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Yao J, Crockett J, D'Souza M, A Day G, K Wilcox R, C Jones A, Mengoni M. Effect of meniscus modelling assumptions in a static tibiofemoral finite element model: importance of geometry over material. Biomech Model Mechanobiol 2024; 23:1055-1065. [PMID: 38349433 PMCID: PMC11101373 DOI: 10.1007/s10237-024-01822-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 01/06/2024] [Indexed: 05/18/2024]
Abstract
Finite element studies of the tibiofemoral joint have increased use in research, with attention often placed on the material models. Few studies assess the effect of meniscus modelling assumptions in image-based models on contact mechanics outcomes. This work aimed to assess the effect of modelling assumptions of the meniscus on knee contact mechanics and meniscus kinematics. A sensitivity analysis was performed using three specimen-specific tibiofemoral models and one generic knee model. The assumptions in representing the meniscus attachment on the tibia (shape of the roots and position of the attachment), the material properties of the meniscus, the shape of the meniscus and the alignment of the joint were evaluated, creating 40 model instances. The values of material parameters for the meniscus and the position of the root attachment had a small influence on the total contact area but not on the meniscus displacement or the force balance between condyles. Using 3D shapes to represent the roots instead of springs had a large influence in meniscus displacement but not in knee contact area. Changes in meniscus shape and in knee alignment had a significantly larger influence on all outcomes of interest, with differences two to six times larger than those due to material properties. The sensitivity study demonstrated the importance of meniscus shape and knee alignment on meniscus kinematics and knee contact mechanics, both being more important than the material properties or the position of the roots. It also showed that differences between knees were large, suggesting that clinical interpretations of modelling studies using single geometries should be avoided.
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Affiliation(s)
- Jiacheng Yao
- Institute of Medical and Biological Engineering, School of Mechanical Engineering, University of Leeds, Leeds, UK
| | - John Crockett
- Institute of Medical and Biological Engineering, School of Mechanical Engineering, University of Leeds, Leeds, UK
| | - Mathias D'Souza
- Institute of Medical and Biological Engineering, School of Mechanical Engineering, University of Leeds, Leeds, UK
| | - Gavin A Day
- Institute of Medical and Biological Engineering, School of Mechanical Engineering, University of Leeds, Leeds, UK
| | - Ruth K Wilcox
- Institute of Medical and Biological Engineering, School of Mechanical Engineering, University of Leeds, Leeds, UK
| | - Alison C Jones
- Institute of Medical and Biological Engineering, School of Mechanical Engineering, University of Leeds, Leeds, UK
| | - Marlène Mengoni
- Institute of Medical and Biological Engineering, School of Mechanical Engineering, University of Leeds, Leeds, UK.
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2
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Setliff JC, Anderst WJ. A scoping review of human skeletal kinematics research using biplane radiography. J Orthop Res 2024; 42:915-922. [PMID: 38366965 DOI: 10.1002/jor.25806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 10/18/2023] [Accepted: 12/12/2023] [Indexed: 02/19/2024]
Abstract
Biplane radiography has emerged as the gold standard for accurately measuring in vivo skeletal kinematics during physiological loading. The purpose of this scoping review was to map the extent, range, and nature of biplane radiography research on humans from 2004 through 2022. A literature search was performed using the terms biplane radiography, dual fluoroscopy, dynamic stereo X-ray, and biplane videoradiography. All articles referenced in included publications were also assessed for inclusion. A secondary search was then performed using the names of the most frequently appearing principal investigators among included papers. A total of 379 manuscripts were identified and included. The first studies published in 2004 focused on the native knee, followed by studies of the ankle joint complex in 2006, the shoulder in 2007, and the spine in 2008. Nearly half (180, 47.5%) of all manuscripts investigated knee kinematics. The average number of publications increased from 21.6 per year from 2012 to 2017 to 34.6 per year from 2017 to 2022. The average number of participants per study was 16, with a range from 1 to 101. A total of 90.2% of studies featured cohorts of 30 or less. The most prolific research groups for each joint were: Mass General Hospital (lumbar spine and knee), Henry Ford Hospital (shoulder), the University of Utah (ankle and hip), The University of Pittsburgh (cervical spine), and Brown University (hand/wrist/elbow). Future advancements in biplane radiography research are dependent upon increased availability of these imaging systems, standardization of data collection protocols, and the development of automated approaches to expedite data processing.
