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Shi B, Barzan M, Nasseri A, Maharaj JN, Diamond LE, Saxby DJ. Automatic generation of knee kinematic models from medical imaging. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2024; 256:108370. [PMID: 39180912 DOI: 10.1016/j.cmpb.2024.108370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 08/07/2024] [Accepted: 08/08/2024] [Indexed: 08/27/2024]
Abstract
BACKGROUND AND OBJECTIVE Three-dimensional spatial mechanisms have been used to accurately predict passive knee kinematics, and have shown potential to be used in optimized multibody kinematic models. Such multi-body models are anatomically consistent and can accurately predict passive knee kinematics, but require extensive medical image processing and thus are not widely adopted. This study aimed to automate the generation of kinematic models of tibiofemoral (TFJ) and patellofemoral (PFJ) joints from segmented magnetic resonance imaging (MRI) and compare them against a corresponding manual pipeline. METHODS From segmented MRI of eight healthy participants (four females; aged 14.0 ± 2.6 years), geometric parameters (i.e., articular surfaces, ligament attachments) were determined both automatically and manually, and then assembled into TFJ and PFJ kinematic models to predict passive kinematics. The TFJ model was a six-link mechanism with deformable ligamentous constraints, whereas PFJ was a modified hinge. The ligament length changes through TFJ flexion were prescribed to literature strain profile. The geometric parameters were optimized to ensure physiological kinematic predictions through a Multiple Objective Particle Swarm Optimization. RESULTS Geometric parameters showed strong agreement between automatic and manual pipelines (median error of 2.8 mm for anatomical landmarks and 1.5 mm for ligament lengths). Predicted TFJ and PFJ kinematics from the two pipelines were not statistically different, except for tibial superior/inferior translation near terminal TFJ extension. The TFJ kinematics predicted from the automatic pipeline had mean errors of 3.6° and 12.4° for adduction/abduction and internal/external rotation, respectively, and <7 mm mean translational error compared to the manual pipeline. Predicted PFJ had <9° mean rotational errors and <6 mm mean translational errors. CONCLUSIONS The automatic pipeline developed and presented here can predict passive knee kinematics comparable to a manual pipeline, but removes laborious manual processing and provides a systematic approach to model creation.
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Affiliation(s)
- Beichen Shi
- Griffith Centre of Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Gold Coast campus Griffith University QLD 4222, Australia; School of Health Sciences and Social Work, Gold Coast campus Griffith University, Parklands Dr Southport QLD 4222, Australia.
| | - Martina Barzan
- Griffith Centre of Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Gold Coast campus Griffith University QLD 4222, Australia; School of Health Sciences and Social Work, Gold Coast campus Griffith University, Parklands Dr Southport QLD 4222, Australia
| | - Azadeh Nasseri
- Griffith Centre of Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Gold Coast campus Griffith University QLD 4222, Australia; School of Health Sciences and Social Work, Gold Coast campus Griffith University, Parklands Dr Southport QLD 4222, Australia
| | - Jayishni N Maharaj
- Griffith Centre of Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Gold Coast campus Griffith University QLD 4222, Australia; School of Health Sciences and Social Work, Gold Coast campus Griffith University, Parklands Dr Southport QLD 4222, Australia
| | - Laura E Diamond
- Griffith Centre of Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Gold Coast campus Griffith University QLD 4222, Australia; School of Health Sciences and Social Work, Gold Coast campus Griffith University, Parklands Dr Southport QLD 4222, Australia
| | - David J Saxby
- Griffith Centre of Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Gold Coast campus Griffith University QLD 4222, Australia; School of Health Sciences and Social Work, Gold Coast campus Griffith University, Parklands Dr Southport QLD 4222, Australia
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Seo S, Kang M, Han MW. Shape Memory Alloys Patches to Mimic Rolling, Sliding, and Spinning Movements of the Knee. Biomimetics (Basel) 2024; 9:255. [PMID: 38786465 PMCID: PMC11118610 DOI: 10.3390/biomimetics9050255] [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: 03/13/2024] [Revised: 04/11/2024] [Accepted: 04/17/2024] [Indexed: 05/25/2024] Open
Abstract
Every year, almost 4 million patients received medical care for knee osteoarthritis. Osteoarthritis involves progressive deterioration or degenerative changes in the cartilage, leading to inflammation and pain as the bones and ligaments are affected. To enhance treatment and surgical outcomes, various studies analyzing the biomechanics of the human skeletal system by fabricating simulated bones, particularly those reflecting the characteristics of patients with knee osteoarthritis, are underway. In this study, we fabricated replicated bones that mirror the bone characteristics of patients with knee osteoarthritis and developed a skeletal model that mimics the actual movement of the knee. To create patient-specific replicated bones, models were extracted from computerized tomography (CT) scans of knee osteoarthritis patients. Utilizing 3D printing technology, we replicated the femur and tibia, which bear the weight of the body and support movement, and manufactured cartilage capable of absorbing and dispersing the impact of knee joint loads using flexible polymers. Furthermore, to implement knee movement in the skeletal model, we developed artificial muscles based on shape memory alloys (SMAs) and used them to mimic the rolling, sliding, and spinning motions of knee flexion. The knee movement was investigated by changing the SMA spring's position, the number of coils, and the applied voltage. Additionally, we developed a knee-joint-mimicking system to analyze the movement of the femur. The proposed artificial-skeletal-model-based knee-joint-mimicking system appears to be applicable for analyzing skeletal models of knee patients and developing surgical simulation equipment for artificial joint replacement surgery.
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Affiliation(s)
| | | | - Min-Woo Han
- Advanced Manufacturing & Soft Robotics Laboratory, Department of Mechanical Engineering, Dongguk University, 30 Pildong-ro 1, Jung-gu, Seoul 04620, Republic of Korea; (S.S.); (M.K.)
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Feng L, Duan Q, Lai R, Liu W, Song X, Lyu Y. Development of a three-dimensional muscle-driven lower limb model developed using an improved CFD-FE method. Comput Methods Biomech Biomed Engin 2023:1-12. [PMID: 38017708 DOI: 10.1080/10255842.2023.2286921] [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: 07/04/2023] [Accepted: 11/18/2023] [Indexed: 11/30/2023]
Abstract
Analysis of the musculoskeletal movements (gait analysis) is needed in many scenarios. The in vivo method has some difficulties. For example, recruiting human subjects for the gait analysis is challenging due to many issues. In addition, when plenty of subjects are required, the follow-up experiments take a long period and the dropout of subjects always occurs. An efficient and reliable in silico simulation platform for gait analysis has been desired for a long time. Therefore, a technique using three-dimensional (3D) muscle modeling to drive the 3D musculoskeletal model was developed and the application of the technique in the simulation of lower limb movements was demonstrated. A finite element model of the lower limb with anatomically high fidelity was developed from the MRI data, where the main muscles, the bones, the subcutaneous tissues, and the skin were reconstructed. To simulate the active behavior of 3D muscles, an active, fiber-reinforced hyperelastic muscle model was developed using the user-defined material (VUMAT) model. Two typical movements, that is, hip abduction and knee lifting, were simulated by activating the responsible muscles. The results show that it is reasonable to use the improved CFD-FE method proposed in the present study to simulate the active contraction of the muscle, and it is feasible to simulate the movements by activating the relevant muscles. The results from the present technique closely match the physiological scenario and thus the technique developed has a great potential to be used in the in silico human simulation platform for many purposes.
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Affiliation(s)
- Luming Feng
- DUT-BSU Joint Institute, Dalian University of Technology, Dalian, China
| | - Qinglin Duan
- DUT-BSU Joint Institute, Dalian University of Technology, Dalian, China
- Department of Engineering Mechanics, Dalian University of Technology, Dalian, China
| | - Rongwu Lai
- Department of Engineering Mechanics, Dalian University of Technology, Dalian, China
| | - Wenhang Liu
- Department of Engineering Mechanics, Dalian University of Technology, Dalian, China
| | - Xiaoshuang Song
- Department of Engineering Mechanics, Dalian University of Technology, Dalian, China
| | - Yongtao Lyu
- DUT-BSU Joint Institute, Dalian University of Technology, Dalian, China
- Department of Engineering Mechanics, Dalian University of Technology, Dalian, China
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Moissenet F, Beauseroy V, Gasparutto X, Armand S, Hannouche D, Dumas R. Estimation of two wear factors for total hip arthroplasty: A simulation study based on musculoskeletal modelling. Clin Biomech (Bristol, Avon) 2023; 107:106035. [PMID: 37413813 DOI: 10.1016/j.clinbiomech.2023.106035] [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: 01/04/2023] [Revised: 05/31/2023] [Accepted: 06/26/2023] [Indexed: 07/08/2023]
Abstract
BACKGROUND Primary causes of surgical revision after total hip arthroplasty are polyethylene wear and implant loosening. These factors are particularly related to joint friction and thus patients' physical activity. Assessing implant wear over time according to patients' morphology and physical activity level is key to improve follow-up and patients' quality of life. METHODS An approach initially proposed for tibiofemoral prosthetic wear estimation was adapted to compute two wear factors (force-velocity, directional wear intensity) using a musculoskeletal model. It was applied on 17 participants with total hip arthroplasty to compute joint angular velocity, contact force, sliding velocity, and wear factors during common daily living activities. FINDINGS Differences were observed between gait, sitting down, and standing up tasks. An incremental increase of both global wear factors (time-integral) was observed during gait from slow to fast speeds (p ≤ 0.01). Interestingly, these two wear factors did not result in same trend for sitting down and standing up tasks. Compared to gait, one cycle of sitting down or standing up tends to induce higher friction-related wear but lower cross-shear-related wear. Depending on the wear factor, significant differences can be found between sitting down and gait at slow speed (p ≤ 0.05), and between sitting down (p ≤ 0.05) or standing up (p ≤ 0.05) and gait at fast speed. Furthermore, depending on the activity, wear can be fostered by joint contact force and/or sliding velocity. INTERPRETATION This study demonstrated the potential of wear estimation to highlight activities inducing a higher risk of implant wear after total hip arthroplasty from motion capture data.
