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Lopez Poncelas M, La Barbera L, Rawlinson JJ, Crandall D, Aubin CE. Credibility assessment of patient-specific biomechanical models to investigate proximal junctional failure in clinical cases with adult spine deformity using ASME V&V40 standard. Comput Methods Biomech Biomed Engin 2021; 25:543-553. [PMID: 34427119 DOI: 10.1080/10255842.2021.1968380] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Computational models are increasingly used to assess spine biomechanics and support surgical planning. However, varying levels of model verification and validation, along with characterization of uncertainty effects limit the level of confidence in their predictive potential. The objective was to assess the credibility of an adult spine deformity instrumentation model for proximal junction failure (PJF) analysis using the ASME V&V40:2018 framework. To assess model applicability, the surgery, erected posture, and flexion movement of actual clinical cases were simulated. The loads corresponding to PJF indicators for a group of asymptomatic patients and a group of PJF patients were compared. Model consistency was demonstrated by finding PJF indicators significantly higher for the simulated PJF vs. asymptomatic patients. A detailed sensitivity analysis and uncertainty quantification were performed to further establish the model credibility.
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Affiliation(s)
- M Lopez Poncelas
- Department of Mechanical Engineering, Polytechnique Montréal, Montréal, Quebec, Canada.,Research Center, Sainte-Justine University Hospital Center, Montréal, Quebec, Canada
| | - L La Barbera
- Department of Mechanical Engineering, Polytechnique Montréal, Montréal, Quebec, Canada.,Research Center, Sainte-Justine University Hospital Center, Montréal, Quebec, Canada.,Department of Chemistry and Chemical Engineering, Politecnico di Milano, Milano, Italy
| | - J J Rawlinson
- Department of Mechanical Engineering, Polytechnique Montréal, Montréal, Quebec, Canada.,Applied Research, Medtronic Spine, Memphis, TN, USA
| | - D Crandall
- Sonoran Spine Center, Tempe, AZ, USA.,Mayo Clinic School of Medicine, Phoenix, AZ, USA.,School of Medicine, University of Arizona, Phoenix, AZ, USA
| | - C E Aubin
- Department of Mechanical Engineering, Polytechnique Montréal, Montréal, Quebec, Canada.,Research Center, Sainte-Justine University Hospital Center, Montréal, Quebec, Canada
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Early Spatiotemporal Patterns and Knee Kinematics during Level Walking in Individuals following Total Knee Arthroplasty. JOURNAL OF HEALTHCARE ENGINEERING 2017; 2017:7056469. [PMID: 29065637 PMCID: PMC5554991 DOI: 10.1155/2017/7056469] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2017] [Revised: 05/05/2017] [Accepted: 05/23/2017] [Indexed: 12/22/2022]
Abstract
Purpose With the aim of investigating the spatiotemporal features of early gait pattern and knee kinematics after total knee arthroplasty and analyzing the association between outcomes of gait analyses and knee kinematic parameters, the relationship between walking and dynamic knee deformity at the early period after total knee arthroplasty was assessed in this study. Methods Eighteen patients including 14 women and 4 men who underwent total knee arthroplasty were analyzed using three-dimensional gait analysis system to observe gait parameters and values of maximum knee flexion angle (MKFA) during swing phase and knee flexion angle (KFA) and knee valgus angle (KVA) at midstance phase. Results 3D gait analysis showed that operated side exhibited significantly less total support time and single support time as well as significantly longer swing phase compared with the other side. During walking, the operated side had significantly smaller MKFA and greater KFA and KVA than the nonoperated side. There was moderate to significant correlation between gait pattern and the dynamic knee kinematics. Conclusion The gait abnormality of patients after TKA was associated with inadequate flexion of knees at swing phase and insufficient extension at stance phase as well as increased range of valgus.
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