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Affiliation(s)
- Joshua C Setliff
- Biodynamics Lab, Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - William J Anderst
- Biodynamics Lab, Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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3
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Lampen N, Su H, Chan DD, Yan P. Finite element modeling with subject-specific mechanical properties to assess knee osteoarthritis initiation and progression. J Orthop Res 2023; 41:72-83. [PMID: 35438803 DOI: 10.1002/jor.25338] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 03/14/2022] [Accepted: 03/31/2022] [Indexed: 02/04/2023]
Abstract
Finite element models of the knee can be used to identify regions at risk of mechanical failure in studies of osteoarthritis. Models of the knee often implement joint geometry obtained from magnetic resonance imaging (MRI) or gait kinematics from motion capture to increase model specificity for a given subject. However, differences exist in cartilage material properties regionally as well as between subjects. This paper presents a method to create subject-specific finite element models of the knee that assigns cartilage material properties from T2 relaxometry. We compared our T2 -refined model to identical models with homogeneous material properties. When tested on three subjects from the Osteoarthritis Initiative data set, we found the T2 -refined models estimated higher principal stresses and shear strains in most cartilage regions and corresponded better to increases in KL grade in follow-ups compared to their corresponding homogeneous material models. Measures of cumulative stress within regions of a T2 -refined model also correlated better with the region's cartilage morphology MRI Osteoarthritis Knee Score as compared with the homogeneous model. We conclude that spatially heterogeneous T2 -refined material properties improve the subject-specificity of finite element models compared to homogeneous material properties in osteoarthritis progression studies. Statement of Clinical Significance: T2 -refined material properties can improve subject-specific finite element model assessments of cartilage degeneration.
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Affiliation(s)
- Nathan Lampen
- Department of Biomedical Engineering, Center for Biotechnology and Interdisciplinary Studies, Rensselaer Polytechnic Institute, Troy, New York, USA
| | - Haoyun Su
- Department of Biomedical Engineering, Center for Biotechnology and Interdisciplinary Studies, Rensselaer Polytechnic Institute, Troy, New York, USA
| | - Deva D Chan
- Department of Biomedical Engineering, Center for Biotechnology and Interdisciplinary Studies, Rensselaer Polytechnic Institute, Troy, New York, USA.,Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana, USA
| | - Pingkun Yan
- Department of Biomedical Engineering, Center for Biotechnology and Interdisciplinary Studies, Rensselaer Polytechnic Institute, Troy, New York, USA
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4
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Kaiser D, Götschi T, Bachmann E, Snedeker JG, Tscholl PM, Fucentese SF. Deepening trochleoplasty may dramatically increase retropatellar contact pressures- a pilot study establishing a finite element model. J Exp Orthop 2022; 9:76. [PMID: 35916944 PMCID: PMC9346018 DOI: 10.1186/s40634-022-00512-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 07/12/2022] [Indexed: 11/10/2022] Open
Affiliation(s)
- Dominik Kaiser
- Department of Orthopedics, Balgrist University Hospital, University of Zurich, Forchstrasse 340, 8008, Zurich, Switzerland.