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Affiliation(s)
- Florent Moissenet
- Kinesiology Laboratory, Geneva University Hospitals and University of Geneva, Geneva, Switzerland; Biomechanics Laboratory, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.
| | - Victor Beauseroy
- Univ Lyon, Univ Gustave Eiffel, Univ Claude Bernard Lyon 1, LBMC UMR T_9406, F-69622 Lyon, France
| | - Xavier Gasparutto
- Kinesiology Laboratory, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Stéphane Armand
- Kinesiology Laboratory, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Didier Hannouche
- Department of Surgery, Geneva University Hospitals, Geneva, Switzerland
| | - Raphaël Dumas
- Univ Lyon, Univ Gustave Eiffel, Univ Claude Bernard Lyon 1, LBMC UMR T_9406, F-69622 Lyon, France
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Guitteny S, Aissaoui R, Dumas R. Can a Musculoskeletal Model Adapted to Knee Implant Geometry Improve Prediction of 3D Contact Forces and Moments? Ann Biomed Eng 2023:10.1007/s10439-023-03216-y. [PMID: 37101092 DOI: 10.1007/s10439-023-03216-y] [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: 01/09/2023] [Accepted: 04/19/2023] [Indexed: 04/28/2023]
Abstract
Tibiofemoral contact loads are crucial parameters in the onset and progression of osteoarthrosis. While contact loads are frequently estimated from musculoskeletal models, their customization is often limited to scaling musculoskeletal geometry or adapting muscle lines. Moreover, studies have usually focused on superior-inferior contact force without investigating three-dimensional contact loads. Using experimental data from six patients with instrumented total knee arthroplasty (TKA), this study customized a lower limb musculoskeletal model to consider the positioning and the geometry of the implant at knee level. Static optimization was performed to estimate tibiofemoral contact forces and contact moments as well as musculotendinous forces. Predictions from both a generic and a customized model were compared to the instrumented implant measurements. Both models accurately predict superior-inferior (SI) force and abduction-adduction (AA) moment. Notably, the customization improves prediction of medial-lateral (ML) force and flexion-extension (FE) moments. However, there is subject-dependent variability in the prediction of anterior-posterior (AP) force. The customized models presented here predict loads on all joint axes and in most cases improve prediction. Unexpectedly, this improvement was more limited for patients with more rotated implants, suggesting a need for further model adaptations such as muscle wrapping or redefinition of hip and ankle joint centers and axes.
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Affiliation(s)
- Sacha Guitteny
- Univ Lyon, Univ Claude Bernard Lyon 1, Univ Gustave Eiffel, LBMC UMR_T 9406, 69622, Lyon, France
| | - Rachid Aissaoui
- Laboratoire de Recherche en Imagerie Et Orthopédie (LIO), Département Génie des Systèmes, Ecole de Technologie Supérieure, Montréal, Canada
| | - Raphael Dumas
- Univ Lyon, Univ Claude Bernard Lyon 1, Univ Gustave Eiffel, LBMC UMR_T 9406, 69622, Lyon, France.
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Guan S, Gray HA, Thomeer LT, Pandy MG. A Two-Degree-of-Freedom Knee Model Predicts Full Three-Dimensional Tibiofemoral and Patellofemoral Joint Motion During Functional Activity. Ann Biomed Eng 2023; 51:493-505. [PMID: 36085332 PMCID: PMC9928808 DOI: 10.1007/s10439-022-03048-2] [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: 02/08/2022] [Accepted: 08/09/2022] [Indexed: 11/01/2022]
Abstract
Six kinematic parameters are needed to fully describe three-dimensional (3D) bone motion at a joint. At the knee, the relative movements of the femur and tibia are often represented by a 1-degree-of-freedom (1-DOF) model with a single flexion-extension axis or a 2-DOF model comprising a flexion-extension axis and an internal-external rotation axis. The primary aim of this study was to determine the accuracy with which 1-DOF and 2-DOF models predict the 3D movements of the femur, tibia and patella during daily activities. Each model was created by fitting polynomial functions to 3D tibiofemoral (TF) and patellofemoral (PF) kinematic data recorded from 10 healthy individuals performing 6 functional activities. Model cross-validation analyses showed that the 2-DOF model predicted 3D knee kinematics more accurately than the 1-DOF model. At the TF joint, mean root-mean-square (RMS) errors across all activities and all participants were 3.4°|mm (deg or mm) for the 1-DOF model and 2.4°|mm for the 2-DOF model. At the PF joint, mean RMS errors were 4.0°|mm and 3.9°|mm for the 1-DOF and 2-DOF models, respectively. These results indicate that a 2-DOF model with two rotations as inputs may be used with confidence to predict the full 3D motion of the knee-joint complex.
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Affiliation(s)
- Shanyuanye Guan
- grid.1008.90000 0001 2179 088XDepartment of Mechanical Engineering, University of Melbourne, Parkville, VIC 3010 Australia
| | - Hans A. Gray
- grid.1008.90000 0001 2179 088XDepartment of Mechanical Engineering, University of Melbourne, Parkville, VIC 3010 Australia
| | - Lucas T. Thomeer
- grid.1008.90000 0001 2179 088XDepartment of Mechanical Engineering, University of Melbourne, Parkville, VIC 3010 Australia
| | - Marcus G. Pandy
- grid.1008.90000 0001 2179 088XDepartment of Mechanical Engineering, University of Melbourne, Parkville, VIC 3010 Australia
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Zhang L, Liu G, Yan Y, Han B, Li H, Ma J, Wang X. A subject-specific musculoskeletal model to predict the tibiofemoral contact forces during daily living activities. Comput Methods Biomech Biomed Engin 2022; 26:972-985. [PMID: 35852103 DOI: 10.1080/10255842.2022.2101889] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Accurate prediction of tibiofemoral contact force (TFCF) during daily living activities is significant for understanding the initiation, progression, and treatment of knee osteoarthritis (KOA). However, the diversity of target activities, prediction accuracy, and computational efficiency of the current musculoskeletal simulations need to be further improved. In this study, a subject-specific musculoskeletal model considered the tibiofemoral alignment, medial-lateral contact locations, secondary tibiofemoral and all patellofemoral motions, and knee ligaments was proposed to predict the TFCFs during the five daily activities (normal walking, sit-to-stand, stand-to-sit, stair ascent, and stair descent) in OpenSim software. The standing lower-limbs-full-length radiograph, local radiograph of knee joint, motion capture data, and force plate data of eighteen subjects were acquired as the input data of the musculoskeletal model. The results showed good agreements of TFCFs between the predictions based on our proposed musculoskeletal model and the in-vivo measurements based on instrumented knee implants during the five daily activities (RMSE: 0.16 ∼ 0.31 BW, R2: 0.88 ∼ 0.97, M: -0.11 ∼ -0.02, P: 0.03 ∼ 0.10, and C: 0.04 ∼ 0.14). Additionally, the order of the peak total and lateral TFCFs from low to high was normal walking, stair ascent and stand-to-sit, and stair descent and sit-to-stand (P < 0.05), and the peak medial TFCF was stand-to-sit, sit-to-stand, normal walking, stair ascent and stair descent (P < 0.05). The outcomes of this study are valuable for further understanding the knee biomechanics during daily living activities and providing theoretical guidance for the treatments of KOA.
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Affiliation(s)
- Li Zhang
- Innovation Center of Bioengineering, Shaanxi Engineering Laboratory for Transmissions and Controls, Northwestern Polytechnical University, Xi'an, P.R. China
| | - Geng Liu
- Innovation Center of Bioengineering, Shaanxi Engineering Laboratory for Transmissions and Controls, Northwestern Polytechnical University, Xi'an, P.R. China
| | - Yuzhou Yan
- Innovation Center of Bioengineering, Shaanxi Engineering Laboratory for Transmissions and Controls, Northwestern Polytechnical University, Xi'an, P.R. China
| | - Bing Han
- Innovation Center of Bioengineering, Shaanxi Engineering Laboratory for Transmissions and Controls, Northwestern Polytechnical University, Xi'an, P.R. China
| | - Hui Li
- Joint Surgery Department, Xi’an Hong-hui Hospital, Xi’an Jiaotong University College of Medicine, Xi’an, P.R. China
| | - Jianbing Ma
- Joint Surgery Department, Xi’an Hong-hui Hospital, Xi’an Jiaotong University College of Medicine, Xi’an, P.R. China
| | - Xupeng Wang
- Department of Industrial Design, School of Art and Design, Xi’an University of Technology, Xi’an, P.R. China
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Washabaugh EP, Brown SR, Palmieri-Smith RM, Krishnan C. Functional Resistance Training Differentially Alters Gait Kinetics After Anterior Cruciate Ligament Reconstruction: A Pilot Study. Sports Health 2022; 15:372-381. [PMID: 35766451 PMCID: PMC10170229 DOI: 10.1177/19417381221104042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Quadriceps weakness is common after anterior cruciate ligament (ACL) reconstruction and can alter gait mechanics. Functional resistance training (FRT) is a novel approach to retraining strength after injury, but it is unclear how it alters gait mechanics. Therefore, we tested how 3 different types of FRT devices: a knee brace resisting extension (unidirectional brace), a knee brace resisting extension and flexion (bidirectional brace), and an elastic band pulling backwards on the ankle (elastic band)-acutely alter gait kinetics in this population. HYPOTHESIS The type of FRT device will affect ground-reaction forces (GRFs) during and after the training. Specifically, the uni- and bidirectional braces will increase GRFs when compared with the elastic band. STUDY DESIGN Crossover study. LEVEL OF EVIDENCE Level 2. METHODS A total of 15 individuals with ACL reconstruction received FRT with each device over 3 separate randomized sessions. During training, participants walked on a treadmill while performing a tracking task with visual feedback. Sessions contained 5 training trials (180 seconds each) with rest between. Vertical and anterior-posterior GRFs were assessed on the ACL-reconstructed leg before, during, and after training. Changes in GRFs were compared across devices using 1-dimensional statistical parametric mapping. RESULTS Resistance applied via bidirectional brace acutely increased gait kinetics during terminal stance/pre-swing (ie, push-off), while resistance applied via elastic band acutely increased gait kinetics during initial contact/loading (ie, braking). Both braces behaved similarly, but the unidirectional brace was less effective for increasing push-off GRFs. CONCLUSION FRT after ACL reconstruction can acutely alter gait kinetics during training. Devices can be applied to selectively alter gait kinetics. However, the long-term effects of FRT after ACL reconstruction with these devices are still unknown. CLINICAL RELEVANCE FRT may be applied to alter gait kinetics of the involved limb after ACL reconstruction, depending on the device used.
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Affiliation(s)
- Edward P Washabaugh
- Neuromuscular and Rehabilitation Robotics Laboratory (NeuRRo Lab), Department of Physical Medicine and Rehabilitation, Michigan Medicine, University of Michigan, Ann Arbor, Michigan.,Department of Biomedical Engineering, Wayne State University, Detroit, Michigan
| | - Scott R Brown
- Neuromuscular and Rehabilitation Robotics Laboratory (NeuRRo Lab), Department of Physical Medicine and Rehabilitation, Michigan Medicine, University of Michigan, Ann Arbor, Michigan.,Department of Kinesiology, Aquinas College, Grand Rapids, Michigan
| | - Riann M Palmieri-Smith
- Neuromuscular and Rehabilitation Robotics Laboratory (NeuRRo Lab), Department of Physical Medicine and Rehabilitation, Michigan Medicine, University of Michigan, Ann Arbor, Michigan.,School of Kinesiology, University of Michigan, Ann Arbor, Michigan.,Department of Orthopaedic Surgery, Michigan Medicine, University of Michigan, Ann Arbor, Michigan
| | - Chandramouli Krishnan
- Neuromuscular and Rehabilitation Robotics Laboratory (NeuRRo Lab), Department of Physical Medicine and Rehabilitation, Michigan Medicine, University of Michigan, Ann Arbor, Michigan.,School of Kinesiology, University of Michigan, Ann Arbor, Michigan.,Michigan Robotics Institute, University of Michigan, Ann Arbor, Michigan
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Manal K, Buchanan TS. An Efficient One-Step Moment Balancing Algorithm for Computing Medial and Lateral Knee Compartment Contact Forces. J Biomech Eng 2022; 144:1120495. [PMID: 34549259 DOI: 10.1115/1.4052494] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Indexed: 11/08/2022]
Abstract
The knee adduction moment is associated with the progression of knee osteoarthritis (OA). The adduction moment reflects the net effect of muscles, passive tissues and bone-on-bone contact forces. Medial compartment OA is more common than lateral and therefore our ability to correctly partition bone-on-bones forces across the medial and lateral compartments is key to understanding mechanical factors associated with the onset and progression of knee OA. In this technical brief we present an efficient one-step moment balancing algorithm linking the sagittal and frontal planes in the determination of musculotendon forces. Novel to the one-step approach is the introduction of a penalty function limiting total compressive force from acting in the lateral compartment when the internal moment is net abduction (i.e., external knee adduction). Medial and lateral knee contact forces were computed using the one-step moment balancing algorithm for 10 subjects walking at a self-selected pace and compared to values determined using a well-established two-step frontal moment balancing approach. Overall, average peak differences in magnitude and timing were small and the ensemble-averaged contact force profiles were similar between methods. The only statistical difference was slightly larger (0.2 BWs) peak medial contact force for the one-step method during the first half of stance, however these differences are small relative to peak values and would not likely alter interpretation of the data. The 1-step moment balancing method is a more efficient methodology for computing medial and lateral knee contact forces that can be used in place of two-step frontal plane moment balancing.
