthetics, 3D printing, regenerative medicine, and artificial intelligence have been developed. These innovative technologies hold the potential to significantly enhance the functionality of orthopedic prostheses. Realizing the full potential of these next-generation orthopedic prostheses requires addressing several critical factors. These include interdisciplinary collaboration between experts in orthopedics, materials science, biology, and engineering, increased investment in research and development, standardization of components to ensure quality and reliability, and improved access to prosthetics. A comprehensive review of these challenges and considerations for future orthopedic prosthesis design is s provided in this paper addressing the further advances to the field. By addressing these issues, we can continue to improve the lives of individuals with orthopedic disabilities and further enhance the field of orthopedic prosthetics.
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Affiliation(s)
| | - Namuna Paudel
- Department of Chemistry, Amrit Campus, Institute of Science and Technology, Tribhuvan University, Lainchaur, Kathmandu, 44600 Nepal
| | - Shilpa Magar
- Seeta Nursing Home, Shivaji Nagar, Nashik, Maharashtra 422002 India
| | | | | | | | - Paolo Zamboni
- Chair Vascular Diseases Center, University of Ferrara, 44124 Ferrara, Italy
| | - Priyank Vasavada
- M.S. Ramaiah Medical College and Hospital, Bengaluru, 560054 India
| | - Aman Katiyar
- Jain University, Bengaluru, Karnataka 560069 India
| | - Ajay Vikram Singh
- Department of Chemical and Product Safety, German Federal Institute of Risk Assessment (BfR), Maxdohrnstrasse 8-10, 10589 Berlin, Germany
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Zhang Q, Peng Y, Chen Z, Jin Z, Qin L. Conformity design can change the effect of tibial component malrotation on knee biomechanics after total knee arthroplasty. Clin Biomech (Bristol, Avon) 2023; 105:105985. [PMID: 37182435 DOI: 10.1016/j.clinbiomech.2023.105985] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 05/01/2023] [Accepted: 05/08/2023] [Indexed: 05/16/2023]
Abstract
BACKGROUND Component alignment is essential to improve knee function and survival in total knee arthroplasty. However, it is still unclear whether the conformity design of tibiofemoral component can mitigate abnormal knee biomechanics caused by component malrotation. The purpose of this study was to investigate whether the sagittal/coronal conformity design of the tibial component could change the effect of the tibial component malrotation on knee biomechanics in total knee arthroplasty. METHODS A developed patient-specific musculoskeletal multi-body dynamics model of total knee arthroplasty was used to investigate the effects of the sagittal/coronal conformity of the tibial component on knee contact forces and kinematics caused by tibial component malrotation during the walking gait. FINDINGS Medial and lateral contact forces, internal-external rotation, and anterior-posterior translation were significantly affected by tibial component malrotation after total knee arthroplasty during the walking gait. The lower sagittal conformity of the tibial component can mitigate the abnormal internal-external rotation caused by tibial component malrotation in total knee arthroplasty, the higher coronal conformity of the tibial component can mitigate the abnormal medial-lateral translation caused by tibial component malrotation in total knee arthroplasty. INTERPRETATION This study highlights the importance of the tibiofemoral conformity designs on knee biomechanics caused by component malrotation in total knee arthroplasty. The optimization of the tibiofemoral conformity designs should be thoroughly considered in the design of new implants and in the planning of surgical procedures.