| | - Tobias Götschi
- Department of Orthopedics, Biomechanical Research Laboratory, Balgrist Campus, University of Zurich, Zurich, Switzerland
| | - Elias Bachmann
- Department of Orthopedics, Biomechanical Research Laboratory, Balgrist Campus, University of Zurich, Zurich, Switzerland
| | - Jess G Snedeker
- Department of Orthopedics, Biomechanical Research Laboratory, Balgrist Campus, University of Zurich, Zurich, Switzerland
| | - Philippe M Tscholl
- Department of Orthopedics, Balgrist University Hospital, University of Zurich, Forchstrasse 340, 8008, Zurich, Switzerland
| | - Sandro F Fucentese
- Department of Orthopedics, Balgrist University Hospital, University of Zurich, Forchstrasse 340, 8008, Zurich, Switzerland
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Evaluation of anterior cruciate ligament surgical reconstruction through finite element analysis. Sci Rep 2022; 12:8044. [PMID: 35577879 PMCID: PMC9110399 DOI: 10.1038/s41598-022-11601-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 04/21/2022] [Indexed: 11/08/2022] Open
Abstract
Anterior cruciate ligament (ACL) tear is one of the most common knee injuries. The ACL reconstruction surgery aims to restore healthy knee function by replacing the injured ligament with a graft. Proper selection of the optimal surgery parameters is a complex task. To this end, we developed an automated modeling framework that accepts subject-specific geometries and produces finite element knee models incorporating different surgical techniques. Initially, we developed a reference model of the intact knee, validated with data provided by the Open Knee(s) project. This helped us evaluate the effectiveness of estimating ligament stiffness directly from MRI. Next, we performed a plethora of “what-if” simulations, comparing responses with the reference model. We found that (a) increasing graft pretension and radius reduces relative knee displacement, (b) the correlation of graft radius and tension should not be neglected, (c) graft fixation angle of 20\documentclass[12pt]{minimal}
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\begin{document}$$^{\circ }$$\end{document}∘ can reduce knee laxity, and (d) single-versus double-bundle techniques demonstrate comparable performance in restraining knee translation. In most cases, these findings confirm reported values from comparative clinical studies. The numerical models are made publicly available, allowing for experimental reuse and lowering the barriers for meta-studies. The modeling approach proposed here can complement orthopedic surgeons in their decision-making.
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Seyedpour SM, Nafisi S, Nabati M, Pierce DM, Reichenbach JR, Ricken T. Magnetic Resonance Imaging-based biomechanical simulation of cartilage: A systematic review. J Mech Behav Biomed Mater 2021; 126:104963. [PMID: 34894500 DOI: 10.1016/j.jmbbm.2021.104963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 10/30/2021] [Accepted: 11/06/2021] [Indexed: 11/19/2022]
Abstract
MRI-based mathematical and computational modeling studies can contribute to a better understanding of the mechanisms governing cartilage's mechanical performance and cartilage disease. In addition, distinct modeling of cartilage is needed to optimize artificial cartilage production. These studies have opened up the prospect of further deepening our understanding of cartilage function. Furthermore, these studies reveal the initiation of an engineering-level approach to how cartilage disease affects material properties and cartilage function. Aimed at researchers in the field of MRI-based cartilage simulation, research articles pertinent to MRI-based cartilage modeling were identified, reviewed, and summarized systematically. Various MRI applications for cartilage modeling are highlighted, and the limitations of different constitutive models used are addressed. In addition, the clinical application of simulations and studied diseases are discussed. The paper's quality, based on the developed questionnaire, was assessed, and out of 79 reviewed papers, 34 papers were determined as high-quality. Due to the lack of the best constitutive models for various clinical conditions, researchers may consider the effect of constitutive material models on the cartilage disease simulation. In the future, research groups may incorporate various aspects of machine learning into constitutive models and MRI data extraction to further refine the study methodology. Moreover, researchers should strive for further reproducibility and rigorous model validation and verification, such as gait analysis.
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Affiliation(s)
- S M Seyedpour
- Institute of Mechanics, Structural Analysis and Dynamics, Faculty of Aerospace Engineering and Geodesy, University of Stuttgart, Pfaffenwaldring 27, 70569 Stuttgart, Germany; Biomechanics Lab, Institute of Mechanics, Structural Analysis and Dynamics, Faculty of Aerospace Engineering and Geodesy, University of Stuttgart, Pfaffenwaldring 27, 70569 Stuttgart, Germany
| | - S Nafisi
- Faculty of Pharmacy, Istinye University, Maltepe, Cirpici Yolu B Ck. No. 9, 34010 Zeytinburnu, Istanbul, Turkey
| | - M Nabati
- Department of Mechanical Engineering, Faculty of Engineering, Boğaziçi University, 34342 Bebek, Istanbul, Turkey
| | - D M Pierce
- Department of Mechanical Engineering, University of Connecticut, 191 Auditorium Road, Unit 3139, Storrs, CT, 06269, USA; Department of Biomedical Engineering, University of Connecticut, 260 Glenbrook Road, Unit 3247, Storrs, CT, 06269, USA
| | - J R Reichenbach
- Medical Physics Group, Institute of Diagnostic and Interventional Radiology, Jena University Hospital-Friedrich Schiller University Jena, Jena, Germany; Center of Medical Optics and Photonics, Friedrich Schiller University Jena, Germany; Michael Stifel Center for Data-driven and Simulation Science Jena, Friedrich Schiller University Jena, Germany
| | - T Ricken
- Institute of Mechanics, Structural Analysis and Dynamics, Faculty of Aerospace Engineering and Geodesy, University of Stuttgart, Pfaffenwaldring 27, 70569 Stuttgart, Germany; Biomechanics Lab, Institute of Mechanics, Structural Analysis and Dynamics, Faculty of Aerospace Engineering and Geodesy, University of Stuttgart, Pfaffenwaldring 27, 70569 Stuttgart, Germany.