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Affiliation(s)
- Kurt Manal
- Department of Kinesiology and Applied Physiology, University of Delaware, 540 S. College Ave, Room 148, Newark, DE 19713; Department of Biomechanics and Movement Science, University of Delaware, Newark, DE 19713; Department of Biomedical Engineering, University of Delaware, Newark, DE 19713
| | - Thomas S Buchanan
- Department of Biomechanics and Movement Science, University of Delaware, Newark, DE 19713; Department of Biomedical Engineering, University of Delaware, Newark, DE 19713; Department of Mechanical Engineering, University of Delaware, Newark, DE 19713
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Sakata J, Tamaki T, Kishino A, Kubota S, Akeda M. Risk factors for throwing elbow injuries during pitching analyzed by simulation using human musculoskeletal model in youth baseball pitchers. J Shoulder Elbow Surg 2021; 30:1309-1315. [PMID: 33675973 DOI: 10.1016/j.jse.2021.01.039] [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: 10/24/2020] [Revised: 01/16/2021] [Accepted: 01/31/2021] [Indexed: 02/01/2023]
Abstract
BACKGROUND Pitching mechanics are believed to be risk factors for throwing elbow injury. Thus, a prospective study of abnormal mechanics in youth baseball players is needed. This study aimed to analyze the ulnar collateral ligament during normal pitching using SIMM (Software for Interactive Musculoskeletal Modeling) for analysis and investigate the risk parameters of throwing elbow injuries in youth baseball players. We hypothesized that excessive ulnar collateral ligament force during pitching would be a risk factor for throwing elbow injuries in this population. METHODS In this cohort study, youth baseball pitchers (aged 9-11 years) were instructed to throw a ball into a netted target. Using a SIMM musculoskeletal model, we analyzed the force of the anterior band of the anterior oblique ligament, posterior band of the anterior oblique ligament (AOL_PB), and elbow varus moment during pitching (foot contact to ball release). We calculated the integral of each force of the anterior band of the anterior oblique ligament and AOL_PB during pitching and summarized these data to establish an impulse at the medial epicondyle. Each participant was followed up for 12 months to assess the occurrence of throwing elbow injury. RESULTS During the 12-month follow-up period, 18 pitchers (28.1%) reported throwing elbow injuries in the throwing arm. The results of this study showed that the maximum AOL_PB force and the impulse at the medial epicondyle were risk factors for throwing elbow injuries. The maximum AOL_PB force was significantly higher in the throwing elbow injury group than in the uninjured group (59.4 ± 17.8 N vs. 47.1 ± 17.5 N, P = .014). The impulse at the medial epicondyle was also significantly different (11.1 ± 4.0 N ・ s in the throwing elbow injury group vs. 8.3 ± 4.4 N ・ s in the uninjured group, P = .025). CONCLUSIONS Increasing the AOL_PB force or the impulse at the medial epicondyle may increase the risk of throwing elbow injuries in youth baseball pitchers. It may be possible to reduce injury risk by focusing on ways to decrease AOL_PB load and cumulative stress on the medial epicondyle throughout the throwing motion while still maintaining high levels of ball velocity.
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Affiliation(s)
- Jun Sakata
- Department of Rehabilitation, Toyota Memorial Hospital, Toyota, Japan.
| | - Tatsuya Tamaki
- Department of Rehabilitation, Yokohama Sports Medical Center, Yokohama, Japan
| | - Asami Kishino
- Department of Rehabilitation, Yokohama Sports Medical Center, Yokohama, Japan
| | - Satoshi Kubota
- Department of Rehabilitation, Yokohama Sports Medical Center, Yokohama, Japan; Department of Sport Sciences, School of Human and Social Sciences, Tokyo International University, Tokyo, Japan
| | - Masaki Akeda
- Department of Orthopedic Sports Medicine, Yokohama Minami Kyosai Hospital, Yokohama, Japan
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Knee loading in OA subjects is correlated to flexion and adduction moments and to contact point locations. Sci Rep 2021; 11:8594. [PMID: 33883591 PMCID: PMC8060429 DOI: 10.1038/s41598-021-87978-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 03/29/2021] [Indexed: 11/29/2022] Open
Abstract
This study evaluated the association of contact point locations with the knee medial and lateral contact force (Fmed, Flat) alterations in OA and healthy subjects. A musculoskeletal model of the lower limb with subject-specific tibiofemoral contact point trajectories was used to estimate the Fmed and Flat in ten healthy and twelve OA subjects during treadmill gait. Regression analyses were performed to evaluate the correlation of the contact point locations, knee adduction moment (KAM), knee flexion moment (KFM), frontal plane alignment, and gait speed with the Fmed and Flat. Medial contact point locations in the medial–lateral direction showed a poor correlation with the Fmed in OA (R2 = 0.13, p = 0.01) and healthy (R2 = 0.24, p = 0.001) subjects. Anterior–posterior location of the contact points also showed a poor correlation with the Fmed of OA subjects (R2 = 0.32, p < 0.001). Across all subjects, KAM and KFM remained the best predictors of the Fmed and Flat, respectively (R2 between 0.62 and 0.69). Results suggest different mechanisms of contact force distribution in OA joints. The variations in the location of the contact points participate partially to explains the Fmed variations in OA subjects together with the KFM and KAM.
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Ding Z, Jarvis HL, Bennett AN, Baker R, Bull AMJ. Higher knee contact forces might underlie increased osteoarthritis rates in high functioning amputees: A pilot study. J Orthop Res 2021; 39:850-860. [PMID: 32427347 DOI: 10.1002/jor.24751] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 04/24/2020] [Accepted: 05/01/2020] [Indexed: 02/04/2023]
Abstract
High functioning military transtibial amputees (TTAs) with well-fitted state of the art prosthetics have gait that is indistinguishable from healthy individuals, yet they are more likely to develop knee osteoarthritis (OA) of their intact limbs. This contrasts with the information at the knees of the amputated limbs that have been shown to be at a significantly reduced risk of pain and OA. The hypothesis of this study is that biomechanics can explain the difference in knee OA risk. Eleven military unilateral TTAs and eleven matched healthy controls underwent gait analysis. Muscle forces and joint contact forces at the knee were quantified using musculoskeletal modeling, validated using electromyography measurements. Peak knee contact forces for the intact limbs on both the medial and lateral compartments were significantly greater than the healthy controls (P ≤ .006). Additionally, the intact limbs had greater peak semimembranosus (P = .001) and gastrocnemius (P ≤ .001) muscle forces compared to the controls. This study has for the first time provided robust evidence of increased force on the non-affected knees of high functioning TTAs that supports the mechanically based hypothesis to explain the documented higher risk of knee OA in this patient group. The results suggest several protentional strategies to mitigate knee OA of the intact limbs, which may include the improvements of the prosthetic foot control, socket design, and strengthening of the amputated muscles.
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Affiliation(s)
- Ziyun Ding
- Department of Bioengineering, Imperial College London, London, United Kingdom
| | - Hannah L Jarvis
- Faculty of Science and Engineering, School of Healthcare Science, Manchester Metropolitan University, Manchester, United Kingdom
| | - Alexander N Bennett
- Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre Headley Court, Epsom, United Kingdom.,National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Richard Baker
- School of Health Sciences, University of Salford, Salford, United Kingdom
| | - Anthony M J Bull
- Department of Bioengineering, Imperial College London, London, United Kingdom
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13
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Charles JP, Fu FH, Anderst WJ. Predictions of Anterior Cruciate Ligament Dynamics From Subject-Specific Musculoskeletal Models and Dynamic Biplane Radiography. J Biomech Eng 2021; 143:031006. [PMID: 33030199 PMCID: PMC7871995 DOI: 10.1115/1.4048710] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 09/17/2020] [Indexed: 01/13/2023]
Abstract
In vivo knee ligament forces are important to consider for informing rehabilitation or clinical interventions. However, they are difficult to directly measure during functional activities. Musculoskeletal models and simulations have become the primary methods by which to estimate in vivo ligament loading. Previous estimates of anterior cruciate ligament (ACL) forces range widely, suggesting that individualized anatomy may have an impact on these predictions. Using ten subject-specific (SS) lower limb musculoskeletal models, which include individualized musculoskeletal geometry, muscle architecture, and six degree-of-freedom knee joint kinematics from dynamic biplane radiography (DBR), this study provides SS estimates of ACL force (anteromedial-aACL; and posterolateral-pACL bundles) during the full gait cycle of treadmill walking. These forces are compared to estimates from scaled-generic (SG) musculoskeletal models to assess the effect of musculoskeletal knee joint anatomy on predicted forces and the benefit of SS modeling in this context. On average, the SS models demonstrated a double force peak during stance (0.39-0.43 xBW per bundle), while only a single force peak during stance was observed in the SG aACL. No significant differences were observed between continuous SG and SS ACL forces; however, root mean-squared differences between SS and SG predictions ranged from 0.08 xBW to 0.27 xBW, suggesting SG models do not reliably reflect forces predicted by SS models. Force predictions were also found to be highly sensitive to ligament resting length, with ±10% variations resulting in force differences of up to 84%. Overall, this study demonstrates the sensitivity of ACL force predictions to SS anatomy, specifically musculoskeletal joint geometry and ligament resting lengths, as well as the feasibility for generating SS musculoskeletal models for a group of subjects to predict in vivo tissue loading during functional activities.