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Affiliation(s)
- Qida Zhang
- Musculoskeletal Research Laboratory, Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Yinghu Peng
- CAS Key Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen Institutes of Advanced Technology Chinese Academy of Sciences, Shenzhen, China
| | - Zhenxian Chen
- Key Laboratory of Road Construction Technology and Equipment (Ministry of Education), School of Mechanical Engineering, Chang'an University, Xi'an, China
| | - Zhongmin Jin
- Tribology Research Institute, School of Mechanical Engineering, Southwest Jiaotong University, Chengdu, China; Institute of Medical and Biological Engineering, School of Mechanical Engineering, University of Leeds, Leeds, UK
| | - Ling Qin
- Musculoskeletal Research Laboratory, Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China
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49
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Di Raimondo G, Willems M, Killen BA, Havashinezhadian S, Turcot K, Vanwanseele B, Jonkers I. Peak Tibiofemoral Contact Forces Estimated Using IMU-Based Approaches Are Not Significantly Different from Motion Capture-Based Estimations in Patients with Knee Osteoarthritis. SENSORS (BASEL, SWITZERLAND) 2023; 23:s23094484. [PMID: 37177688 PMCID: PMC10181595 DOI: 10.3390/s23094484] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 05/01/2023] [Accepted: 05/03/2023] [Indexed: 05/15/2023]
Abstract
Altered tibiofemoral contact forces represent a risk factor for osteoarthritis onset and progression, making optimization of the knee force distribution a target of treatment strategies. Musculoskeletal model-based simulations are a state-of-the-art method to estimate joint contact forces, but they typically require laboratory-based input and skilled operators. To overcome these limitations, ambulatory methods, relying on inertial measurement units, have been proposed to estimated ground reaction forces and, consequently, knee contact forces out-of-the-lab. This study proposes the use of a full inertial-capture-based musculoskeletal modelling workflow with an underlying probabilistic principal component analysis model trained on 1787 gait cycles in patients with knee osteoarthritis. As validation, five patients with knee osteoarthritis were instrumented with 17 inertial measurement units and 76 opto-reflective markers. Participants performed multiple overground walking trials while motion and inertial capture methods were synchronously recorded. Moderate to strong correlations were found for the inertial capture-based knee contact forces compared to motion capture with root mean square error between 0.15 and 0.40 of body weight. The results show that our workflow can inform and potentially assist clinical practitioners to monitor knee joint loading in physical therapy sessions and eventually assess long-term therapeutic effects in a clinical context.
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Affiliation(s)
- Giacomo Di Raimondo
- Department of Movement Sciences, Katholieke Universiteit Leuven, 3001 Heverlee, Belgium
| | - Miel Willems
- Department of Movement Sciences, Katholieke Universiteit Leuven, 3001 Heverlee, Belgium
| | - Bryce Adrian Killen
- Department of Movement Sciences, Katholieke Universiteit Leuven, 3001 Heverlee, Belgium
| | | | - Katia Turcot
- Department of Kinesiology, Université Laval, Québec, QC G1V 0A6, Canada
| | - Benedicte Vanwanseele
- Department of Movement Sciences, Katholieke Universiteit Leuven, 3001 Heverlee, Belgium
| | - Ilse Jonkers
- Department of Movement Sciences, Katholieke Universiteit Leuven, 3001 Heverlee, Belgium
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McCain EM, Dalman MJ, Berno ME, Libera TL, Lewek MD, Sawicki GS, Saul KR. The influence of induced gait asymmetry on joint reaction forces. J Biomech 2023; 153:111581. [PMID: 37141689 PMCID: PMC10424665 DOI: 10.1016/j.jbiomech.2023.111581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 02/24/2023] [Accepted: 04/04/2023] [Indexed: 05/06/2023]
Abstract
Chronic injury- or disease-induced joint impairments result in asymmetric gait deviations that may precipitate changes in joint loading associated with pain and osteoarthritis. Understanding the impact of gait deviations on joint reaction forces (JRFs) is challenging because of concurrent neurological and/or anatomical changes and because measuring JRFs requires medically invasive instrumented implants. Instead, we investigated the impact of joint motion limitations and induced asymmetry on JRFs by simulating data recorded as 8 unimpaired participants walked with bracing to unilaterally and bilaterally restrict ankle, knee, and simultaneous ankle + knee motion. Personalized models, calculated kinematics, and ground reaction forces (GRFs) were input into a computed muscle control tool to determine lower limb JRFs and simulated muscle activations guided by electromyography-driven timing constraints. Unilateral knee restriction increased GRF peak and loading rate ipsilaterally but peak values decreased contralaterally when compared to walking without joint restriction. GRF peak and loading rate increased with bilateral restriction compared to the contralateral limb of unilaterally restricted conditions. Despite changes in GRFs, JRFs were relatively unchanged due to reduced muscle forces during loading response. Thus, while joint restriction results in increased limb loading, reductions in muscle forces counteract changes in limb loading such that JRFs were relatively unchanged.
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Affiliation(s)
| | | | | | - Theresa L Libera
- North Carolina State University, Raleigh, NC, USA; University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Michael D Lewek
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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