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7
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Niu J, Qin X, Bai J, Li H. Reconstruction and optimization of the 3D geometric anatomy structure model for subject-specific human knee joint based on CT and MRI images. Technol Health Care 2021; 29:221-238. [PMID: 33682761 PMCID: PMC8150550 DOI: 10.3233/thc-218022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND: Nowadays, the total knee arthroplasty (TKA) technique plays an important role in surgical treatment for patients with severe knee osteoarthritis (OA). However, there are still several key issues such as promotion of osteotomy accuracy and prosthesis matching degree that need to be addressed. OBJECTIVE: It is significant to construct an accurate three-dimensional (3D) geometric anatomy structure model of subject-specific human knee joint with major bone and soft tissue structures, which greatly contributes to obtaining personalized osteotomy guide plate and suitable size of prosthesis. METHODS: Considering different soft tissue structures, magnetic resonance imaging (MRI) scanning sequences involving two-dimensional (2D) spin echo (SE) sequence T1 weighted image (T1WI) and 3D SE sequence T2 weighted image (T2WI) fat suppression (FS) are selected. A 3D modeling methodology based on computed tomography (CT) and two sets of MRI images is proposed. RESULTS: According to the proposed methods of image segmentation and 3D model registration, a novel 3D knee joint model with high accuracy is finally constructed. Furthermore, remeshing is used to optimize the established model by adjusting the relevant parameters. CONCLUSIONS: The modeling results demonstrate that reconstruction and optimization model of 3D knee joint can clearly and accurately reflect the key characteristics, including anatomical structure and geometric morphology for each component.
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Affiliation(s)
- Junlong Niu
- School of Mechanical Engineering, Northwestern Polytechnical University, Xi'an, Shaanxi 710072, China
| | - Xiansheng Qin
- School of Mechanical Engineering, Northwestern Polytechnical University, Xi'an, Shaanxi 710072, China
| | - Jing Bai
- School of Mechanical Engineering, Northwestern Polytechnical University, Xi'an, Shaanxi 710072, China
| | - Haiyan Li
- Department of Magnetic Resonance Imaging, Xi'an Honghui Hospital Affiliated to Xi'an Jiaotong University, Xi'an, Shaanxi 710054, China
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8
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McKeon BP, Zaslav KR, Alfred RH, Alley RM, Edelson RH, Gersoff WK, Greenleaf JE, Kaeding CC. Preliminary Results From a US Clinical Trial of a Novel Synthetic Polymer Meniscal Implant. Orthop J Sports Med 2020; 8:2325967120952414. [PMID: 33062765 PMCID: PMC7536377 DOI: 10.1177/2325967120952414] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 04/09/2020] [Indexed: 01/03/2023] Open
Abstract
Background: At least 760,000 outpatient meniscectomies are performed in the United States
each year, making this the most common musculoskeletal procedure. However,
meniscal resection can alter the joint biomechanics and overload the
articular cartilage, which may contribute to degenerative changes and the
need for knee replacement. Avoiding or delaying knee replacement is
particularly important in younger or more active patients. Synthetic
meniscal implants have been developed in an attempt to restore the natural
joint biomechanics, alleviate pain and disability, and potentially minimize
degenerative changes in patients who require meniscectomy. Purpose To evaluate the preliminary results from 2 ongoing trials that are evaluating
the safety and effectiveness of a synthetic polymer meniscal implant
(NUsurface; Active Implants, LLC). Study Design: Cohort study; Level of evidence, 2. Methods: This was a preliminary analysis of the first 100 patients enrolled across 2
studies for 12 months: a single-arm, intervention-only study and a
randomized controlled trial comparing the investigational meniscal implant
with nonsurgical therapy. There were 65 patients in the implant group (30
randomized) and 35 in the control group. Outcomes included Knee injury and
Osteoarthritis Outcome Score (KOOS) and adverse events (AEs) collected at
baseline and follow-up visits of 6 weeks, 6 months, and 12 months. Results: No statistically significant differences were found in baseline
characteristics between the implant and control groups. At 12 months,
follow-up KOOS data were available for 87% of the 100 included patients.