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Affiliation(s)
- James P. Charles
- Evolutionary Morphology and Biomechanics Lab, Musculoskeletal Biology, University of Liverpool, Liverpool L7 8TX, UK; Biodynamics Lab, Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA 15260
| | - Freddie H. Fu
- Biodynamics Lab, Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA 15260
| | - William J. Anderst
- Biodynamics Lab, Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA 15260
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14
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Accuracy of the tibiofemoral contact forces estimated by a subject-specific musculoskeletal model with fluoroscopy-based contact point trajectories. J Biomech 2020; 113:110117. [PMID: 33197692 DOI: 10.1016/j.jbiomech.2020.110117] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 10/22/2020] [Accepted: 10/29/2020] [Indexed: 11/22/2022]
Abstract
Accurate estimation of the tibiofemoral contact forces relies on exact kinematics and joint geometry. Subject-specific kinematic constraints representing contact point trajectories derived from fluoroscopic measurements during lunge are introduced in a musculoskeletal model of the lower limb and compared to generic kinematic constraints. The medial, lateral, and total contact forces during gait and squat are validated using the data of four patients with an instrumented prosthesis. The accuracy of the estimated contact forces (both with subject-specific and generic kinematic constraints) remains close to the level reported in the literature. The mean root mean square errors range from 0.32 to 0.52 body weights for gait and from 0.27 to 0.72 body weights for squat. The impact of the subject-specific contact point trajectories is not found substantial or consistent between patients and tasks. Indeed, the kinematics of the total knee prostheses remains close to the kinematics of a hinge joint and the contact point locations remain generally centred at 20 mm from the tibia centreline (close to the constant value defined in the generic constraints). The contact point trajectories are also suspected to differ between tasks (lunge vs. gait and squat). While the contact point trajectories have been reported to be sensitive model parameters, no clear improvement of the contact force accuracy is demonstrated on patients with instrumented prosthesis. The introduction (as kinematic constraints) of fluoroscopy-based contact point trajectories may be considered in cases where these trajectories are significantly altered, as reported for osteoarthritis patients.
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15
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Sednieva Y, Viste A, Naaim A, Bruyère-Garnier K, Gras LL. Strain Assessment of Deep Fascia of the Thigh During Leg Movement: An in situ Study. Front Bioeng Biotechnol 2020; 8:750. [PMID: 32850692 PMCID: PMC7403494 DOI: 10.3389/fbioe.2020.00750] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 06/11/2020] [Indexed: 11/30/2022] Open
Abstract
Fascia is a fibrous connective tissue present all over the body. At the lower limb level, the deep fascia that is overlying muscles of the outer thigh and sheathing them (fascia lata) is involved in various pathologies. However, the understanding and quantification of the mechanisms involved in these sheathing effects are still unclear. The aim of this study is to observe and quantify the strain field of the fascia lata, including the iliotibial tract (ITT), during a passive movement of the knee. Three fresh postmortem human subjects were studied. To measure hip and knee angles during knee flexion-extension, passive movements from 0° to around 120° were recorded with a motion analysis system and strain fields of the fascia were acquired using digital image correlation. Strains were computed for three areas of the fascia lata: anterior fascia, lateral fascia, and ITT. Mean principal strains showed different strain mechanisms depending on location on the fascia and knee angle. For the ITT, two strain mechanisms were observed depending on knee movement: compression is observed when the knee is extended relative to the reference position of 47°, however, tension and pure shear can be observed when the knee is flexed. For the anterior and lateral fascia, in most cases, minor strain is higher than major strain in absolute value, suggesting high tissue compression probably due to microstructural fiber rearrangements. This in situ study is the first attempt to quantify the superficial strain field of fascia lata during passive leg movement. The study presents some limitations but provides a step in understanding strain mechanism of the fascia lata during passive knee movement.
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Affiliation(s)
- Yuliia Sednieva
- Univ Lyon, Université Claude Bernard Lyon 1, Univ Gustave Eiffel, IFSTTAR, LBMC UMR_T9406, Lyon, France
| | - Anthony Viste
- Univ Lyon, Université Claude Bernard Lyon 1, Univ Gustave Eiffel, IFSTTAR, LBMC UMR_T9406, Lyon, France
- Hospices Civils de Lyon, Hôpital Lyon Sud, Chirurgie Orthopédique, Pierre-Bénite, France
| | - Alexandre Naaim
- Univ Lyon, Université Claude Bernard Lyon 1, Univ Gustave Eiffel, IFSTTAR, LBMC UMR_T9406, Lyon, France
| | - Karine Bruyère-Garnier
- Univ Lyon, Université Claude Bernard Lyon 1, Univ Gustave Eiffel, IFSTTAR, LBMC UMR_T9406, Lyon, France
| | - Laure-Lise Gras
- Univ Lyon, Université Claude Bernard Lyon 1, Univ Gustave Eiffel, IFSTTAR, LBMC UMR_T9406, Lyon, France
- *Correspondence: Laure-Lise Gras,
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16
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An Anatomical-Based Subject-Specific Model of In-Vivo Knee Joint 3D Kinematics From Medical Imaging. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10062100] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Biomechanical models of the knee joint allow the development of accurate procedures as well as novel devices to restore the joint natural motion. They are also used within musculoskeletal models to perform clinical gait analysis on patients. Among relevant knee models in the literature, the anatomy-based spatial parallel mechanisms represent the joint motion using rigid links for the ligaments’ isometric fibres and point contacts for the articular surfaces. To customize analyses, therapies and devices, there is the need to define subject-specific models, but relevant procedures and their accuracy are still questioned. A procedure is here proposed and validated to define a customized knee model based on a spatial parallel mechanism. Computed tomography, magnetic resonance and 3D-video-fluoroscopy were performed on a healthy volunteer to define the personalized model geometry. The model was then validated by comparing the measured and the replicated joint motion. The model showed mean absolute difference and standard deviations in translations and rotations, respectively of 0.98 ± 0.40 mm and 0.68 ± 0.29 ° for the tibia–femur motion, and of 0.77 ± 0.15 mm and 2.09 ± 0.69 ° for the patella–femur motion. These results show that accurate personalized spatial models of knee kinematics can be obtained from in-vivo imaging.
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17
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Davico G, Pizzolato C, Killen BA, Barzan M, Suwarganda EK, Lloyd DG, Carty CP. Best methods and data to reconstruct paediatric lower limb bones for musculoskeletal modelling. Biomech Model Mechanobiol 2019; 19:1225-1238. [DOI: 10.1007/s10237-019-01245-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Accepted: 10/25/2019] [Indexed: 11/28/2022]
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18
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Dzialo CM, Pedersen PH, Jensen KK, de Zee M, Andersen MS. Evaluation of predicted patellofemoral joint kinematics with a moving-axis joint model. Med Eng Phys 2019; 73:85-91. [PMID: 31474509 DOI: 10.1016/j.medengphy.2019.08.001] [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: 12/20/2018] [Revised: 07/27/2019] [Accepted: 08/15/2019] [Indexed: 10/26/2022]
Abstract
The main objectives of this study were to expand the moving-axis joint model concept to the patellofemoral joint and evaluate the patellar motion against experimental patellofemoral kinematics. The experimental data was obtained through 2D-to-3D bone reconstruction of EOS images and segmented MRI data utilizing an iterative closest point optimization technique. Six knee model variations were developed using the AnyBody Modeling System and subject-specific bone geometries. These models consisted of various combinations of tibiofemoral (hinge, moving-axis, and interpolated) and patellofemoral (hinge and moving-axis) joint types. The newly introduced interpolated tibiofemoral joint is calibrated from the five EOS quasi-static lunge positions. The patellofemoral axis of the hinge model was defined by performing surface fits to the patellofemoral contact area; and the moving-axis model was defined based upon the position of the patellofemoral joint at 0° and 90° tibiofemoral-flexion. In between these angles, the patellofemoral axis moved linearly as a function of tibiofemoral-flexion, while outside these angles, the axis remained fixed. When using a moving-axis tibiofemoral joint, a hinge patellofemoral joint offers (-5.12 ± 1.23 mm, 5.81 ± 0.97 mm, 14.98 ± 2.30°, -4.35 ± 1.95°) mean differences (compared to EOS) while a moving-axis patellofemoral model provides (-2.69 ± 1.04 mm, 1.13 ± 0.80 mm, 12.63 ± 2.03°, 1.74 ± 1.46°) in terms of lateral-shift, superior translation, patellofemoral-flexion, and patellar-rotation, respectively. Furthermore, the model predictive capabilities increased as a direct result of adding more calibrated positions to the tibiofemoral model (hinge-1, moving-axis-2, and interpolated-5). Overall, a novel subject-specific moving-axis patellofemoral model has been established; that produces realistic patellar motion and is computationally fast enough for clinical applications.
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Affiliation(s)
- C M Dzialo
- AnyBody Technology, A/S Niels Jernes Vej 10, DK 9220 Aalborg, Denmark; Department of Materials and Production, Aalborg University, Fibigerstræde 16, DK-9220 Aalborg, Denmark.
| | - P H Pedersen
- Department of Orthopedic Surgery, Aalborg University Hospital, Hobrovej 18-22, DK-9000 Aalborg, Denmark
| | - K K Jensen
- Department of Radiology, Aalborg University Hospital, Hobrovej 18-22, DK-9000 Aalborg, Denmark
| | - M de Zee
- Department of Health Science and Technology, Sport Sciences, Aalborg University, Fredrik Bajers Vej 7D, DK-9220 Aalborg, Denmark
| | - M S Andersen
- Department of Materials and Production, Aalborg University, Fibigerstræde 16, DK-9220 Aalborg, Denmark
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19
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Barzan M, Modenese L, Carty CP, Maine S, Stockton CA, Sancisi N, Lewis A, Grant J, Lloyd DG, Brito da Luz S. Development and validation of subject-specific pediatric multibody knee kinematic models with ligamentous constraints. J Biomech 2019; 93:194-203. [DOI: 10.1016/j.jbiomech.2019.07.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 05/16/2019] [Accepted: 07/02/2019] [Indexed: 01/08/2023]
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20
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Shu L, Yamamoto K, Yao J, Saraswat P, Liu Y, Mitsuishi M, Sugita N. A subject-specific finite element musculoskeletal framework for mechanics analysis of a total knee replacement. J Biomech 2018; 77:146-154. [DOI: 10.1016/j.jbiomech.2018.07.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Revised: 06/27/2018] [Accepted: 07/04/2018] [Indexed: 10/28/2022]
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21
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Lin YC, Walter JP, Pandy MG. Predictive Simulations of Neuromuscular Coordination and Joint-Contact Loading in Human Gait. Ann Biomed Eng 2018; 46:1216-1227. [PMID: 29671152 DOI: 10.1007/s10439-018-2026-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 04/11/2018] [Indexed: 12/01/2022]
Abstract
We implemented direct collocation on a full-body neuromusculoskeletal model to calculate muscle forces, ground reaction forces and knee contact loading simultaneously for one cycle of human gait. A data-tracking collocation problem was solved for walking at the normal speed to establish the practicality of incorporating a 3D model of articular contact and a model of foot-ground interaction explicitly in a dynamic optimization simulation. The data-tracking solution then was used as an initial guess to solve predictive collocation problems, where novel patterns of movement were generated for walking at slow and fast speeds, independent of experimental data. The data-tracking solutions accurately reproduced joint motion, ground forces and knee contact loads measured for two total knee arthroplasty patients walking at their preferred speeds. RMS errors in joint kinematics were < 2.0° for rotations and < 0.3 cm for translations while errors in the model-computed ground-reaction and knee-contact forces were < 0.07 BW and < 0.4 BW, respectively. The predictive solutions were also consistent with joint kinematics, ground forces, knee contact loads and muscle activation patterns measured for slow and fast walking. The results demonstrate the feasibility of performing computationally-efficient, predictive, dynamic optimization simulations of movement using full-body, muscle-actuated models with realistic representations of joint function.