Significantly greater improvements from baseline were observed in the
implant group compared with controls in all KOOS subcomponents, except for
symptoms (119%-177% greater improvement at 12 months). AEs were reported at
similar rates between the 2 groups, with 12 AEs among 11 patients in the
implant group (16.9%) versus 5 AEs among 5 patients (14.3%) in the control
group (P = .99). Conclusion: These preliminary results suggest significant improvements in pain and
function scores with the implant over nonsurgical therapy and a similar
adverse event rate.
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Affiliation(s)
- Brian P McKeon
- Boston Sports & Shoulder Center, Waltham, Massachusetts, USA
| | - Kenneth R Zaslav
- Ortho Virginia, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Richard H Alfred
- The Bone & Joint Center and Albany Medical College, Albany, New York, USA
| | - R Maxwell Alley
- The Bone & Joint Center and Albany Medical College, Albany, New York, USA
| | | | - Wayne K Gersoff
- Advanced Orthopedic and Sports Medicine Specialists, Denver, Colorado, USA
| | | | - Christopher C Kaeding
- Sports Medicine Institute and Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
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Steineman BD, LaPrade RF, Haut Donahue TL. Nonanatomic Placement of Posteromedial Meniscal Root Repairs: A Finite Element Study. J Biomech Eng 2020; 142:1072350. [PMID: 31901167 DOI: 10.1115/1.4045893] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Indexed: 11/08/2022]
Abstract
Nonanatomic placement of posteromedial meniscal root repairs alters knee mechanics; however, little is known about how the position and magnitude of misplacement affect knee mechanics. Finite element knee models were developed to assess changes in cartilage and meniscus mechanics for anatomic and various nonanatomic repairs with respect to intact. In total, 25 different repair locations were assessed at loads of 500 N and 1000 N. The two-simple-suture method was represented within the models to simulate posteromedial meniscal root repairs. Anatomic repairs nearly restored total contact area; however, meniscal hoop stress decreased, meniscal extrusion increased, and cartilage-cartilage contact area increased. Repairs positioned further posterior altered knee mechanics the most and repairs positioned further anterior restored knee mechanics for posteromedial root repairs. Despite this, repair tension increased with further anterior placement. Anterior placement of repairs results in more restorative contact mechanics than posterior placement; however, anterior placement also increased the risk of suture cut-out or failure following repairs. Anatomic placement of repairs remains the best option because of the risks involved with anterior placement; however, suture methods need to be improved to better restore the strength of repairs to that of the native insertion. Proper placement of repairs is important to consider with meniscal root repairs because misplacement may negatively affect cartilage and meniscus mechanics in patients.
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Affiliation(s)
- Brett D Steineman
- Department of Biomechanics, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021
| | | | - Tammy L Haut Donahue
- Department of Biomedical Engineering, University of Massachusetts, Amherst, MA 01003
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10
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Esrafilian A, Stenroth L, Mononen ME, Tanska P, Avela J, Korhonen RK. EMG-Assisted Muscle Force Driven Finite Element Model of the Knee Joint with Fibril-Reinforced Poroelastic Cartilages and Menisci. Sci Rep 2020; 10:3026. [PMID: 32080233 PMCID: PMC7033219 DOI: 10.1038/s41598-020-59602-2 10.1109/tnsre.2022.3159685] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2023] Open
Abstract
Abnormal mechanical loading is essential in the onset and progression of knee osteoarthritis. Combined musculoskeletal (MS) and finite element (FE) modeling is a typical method to estimate load distribution and tissue responses in the knee joint. However, earlier combined models mostly utilize static-optimization based MS models and muscle force driven FE models typically use elastic materials for soft tissues or analyze specific time points of gait. Therefore, here we develop an electromyography-assisted muscle force driven FE model with fibril-reinforced poro(visco)elastic cartilages and menisci to analyze knee joint loading during the stance phase of gait. Moreover, since ligament pre-strains are one of the important uncertainties in joint modeling, we conducted a sensitivity analysis on the pre-strains of anterior and posterior cruciate ligaments (ACL and PCL) as well as medial and lateral collateral ligaments (MCL and LCL). The model produced kinematics and kinetics consistent with previous experimental data. Joint contact forces and contact areas were highly sensitive to ACL and PCL pre-strains, while those changed less cartilage stresses, fibril strains, and fluid pressures. The presented workflow could be used in a wide range of applications related to the aetiology of cartilage degeneration, optimization of rehabilitation exercises, and simulation of knee surgeries.