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Affiliation(s)
- Yi-Chung Lin
- Department of Mechanical Engineering, University of Melbourne, Parkville, VIC, 3010, Australia.
| | - Jonathan P Walter
- CED Technologies, 6817 Southpoint Pkwy, Suite 1901, Jacksonville, FL, 32216, USA
| | - Marcus G Pandy
- Department of Mechanical Engineering, University of Melbourne, Parkville, VIC, 3010, Australia
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22
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Hu J, Chen Z, Xin H, Zhang Q, Jin Z. Musculoskeletal multibody dynamics simulation of the contact mechanics and kinematics of a natural knee joint during a walking cycle. Proc Inst Mech Eng H 2018; 232:508-519. [DOI: 10.1177/0954411918767695] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Detailed knowledge of the in vivo loading and kinematics in the knee joint is essential to understand its normal functions and the aetiology of osteoarthritis. Computer models provide a viable non-invasive solution for estimating joint loading and kinematics during different physiological activities. However, the joint loading and kinematics of the tibiofemoral and patellofemoral joints during a gait cycle were not typically investigated concurrently in previous computational simulations. In this study, a natural knee architecture was incorporated into a lower extremity musculoskeletal multibody dynamics model based on a force-dependent kinematics approach to investigate the contact mechanics and kinematics of a natural knee joint during a walking cycle. Specifically, the contact forces between the femoral/tibial articular cartilages and menisci and between the femoral and tibial/patellar articular cartilages were quantified. The contact forces and kinematics of the tibiofemoral and patellofemoral joints and the muscle activations and ligament forces were predicted simultaneously with a reasonable level of accuracy. The developed musculoskeletal multibody dynamics model with a natural knee architecture can serve as a potential platform for assisting clinical decision-making and postoperative rehabilitation planning.
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Affiliation(s)
- Jiayu Hu
- 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
| | - Hua Xin
- State Key Laboratory for Manufacturing System Engineering, School of Mechanical Engineering, Xi’an Jiaotong University, Xi’an, China
| | - Qida Zhang
- State Key Laboratory for Manufacturing System Engineering, School of Mechanical Engineering, Xi’an Jiaotong University, Xi’an, China
| | - Zhongmin Jin
- State Key Laboratory for Manufacturing System Engineering, School of Mechanical Engineering, Xi’an Jiaotong University, Xi’an, China
- 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
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23
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Development and validation of a subject-specific moving-axis tibiofemoral joint model using MRI and EOS imaging during a quasi-static lunge. J Biomech 2018; 72:71-80. [DOI: 10.1016/j.jbiomech.2018.02.032] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 02/21/2018] [Accepted: 02/23/2018] [Indexed: 11/18/2022]
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24
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Lei J, Liu H, Li Z, Wang Z, Liu X, Zhao L. Biomechanical comparison of fixation systems in posterior wall fracture of acetabular by finite element analysis. Comput Assist Surg (Abingdon) 2018; 21:117-126. [PMID: 27973947 DOI: 10.1080/24699322.2016.1218052] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND The use of reconstruction plates and lag screws has been recommended for fractures to the posterior wall of the acetabulum. However, little information about the rigidity of recommended forms of fracture fixation is available. This study aimed to evaluate the biomechanical difference among the fixation systems. METHODS A posterior wall fracture, which is represented by softer elements with lower elastic modulus, was created along an arc of 40-90° about the acetabular rim. Three different fixation systems: screws alone, reconstruction plate with screws, reconstruction plate with T-shaped plates were used to fix the posterior wall fractures to the acetabulum. RESULTS All three fixation system can be used to obtain good functional outcomes. The reconstruction plate with T-shaped plates was beneficial to increasing the effective stiffness, decreasing the stress concentration and enhancing the rigidity of fracture fixation. So this fixation system served an ideal result in the analysis. CONCLUSION Theoretically, the reconstruction plate with T-shaped plates system may reduce many of the risks and limitations compared to the other fixation systems. This fixation system may result in a clinical benefit.
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Affiliation(s)
- Jianyin Lei
- a College of Mechanics , Taiyuan University of Technology , Taiyuan , China
| | - Haibo Liu
- a College of Mechanics , Taiyuan University of Technology , Taiyuan , China
| | - Zhiqiang Li
- a College of Mechanics , Taiyuan University of Technology , Taiyuan , China
| | - Zhihua Wang
- a College of Mechanics , Taiyuan University of Technology , Taiyuan , China
| | - Ximing Liu
- b Department of Orthopedics , Wuhan General Hospital of Guangzhou Command , Wuhan , China
| | - Longmao Zhao
- a College of Mechanics , Taiyuan University of Technology , Taiyuan , China
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25
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Eskinazi I, Fregly BJ. A computational framework for simultaneous estimation of muscle and joint contact forces and body motion using optimization and surrogate modeling. Med Eng Phys 2018; 54:56-64. [PMID: 29487037 DOI: 10.1016/j.medengphy.2018.02.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 01/11/2018] [Accepted: 02/11/2018] [Indexed: 10/17/2022]
Abstract
Concurrent estimation of muscle activations, joint contact forces, and joint kinematics by means of gradient-based optimization of musculoskeletal models is hindered by computationally expensive and non-smooth joint contact and muscle wrapping algorithms. We present a framework that simultaneously speeds up computation and removes sources of non-smoothness from muscle force optimizations using a combination of parallelization and surrogate modeling, with special emphasis on a novel method for modeling joint contact as a surrogate model of a static analysis. The approach allows one to efficiently introduce elastic joint contact models within static and dynamic optimizations of human motion. We demonstrate the approach by performing two optimizations, one static and one dynamic, using a pelvis-leg musculoskeletal model undergoing a gait cycle. We observed convergence on the order of seconds for a static optimization time frame and on the order of minutes for an entire dynamic optimization. The presented framework may facilitate model-based efforts to predict how planned surgical or rehabilitation interventions will affect post-treatment joint and muscle function.
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Affiliation(s)
- Ilan Eskinazi
- Department of Mechanical & Aerospace Engineering, University of Florida, Gainesville, FL, USA
| | - Benjamin J Fregly
- Department of Mechanical Engineering, Rice University, Houston, TX, USA.
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26
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Zeighami A, Aissaoui R, Dumas R. Knee medial and lateral contact forces in a musculoskeletal model with subject-specific contact point trajectories. J Biomech 2018; 69:138-145. [PMID: 29397108 DOI: 10.1016/j.jbiomech.2018.01.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Revised: 01/08/2018] [Accepted: 01/14/2018] [Indexed: 01/27/2023]
Abstract
Contact point (CP) trajectory is a crucial parameter in estimating medial/lateral tibio-femoral contact forces from the musculoskeletal (MSK) models. The objective of the present study was to develop a method to incorporate the subject-specific CP trajectories into the MSK model. Ten healthy subjects performed 45 s treadmill gait trials. The subject-specific CP trajectories were constructed on the tibia and femur as a function of extension-flexion using low-dose bi-plane X-ray images during a quasi-static squat. At each extension-flexion position, the tibia and femur CPs were superimposed in the three directions on the medial side, and in the anterior-posterior and proximal-distal directions on the lateral side to form the five kinematic constraints of the knee joint. The Lagrange multipliers associated to these constraints directly yielded the medial/lateral contact forces. The results from the personalized CP trajectory model were compared against the linear CP trajectory and sphere-on-plane CP trajectory models which were adapted from the commonly used MSK models. Changing the CP trajectory had a remarkable impact on the knee kinematics and changed the medial and lateral contact forces by 1.03 BW and 0.65 BW respectively, in certain subjects. The direction and magnitude of the medial/lateral contact force were highly variable among the subjects and the medial-lateral shift of the CPs alone could not determine the increase/decrease pattern of the contact forces. The suggested kinematic constraints are adaptable to the CP trajectories derived from a variety of joint models and those experimentally measured from the 3D imaging techniques.
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Affiliation(s)
- A Zeighami
- Laboratoire de Recherche en Imagerie et Orthopédie (LIO), École de Technologie Supérieure (ÉTS), Center de Recherche du CHUM, Montréal, Québec, Canada.
| | - R Aissaoui
- Laboratoire de Recherche en Imagerie et Orthopédie (LIO), École de Technologie Supérieure (ÉTS), Center de Recherche du CHUM, Montréal, Québec, Canada.
| | - R Dumas
- Université Lyon, Université Claude Bernard Lyon 1, IFSTTAR, UMR_T9406, LBMC, F69622 Lyon, France.
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27
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Moissenet F, Dumas R. Individual contributions of the lower limb muscles to the position of the centre of pressure during gait. Comput Methods Biomech Biomed Engin 2017; 20:137-138. [DOI: 10.1080/10255842.2017.1382899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- F. Moissenet
- Laboratoire d’Analyse du Mouvement et de la Posture, Centre National de Rééducation Fonctionnelle et de Réadaptation – Rehazenter, Luxembourg
| | - R. Dumas
- IFSTTAR, LBMC, Univ Lyon, Université Claude Bernard Lyon 1, Lyon, France
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28
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Baravalle R, Thomsen F, Delrieux C, Lu Y, Gómez JC, Stošić B, Stošić T. Three-dimensional multifractal analysis of trabecular bone under clinical computed tomography. Med Phys 2017; 44:6404-6412. [PMID: 28972264 DOI: 10.1002/mp.12603] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 09/20/2017] [Accepted: 09/24/2017] [Indexed: 11/08/2022] Open
Abstract
PURPOSE An adequate understanding of bone structural properties is critical for predicting fragility conditions caused by diseases such as osteoporosis, and in gauging the success of fracture prevention treatments. In this work we aim to develop multiresolution image analysis techniques to extrapolate high-resolution images predictive power to images taken in clinical conditions. METHODS We performed multifractal analysis (MFA) on a set of 17 ex vivo human vertebrae clinical CT scans. The vertebrae failure loads (FFailure) were experimentally measured. We combined bone mineral density (BMD) with different multifractal dimensions, and BMD with multiresolution statistics (e.g., skewness, kurtosis) of MFA curves, to obtain linear models to predict FFailure. Furthermore we obtained short- and long-term precisions from simulated in vivo scans, using a clinical CT scanner. Ground-truth data - high-resolution images - were obtained with a High-Resolution Peripheral Quantitative Computed Tomography (HRpQCT) scanner. RESULTS At the same level of detail, BMD combined with traditional multifractal descriptors (Lipschitz-Hölder exponents), and BMD with monofractal features showed similar prediction powers in predicting FFailure (87%, adj. R2 ). However, at different levels of details, the prediction power of BMD with multifractal features raises to 92% (adj. R2) of FFailure. Our main finding is that a simpler but slightly less accurate model, combining BMD and the skewness of the resulting multifractal curves, predicts 90% (adj. R2) of FFailure. CONCLUSIONS Compared to monofractal and standard bone measures, multifractal analysis captured key insights in the conditions leading to FFailure. Instead of raw multifractal descriptors, the statistics of multifractal curves can be used in several other contexts, facilitating further research.
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Affiliation(s)
- Rodrigo Baravalle
- Group of Multimedia Signal Processing, CIFASIS-CONICET, Rosario, Argentina
| | - Felix Thomsen
- Imaging Sciences Lab, DIEC-CONICET, Universidad Nacional del Sur, Bahía Blanca, Argentina
| | - Claudio Delrieux
- Imaging Sciences Lab, DIEC-CONICET, Universidad Nacional del Sur, Bahía Blanca, Argentina
| | - Yongtao Lu
- Department of Engineering Mechanics, Dalian University of Technology, Dalian, China
| | - Juan Carlos Gómez
- Group of Multimedia Signal Processing, CIFASIS-CONICET, Universidad Nacional de Rosario, Argentina
| | - Borko Stošić
- Department of Statistics and Informatics, Universidade Federal Rural de Pernambuco, Recife-PE, Brazil
| | - Tatijana Stošić
- Department of Statistics and Informatics, Universidade Federal Rural de Pernambuco, Recife-PE, Brazil
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Alterations of musculoskeletal models for a more accurate estimation of lower limb joint contact forces during normal gait: A systematic review. J Biomech 2017; 63:8-20. [DOI: 10.1016/j.jbiomech.2017.08.025] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Revised: 06/27/2017] [Accepted: 08/25/2017] [Indexed: 11/21/2022]
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30
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Leardini A, Belvedere C, Nardini F, Sancisi N, Conconi M, Parenti-Castelli V. Kinematic models of lower limb joints for musculo-skeletal modelling and optimization in gait analysis. J Biomech 2017; 62:77-86. [DOI: 10.1016/j.jbiomech.2017.04.029] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 04/22/2017] [Accepted: 04/30/2017] [Indexed: 10/19/2022]
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31
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Aguilera-Bohorquez B, Gil E, Fonseca J, Fernandez M, Sánchez M. Tenosuspension of the Reflected Head of the Rectus Femoris in Hip Arthroscopy: Description of a Portal and a Surgical Maneuver. Arthrosc Tech 2017; 6:e1015-e1019. [PMID: 28970986 PMCID: PMC5621485 DOI: 10.1016/j.eats.2017.03.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 03/09/2017] [Indexed: 02/03/2023] Open
Abstract
Arthroscopy is a surgical technique useful in the treatment of intra- and extra-articular hip pathologies, including femoroacetabular impingement (FAI). In the arthroscopic treatment of pincer-type FAI, tendon interposition of the reflected head of the rectus femoris frequently hinders acetabular edge resection in the anterior-superior region (acetabuloplasty) and labrum repositioning, even causing tendon injury during the surgical procedure. Many surgeons do not give importance to the reflected head of the rectus femoris, and during the procedure they try to avoid it, giving 30° of flexion to the hip. However, this does not always prevent tendon injury caused by the instruments. Some surgeons even resect part of the tendon to improve visualization or to use it as a labral graft. The objective of this work is to describe a reproducible surgical maneuver that allows to perform the anterior-superior acetabular edge resection and chondrolabral union repair with less damage to the reflected head of the rectus femoris.
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Affiliation(s)
- Bernardo Aguilera-Bohorquez
- Orthopedics and Traumatology, Preservation Clinic of Hip and Hip Arthroscopy of the Institute of Osteoarticular Diseases, Centro Médico Imbanaco, Cali, Valle, Colombia,Address correspondence to Bernardo Aguilera-Bohorquez, M.D., Carrera 38A, No 5a -100 Tower A Office 706, Cali, Valle, Columbia.Carrera 38ANo 5a -100 Tower A Office 706CaliValleColumbia
| | - Eduardo Gil
- Orthopedics and Traumatology, Preservation Clinic of Hip and Hip Arthroscopy of the Institute of Osteoarticular Diseases, Centro Médico Imbanaco, Cali, Valle, Colombia
| | - John Fonseca
- Orthopedics and Traumatology, Centro Médico Ardila Lule, Bucaramanga, Santander, Colombia
| | - Miguel Fernandez
- Surgery of Hip Preservation and Hip Arthroscopy, Pontificia Universidad Javeriana de Cali, Centro Médico Imbanaco, Cali, Valle, Colombia
| | - Miguel Sánchez
- Surgery of Hip Preservation and Hip Arthroscopy, Pontificia Universidad Javeriana de Cali, Centro Médico Imbanaco, Cali, Valle, Colombia
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Abstract
Advancing the knowledge of the biomechanics of the human body is essential to improve the clinical decision-makings of musculoskeletal disorders in the framework of in silico medicine. An impressive number of research projects focused on the development of rigid-body musculoskeletal models have been conducted over the world thanks to the new research directives. However, the application of these models in clinical practices remains a challenging issue. The objective of this review paper was to present the most current rigid-body musculoskeletal models of the human body systems and to analyze their trends and weaknesses for clinical applications. Then, recommendations were proposed for future researches toward fully clinical decision support. A systematic review process was performed. Well-selected studies related to the most current rigid-body 3D musculoskeletal models for each body system component (jaw, cervical spine, upper limbs, lumbar spine, and lower limbs) were summarized and explored. Trends in rigid musculoskeletal modeling are highlighted as personalization, new imaging techniques for specific joint kinematics, and computational efficiency. Weaknesses are highlighted as modeling assumptions, use of generic model, lack of modeling consensus, model validation, and parameter and model uncertainties. Future directions related to joint and muscle modeling, neuro-musculoskeletal modeling, model validation, data and model uncertainty quantification are recommended.
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Affiliation(s)
- Tien Tuan Dao
- Sorbonne University, Université de technologie de Compiègne, CNRS, UMR 7338 Biomechanics and Bioengineering, BP 20529, 60205 Compiègne cedex, France
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Lamberto G, Richard V, Dumas R, Valentini PP, Pennestrì E, Lu TW, Camomilla V, Cappozzo A. Modeling the Human Tibiofemoral Joint Using Ex Vivo Determined Compliance Matrices. J Biomech Eng 2016; 138:061010. [PMID: 27109706 DOI: 10.1115/1.4033480] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Indexed: 11/08/2022]
Abstract
Several approaches have been used to devise a model of the human tibiofemoral joint for embedment in lower limb musculoskeletal models. However, no study has considered the use of cadaveric 6 × 6 compliance (or stiffness) matrices to model the tibiofemoral joint under normal or pathological conditions. The aim of this paper is to present a method to determine the compliance matrix of an ex vivo tibiofemoral joint for any given equilibrium pose. Experiments were carried out on a single ex vivo knee, first intact and, then, with the anterior cruciate ligament (ACL) transected. Controlled linear and angular displacements were imposed in single degree-of-freedom (DoF) tests to the specimen, and the resulting forces and moments were measured using an instrumented robotic arm. This was done starting from seven equilibrium poses characterized by the following flexion angles: 0 deg, 15 deg, 30 deg, 45 deg, 60 deg, 75 deg, and 90 deg. A compliance matrix for each of the selected equilibrium poses and for both the intact and ACL-deficient specimen was calculated. The matrix, embedding the experimental load-displacement relationship of the examined DoFs, was calculated using a linear least squares inversion based on a QR decomposition, assuming symmetric and positive-defined matrices. Single compliance matrix terms were in agreement with the literature. Results showed an overall increase of the compliance matrix terms due to the ACL transection (2.6 ratio for rotational terms at full extension) confirming its role in the joint stabilization. Validation experiments were carried out by performing a Lachman test (the tibia is pulled forward) under load control on both the intact and ACL-deficient knee and assessing the difference (error) between measured linear and angular displacements and those estimated using the appropriate compliance matrix. This error increased nonlinearly with respect to the values of the load. In particular, when an incremental posterior-anterior force up to 6 N was applied to the tibia of the intact specimen, the errors on the estimated linear and angular displacements were up to 0.6 mm and 1.5 deg, while for a force up to 18 N, the errors were 1.5 mm and 10.5 deg, respectively. In conclusion, the method used in this study may be a viable alternative to characterize the tibiofemoral load-dependent behavior in several applications.
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Moissenet F, Chèze L, Dumas R. Influence of the Level of Muscular Redundancy on the Validity of a Musculoskeletal Model. J Biomech Eng 2016; 138:021019. [PMID: 26632266 DOI: 10.1115/1.4032127] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Indexed: 11/08/2022]
Abstract
While recent literature has clearly demonstrated that an extensive personalization of the musculoskeletal models was necessary to reach high accuracy, several components of the generic models may be further investigated before defining subject-specific parameters. Among others, the choice in muscular geometry and thus the level of muscular redundancy in the model may have a noticeable influence on the predicted musculotendon and joint contact forces. In this context, the aim of this study was to investigate if the level of muscular redundancy can contribute or not to reduce inaccuracies in tibiofemoral contact forces predictions. For that, the dataset disseminated through the Sixth Grand Challenge Competition to Predict In Vivo Knee Loads was applied to a versatile 3D lower limb musculoskeletal model in which two muscular geometries (i.e., two different levels of muscular redundancy) were implemented. This dataset provides tibiofemoral implant measurements for both medial and lateral compartments and thus allows evaluation of the validity of the model predictions. The results suggest that an increase of the level of muscular redundancy corresponds to a better accuracy of total tibiofemoral contact force whatever the gait pattern investigated. However, the medial and lateral contact forces ratio and accuracy were not necessarily improved when increasing the level of muscular redundancy and may thus be attributed to other parameters such as the location of contact points. To conclude, the muscular geometry, among other components of the generic model, has a noticeable impact on joint contact forces predictions and may thus be correctly chosen even before trying to personalize the model.
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Navacchia A, Kefala V, Shelburne KB. Dependence of Muscle Moment Arms on In Vivo Three-Dimensional Kinematics of the Knee. Ann Biomed Eng 2016; 45:789-798. [PMID: 27620064 DOI: 10.1007/s10439-016-1728-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 09/06/2016] [Indexed: 11/26/2022]
Abstract
Quantification of muscle moment arms is important for clinical evaluation of muscle pathology and treatment, and for estimating muscle and joint forces in musculoskeletal models. Moment arms estimated with musculoskeletal models often assume a default motion of the knee derived from measurements of passive cadaveric flexion. However, knee kinematics are unique to each person and activity. The objective of this study was to estimate moment arms of the knee muscles with in vivo subject- and activity-specific kinematics from seven healthy subjects performing seated knee extension and single-leg lunge to show changes between subjects and activities. 3D knee motion was measured with a high-speed stereo-radiography system. Moment arms of ten muscles were estimated in OpenSim by replacing the default knee motion with in vivo measurements. Estimated inter-subject moment arm variability was similar to previously reported in vitro measurements. RMS deviations up to 9.0 mm (35.2% of peak value) were observed between moment arms estimated with subject-specific knee extension and passive cadaveric motion. The degrees of freedom that most impacted inter-activity differences were superior/inferior and anterior/posterior translations. Musculoskeletal simulations used to estimate in vivo muscle forces and joint loads may provide significantly different results when subject- and activity-specific kinematics are implemented.
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Affiliation(s)
- Alessandro Navacchia
- Center for Orthopaedic Biomechanics, The University of Denver, Denver, CO, USA.
- Department of Mechanical and Materials Engineering, The University of Denver, 2390 S. York St., Denver, CO, 80208, USA.
| | - Vasiliki Kefala
- Center for Orthopaedic Biomechanics, The University of Denver, Denver, CO, USA
- Department of Mechanical and Materials Engineering, The University of Denver, 2390 S. York St., Denver, CO, 80208, USA
| | - Kevin B Shelburne
- Center for Orthopaedic Biomechanics, The University of Denver, Denver, CO, USA
- Department of Mechanical and Materials Engineering, The University of Denver, 2390 S. York St., Denver, CO, 80208, USA
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Clément J, Dumas R, Hagemeister N, de Guise JA. Can generic knee joint models improve the measurement of osteoarthritic knee kinematics during squatting activity? Comput Methods Biomech Biomed Engin 2016; 20:94-103. [DOI: 10.1080/10255842.2016.1202935] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Julien Clément
- Département de génie de la production automatisée, École de technologie supérieure (ÉTS), Montréal, Canada
- Laboratoire de recherche en imagerie et orthopédie (LIO), Centre de recherche du Centre hospitalier de l’Université de Montréal (CRCHUM), Montréal, Canada
| | - Raphaël Dumas
- Université de Lyon, Lyon, France
- Université Claude Bernard Lyon 1, Villeurbanne, France
- Laboratoire de Biomécanique et Mécanique des Chocs, IFSTTAR, UMR_T9406, Bron, France
| | - Nicola Hagemeister
- Département de génie de la production automatisée, École de technologie supérieure (ÉTS), Montréal, Canada
- Laboratoire de recherche en imagerie et orthopédie (LIO), Centre de recherche du Centre hospitalier de l’Université de Montréal (CRCHUM), Montréal, Canada
| | - Jaques A. de Guise
- Département de génie de la production automatisée, École de technologie supérieure (ÉTS), Montréal, Canada
- Laboratoire de recherche en imagerie et orthopédie (LIO), Centre de recherche du Centre hospitalier de l’Université de Montréal (CRCHUM), Montréal, Canada
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Wesseling M, De Groote F, Bosmans L, Bartels W, Meyer C, Desloovere K, Jonkers I. Subject-specific geometrical detail rather than cost function formulation affects hip loading calculation. Comput Methods Biomech Biomed Engin 2016; 19:1475-88. [PMID: 26930478 DOI: 10.1080/10255842.2016.1154547] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This study assessed the relative importance of introducing an increasing level of medical image-based subject-specific detail in bone and muscle geometry in the musculoskeletal model, on calculated hip contact forces during gait. These forces were compared to introducing minimization of hip contact forces in the optimization criterion. With an increasing level of subject-specific detail, specifically MRI-based geometry and wrapping surfaces representing the hip capsule, hip contact forces decreased and were more comparable to contact forces measured using instrumented prostheses (average difference of 0.69 BW at the first peak compared to 1.04 BW for the generic model). Inclusion of subject-specific wrapping surfaces in the model had a greater effect than altering the cost function definition.
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Affiliation(s)
- Mariska Wesseling
- a Department of Kinesiology, Human Movement Biomechanics , KU Leuven , Heverlee , Belgium
| | - Friedl De Groote
- a Department of Kinesiology, Human Movement Biomechanics , KU Leuven , Heverlee , Belgium
| | - Lode Bosmans
- a Department of Kinesiology, Human Movement Biomechanics , KU Leuven , Heverlee , Belgium
| | - Ward Bartels
- b Department of Mechanical Engineering, Biomechanics , KU Leuven , Heverlee , Belgium.,c Mobelife NV , Heverlee , Belgium
| | - Christophe Meyer
- d Department of Rehabilitation Sciences, Neuromotor Rehabilitation , KU Leuven , Heverlee , Belgium
| | - Kaat Desloovere
- d Department of Rehabilitation Sciences, Neuromotor Rehabilitation , KU Leuven , Heverlee , Belgium
| | - Ilse Jonkers
- a Department of Kinesiology, Human Movement Biomechanics , KU Leuven , Heverlee , Belgium
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38
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Ding Z, Nolte D, Kit Tsang C, Cleather DJ, Kedgley AE, Bull AMJ. In Vivo Knee Contact Force Prediction Using Patient-Specific Musculoskeletal Geometry in a Segment-Based Computational Model. J Biomech Eng 2016; 138:021018. [DOI: 10.1115/1.4032412] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Indexed: 11/08/2022]
Abstract
Segment-based musculoskeletal models allow the prediction of muscle, ligament, and joint forces without making assumptions regarding joint degrees-of-freedom (DOF). The dataset published for the “Grand Challenge Competition to Predict in vivo Knee Loads” provides directly measured tibiofemoral contact forces for activities of daily living (ADL). For the Sixth Grand Challenge Competition to Predict in vivo Knee Loads, blinded results for “smooth” and “bouncy” gait trials were predicted using a customized patient-specific musculoskeletal model. For an unblinded comparison, the following modifications were made to improve the predictions: further customizations, including modifications to the knee center of rotation; reductions to the maximum allowable muscle forces to represent known loss of strength in knee arthroplasty patients; and a kinematic constraint to the hip joint to address the sensitivity of the segment-based approach to motion tracking artifact. For validation, the improved model was applied to normal gait, squat, and sit-to-stand for three subjects. Comparisons of the predictions with measured contact forces showed that segment-based musculoskeletal models using patient-specific input data can estimate tibiofemoral contact forces with root mean square errors (RMSEs) of 0.48–0.65 times body weight (BW) for normal gait trials. Comparisons between measured and predicted tibiofemoral contact forces yielded an average coefficient of determination of 0.81 and RMSEs of 0.46–1.01 times BW for squatting and 0.70–0.99 times BW for sit-to-stand tasks. This is comparable to the best validations in the literature using alternative models.
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Affiliation(s)
- Ziyun Ding
- Department of Bioengineering, Imperial College London, London SW7 2AZ, UK e-mail:
| | - Daniel Nolte
- Department of Bioengineering, Imperial College London, London SW7 2AZ, UK e-mail:
| | - Chui Kit Tsang
- Department of Bioengineering, Imperial College London, London SW7 2AZ, UK e-mail:
| | - Daniel J. Cleather
- School of Sport, Health and Applied Science, St Mary's University, Waldegrave Road, Twickenham TW1 4SX, UK e-mail:
| | - Angela E. Kedgley
- Department of Bioengineering, Imperial College London, London SW7 2AZ, UK e-mail:
| | - Anthony M. J. Bull
- Department of Bioengineering, Imperial College London, London SW7 2AZ, UK e-mail:
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A Hertzian Integrated Contact Model of the Total Knee Replacement Implant for the Estimation of Joint Contact Forces. ACTA ACUST UNITED AC 2015. [DOI: 10.1155/2015/945379] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The prediction of lower limb muscle and contact forces may provide useful knowledge to assist the clinicians in the diagnosis as well as in the development of appropriate treatment for musculoskeletal disorders. Research studies have commonly estimated joint contact forces using model-based muscle force estimation due to the lack of a reliable contact model and material properties. The objective of this present study was to develop a Hertzian integrated contact model. Then, in vivo elastic properties of the Total Knee Replacement (TKR) implant were identified using in vivo contact forces leading to providing reliable material properties for modeling purposes. First, a patient specific rigid musculoskeletal model was built. Second, a STL-based implant model was designed to compute the contact area evolutions during gait motions. Finally, a Hertzian integrated contact model was defined for the in vivo identification of elastic properties (Young’s modulus and Poisson coefficient) of the instrumented TKR implant. Our study showed a potential use of a new approach to predict the contact forces without knowledge of muscle forces. Thus, the outcomes may lead to accurate and reliable prediction of human joint contact forces for new case study.
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40
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Moissenet F, Giroux M, Chèze L, Dumas R. Validity of a musculoskeletal model using two different geometries for estimating hip contact forces during normal walking. Comput Methods Biomech Biomed Engin 2015; 18 Suppl 1:2000-1. [PMID: 26241128 DOI: 10.1080/10255842.2015.1069596] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- F Moissenet
- a CNRFR - Rehazenter, Laboratoire d'Analyse du Mouvement et de la Posture , Luxembourg
| | - M Giroux
- b Université de Lyon , Lyon , France.,c Université Claude Bernard Lyon 1 , Villeurbanne , France.,d IFSTTAR, UMR_T9406, LBMC Laboratoire de Biomécanique et Mécanique des Chocs , Bron , France
| | - L Chèze
- b Université de Lyon , Lyon , France.,c Université Claude Bernard Lyon 1 , Villeurbanne , France.,d IFSTTAR, UMR_T9406, LBMC Laboratoire de Biomécanique et Mécanique des Chocs , Bron , France
| | - R Dumas
- b Université de Lyon , Lyon , France.,c Université Claude Bernard Lyon 1 , Villeurbanne , France.,d IFSTTAR, UMR_T9406, LBMC Laboratoire de Biomécanique et Mécanique des Chocs , Bron , France
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41
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Eskinazi I, Fregly BJ. An Open-Source Toolbox for Surrogate Modeling of Joint Contact Mechanics. IEEE Trans Biomed Eng 2015; 63:269-77. [PMID: 26186761 DOI: 10.1109/tbme.2015.2455510] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
GOAL Incorporation of elastic joint contact models into simulations of human movement could facilitate studying the interactions between muscles, ligaments, and bones. Unfortunately, elastic joint contact models are often too expensive computationally to be used within iterative simulation frameworks. This limitation can be overcome by using fast and accurate surrogate contact models that fit or interpolate input-output data sampled from existing elastic contact models. However, construction of surrogate contact models remains an arduous task. The aim of this paper is to introduce an open-source program called Surrogate Contact Modeling Toolbox (SCMT) that facilitates surrogate contact model creation, evaluation, and use. METHODS SCMT interacts with the third-party software FEBio to perform elastic contact analyses of finite-element models and uses MATLAB to train neural networks that fit the input-output contact data. SCMT features sample point generation for multiple domains, automated sampling, sample point filtering, and surrogate model training and testing. RESULTS An overview of the software is presented along with two example applications. The first example demonstrates creation of surrogate contact models of artificial tibiofemoral and patellofemoral joints and evaluates their computational speed and accuracy, while the second demonstrates the use of surrogate contact models in a forward dynamic simulation of an open-chain leg extension-flexion motion. CONCLUSION SCMT facilitates the creation of computationally fast and accurate surrogate contact models. Additionally, it serves as a bridge between FEBio and OpenSim musculoskeletal modeling software. SIGNIFICANCE Researchers may now create and deploy surrogate models of elastic joint contact with minimal effort.
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42
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Natsakis T, Burg J, Dereymaeker G, Jonkers I, Sloten JV. Insertion of a pressure sensing arrayminimally affects hindfoot bone kinematics. J Foot Ankle Res 2015; 8:24. [PMID: 26146518 PMCID: PMC4490695 DOI: 10.1186/s13047-015-0081-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Accepted: 06/01/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Understanding the development of ankle osteoarthritis (OA) is of high importance and interest; however its causality is poorly understood and several links to joint loading conditions have been made. One way of quantifying joint loading conditions is by measuring the intra-articular pressure distribution during gait simulations performed by in-vitro experimental set-ups. However the effect of inserting a pressure sensing array in the ankle joint could potentially disturb the proper kinematics and therefore the loading conditions. METHODS In this study, we performed in-vitro gait simulations in 7 cadaveric feet, before and after inserting a pressure sensing array and quantified the effect on the joints range of motion (ROM). The gait was simulated with a stance phase duration of one second using a custom build cadaveric gait simulator (CGS). RESULTS The results show a limited effect in the ROM for all the joints of the hind foot, not exceeding the variability observed in specimens without a sensor. However, no consistent direction (increase/decrease) can be observed. CONCLUSION The results suggest that even though the effect of inserting a pressure sensing array is minimal, it needs to be evaluated against the demands/requirements of the application.
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Affiliation(s)
- Tassos Natsakis
- Department of Mechanical Engineering, KU Leuven, Celestijnenlaan 300c, Box 2419, Heverlee, 3001 Belgium
| | - Josefien Burg
- Department of Mechanical Engineering, KU Leuven, Celestijnenlaan 300c, Box 2419, Heverlee, 3001 Belgium ; Faculty of Kinesiology and Rehabilitation Science, KU Leuven, Tervuursevest 101, Box 1500, Heverlee, 3001 Belgium
| | - Greta Dereymaeker
- Department of Mechanical Engineering, KU Leuven, Celestijnenlaan 300c, Box 2419, Heverlee, 3001 Belgium
| | - Ilse Jonkers
- Faculty of Kinesiology and Rehabilitation Science, KU Leuven, Tervuursevest 101, Box 1500, Heverlee, 3001 Belgium
| | - Jos Vander Sloten
- Department of Mechanical Engineering, KU Leuven, Celestijnenlaan 300c, Box 2419, Heverlee, 3001 Belgium
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43
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Cleather DJ, Bull AMJ. The development of a segment-based musculoskeletal model of the lower limb: introducing FreeBody. ROYAL SOCIETY OPEN SCIENCE 2015; 2:140449. [PMID: 26543569 PMCID: PMC4632533 DOI: 10.1098/rsos.140449] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2014] [Accepted: 05/29/2015] [Indexed: 05/05/2023]
Abstract
Traditional approaches to the biomechanical analysis of movement are joint-based; that is the mechanics of the body are described in terms of the forces and moments acting at the joints, and that muscular forces are considered to create moments about the joints. We have recently shown that segment-based approaches, where the mechanics of the body are described by considering the effect of the muscle, ligament and joint contact forces on the segments themselves, can also prove insightful. We have also previously described a simultaneous, optimization-based, musculoskeletal model of the lower limb. However, this prior model incorporates both joint- and segment-based assumptions. The purpose of this study was therefore to develop an entirely segment-based model of the lower limb and to compare its performance to our previous work. The segment-based model was used to estimate the muscle forces found during vertical jumping, which were in turn compared with the muscular activations that have been found in vertical jumping, by using a Geers' metric to quantify the magnitude and phase errors. The segment-based model was shown to have a similar ability to estimate muscle forces as a model based upon our previous work. In the future, we will evaluate the ability of the segment-based model to be used to provide results with clinical relevance, and compare its performance to joint-based approaches. The segment-based model described in this article is publicly available as a GUI-based Matlab® application and in the original source code (at www.msksoftware.org.uk).
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Affiliation(s)
- Daniel J. Cleather
- School of Sport, Health and Applied Sciences, St Mary's University, Twickenham, UK
- Author for correspondence: Daniel J. Cleather e-mail: ;
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Validation of a multi-body optimization with knee kinematic models including ligament constraints. J Biomech 2015; 48:1141-6. [DOI: 10.1016/j.jbiomech.2015.01.010] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Revised: 11/17/2014] [Accepted: 01/13/2015] [Indexed: 11/17/2022]
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Kuriyama S, Ishikawa M, Furu M, Ito H, Matsuda S. Malrotated tibial component increases medial collateral ligament tension in total knee arthroplasty. J Orthop Res 2014; 32:1658-66. [PMID: 25171755 DOI: 10.1002/jor.22711] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2013] [Accepted: 07/10/2014] [Indexed: 02/04/2023]
Abstract
Malrotation of the tibial component can lead to complications after total knee arthroplasty (TKA). Despite reports of internal rotation being associated with more severe pain or stiffness than external rotation, the biomechanical reasons remain largely unknown. We used a computer simulation model and evaluated traction forces in the lateral collateral ligament (LCL) and medial collateral ligament (MCL) with a malrotated tibial component during squatting. We also examined tibiofemoral and patellofemoral contact forces and stresses under similar conditions. A dynamic musculoskeletal knee model was simulated in three different constrained tibial geometries with a prototype component. The testing conditions were changed between 15° external and 15° internal rotation of the tibial component. With internal rotation of the tibial component, the MCL force increased progressively; the LCL force also increased, but only up to less than half of the MCL force values. A higher degree of constraint of the tibial component was associated with greater femoral rotational movement and higher MCL forces. The tibiofemoral and patellofemoral contact forces were not influenced by malrotation of the tibial component, but the contact stresses increased because of decreased contact area. This altered loading condition could cause patient complaints and polyethylene problems after TKA.
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Affiliation(s)
- Shinichi Kuriyama
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
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Dumas R, Moissenet F, Lafon Y, Cheze L. Multi-objective optimisation for musculoskeletal modelling: application to a planar elbow model. Proc Inst Mech Eng H 2014; 228:1108-13. [PMID: 25361693 DOI: 10.1177/0954411914556790] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
One of the open issues in musculoskeletal modelling remains the choice of the objective function that is used to solve the muscular redundancy problem. Some authors have recently proposed to introduce joint reaction forces in the objective function, and the question of the weights associated with musculo-tendon forces and joint reaction forces arose. This question typically deals with a multi-objective optimisation problem. The aim of this study is to illustrate, on a planar elbow model, the ensemble of optimal solutions (i.e. Pareto front) and the solution of a global objective method that represent different compromises between musculo-tendon forces, joint compression force, and joint shear force. The solutions of the global objective method, based either on the minimisation of the sum of the squared musculo-tendon forces alone or on the minimisation of the squared joint compression force and shear force together, are in the same range. Minimising either the squared joint compression force or shear force alone leads to extreme force values. The exploration of the compromises between these forces illustrates the existence of major interactions between the muscular and joint structures. Indeed, the joint reaction forces relate to the projection of the sum of the musculo-tendon forces. An illustration of these interactions, due to the projection relation, is that the Pareto front is not a large surface, like in a typical three-objective optimisation, but almost a curve. These interactions, and the possibility to take them into account by a multi-objective optimisation, seem essential for the application of musculoskeletal modelling to joint pathologies.
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Affiliation(s)
- Raphaël Dumas
- Université de Lyon, Lyon, France Université Claude Bernard Lyon 1, Villeurbanne, France UMR_T9406, Laboratoire de Biomécanique et Mécanique des Chocs (LBMC), IFSTTAR, Bron, France
| | - Florent Moissenet
- Laboratoire d'Analyse du Mouvement et de la Posture, CNRFR - Rehazenter, Luxembourg, Luxembourg
| | - Yoann Lafon
- Université de Lyon, Lyon, France Université Claude Bernard Lyon 1, Villeurbanne, France UMR_T9406, Laboratoire de Biomécanique et Mécanique des Chocs (LBMC), IFSTTAR, Bron, France
| | - Laurence Cheze
- Université de Lyon, Lyon, France Université Claude Bernard Lyon 1, Villeurbanne, France UMR_T9406, Laboratoire de Biomécanique et Mécanique des Chocs (LBMC), IFSTTAR, Bron, France
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Moissenet F, Chèze L, Dumas R. Introduction of a set of EMG-based muscular activations in a multi-objective optimisation when solving the muscular redundancy problem during gait. Comput Methods Biomech Biomed Engin 2014; 17 Suppl 1:132-3. [PMID: 25074200 DOI: 10.1080/10255842.2014.931542] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- F Moissenet
- a Laboratoire d'Analyse du Mouvement et de la Posture , CNRFR - Rehazenter , 1 rue André Vésale, L-2647 , Luxembourg , Luxembourg
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Chen Z, Zhang X, Ardestani MM, Wang L, Liu Y, Lian Q, He J, Li D, Jin Z. Prediction of in vivo joint mechanics of an artificial knee implant using rigid multi-body dynamics with elastic contacts. Proc Inst Mech Eng H 2014; 228:564-575. [PMID: 24878735 DOI: 10.1177/0954411914537476] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Lower extremity musculoskeletal computational models play an important role in predicting joint forces and muscle activation simultaneously and are valuable for investigating functional outcomes of the implants. However, current computational musculoskeletal models of total knee replacement rarely consider the bearing surface geometry of the implant. Therefore, these models lack detailed information about the contact loading and joint motion which are important factors for evaluating clinical performances. This study extended a rigid multi-body dynamics simulation of a lower extremity musculoskeletal model to incorporate an artificial knee joint, based upon a novel force-dependent kinematics method, and to characterize the in vivo joint contact mechanics during gait. The developed musculoskeletal total knee replacement model integrated the rigid skeleton multi-body dynamics and the flexible contact mechanics of the tibiofemoral and patellofemoral joints. The predicted contact forces and muscle activations are compared against those in vivo measurements obtained from a single patient with good agreements for the medial contact force (root-mean-square error = 215 N, ρ = 0.96) and lateral contact force (root-mean-square error = 179 N, ρ = 0.75). Moreover, the developed model also predicted the motion of the tibiofemoral joint in all degrees of freedom. This new model provides an important step toward the development of a realistic dynamic musculoskeletal total knee replacement model to predict in vivo knee joint motion and loading simultaneously. This could offer a better opportunity to establish a robust virtual modeling platform for future pre-clinical assessment of knee prosthesis designs, surgical procedures and post-operation rehabilitation.
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Affiliation(s)
- Zhenxian Chen
- State Key Laboratory for Manufacturing Systems Engineering, School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, China
| | - Xuan Zhang
- State Key Laboratory for Manufacturing Systems Engineering, School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, China
| | - Marzieh M Ardestani
- State Key Laboratory for Manufacturing Systems Engineering, School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, China
| | - Ling Wang
- State Key Laboratory for Manufacturing Systems Engineering, School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, China
| | - Yaxiong Liu
- State Key Laboratory for Manufacturing Systems Engineering, School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, China
| | - Qin Lian
- State Key Laboratory for Manufacturing Systems Engineering, School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, China
| | - Jiankang He
- State Key Laboratory for Manufacturing Systems Engineering, School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, China
| | - Dichen Li
- State Key Laboratory for Manufacturing Systems Engineering, School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, China
| | - Zhongmin Jin
- State Key Laboratory for Manufacturing Systems Engineering, School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, China Institute of Medical and Biological Engineering, School of Mechanical Engineering, University of Leeds, Leeds, UK
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