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Affiliation(s)
- A Esrafilian
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland.
| | - L Stenroth
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - M E Mononen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - P Tanska
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - J Avela
- NeuroMuscular Research Center, Unit of Biology of Physical Activity, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - R K Korhonen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
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11
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Esrafilian A, Stenroth L, Mononen ME, Tanska P, Avela J, Korhonen RK. EMG-Assisted Muscle Force Driven Finite Element Model of the Knee Joint with Fibril-Reinforced Poroelastic Cartilages and Menisci. Sci Rep 2020; 10:3026. [PMID: 32080233 PMCID: PMC7033219 DOI: 10.1038/s41598-020-59602-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 01/31/2020] [Indexed: 11/12/2022] Open
Abstract
Abnormal mechanical loading is essential in the onset and progression of knee osteoarthritis. Combined musculoskeletal (MS) and finite element (FE) modeling is a typical method to estimate load distribution and tissue responses in the knee joint. However, earlier combined models mostly utilize static-optimization based MS models and muscle force driven FE models typically use elastic materials for soft tissues or analyze specific time points of gait. Therefore, here we develop an electromyography-assisted muscle force driven FE model with fibril-reinforced poro(visco)elastic cartilages and menisci to analyze knee joint loading during the stance phase of gait. Moreover, since ligament pre-strains are one of the important uncertainties in joint modeling, we conducted a sensitivity analysis on the pre-strains of anterior and posterior cruciate ligaments (ACL and PCL) as well as medial and lateral collateral ligaments (MCL and LCL). The model produced kinematics and kinetics consistent with previous experimental data. Joint contact forces and contact areas were highly sensitive to ACL and PCL pre-strains, while those changed less cartilage stresses, fibril strains, and fluid pressures. The presented workflow could be used in a wide range of applications related to the aetiology of cartilage degeneration, optimization of rehabilitation exercises, and simulation of knee surgeries.
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Affiliation(s)
- A Esrafilian
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland.
| | - L Stenroth
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - M E Mononen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - P Tanska
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - J Avela
- NeuroMuscular Research Center, Unit of Biology of Physical Activity, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - R K Korhonen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
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12
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Castro APG, Altai Z, Offiah AC, Shelmerdine SC, Arthurs OJ, Li X, Lacroix D. Finite element modelling of the developing infant femur using paired CT and MRI scans. PLoS One 2019; 14:e0218268. [PMID: 31211799 PMCID: PMC6581244 DOI: 10.1371/journal.pone.0218268] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 05/29/2019] [Indexed: 11/19/2022] Open
Abstract
Bone finite element (FE) studies based on infant post-mortem computed tomography (CT) examinations are being developed to provide quantitative information to assist the differentiation between accidental and inflicted injury, and unsuspected underlying disease. As the growing skeleton contains non-ossified cartilaginous regions at the epiphyses, which are not well characterised on CT examinations, it is difficult to evaluate the mechanical behaviour of the developing whole bone. This study made use of paired paediatric post mortem femoral CT and magnetic resonance imaging (MRI) examinations at two different stages of development (4 and 7 months) to provide anatomical and constitutive information for both hard and soft tissues. The work aimed to evaluate the effect of epiphyseal ossification on the propensity to shaft fractures in infants. The outcomes suggest that the failure load of the femoral diaphysis in the models incorporating the non-ossified epiphysis is within the range of bone-only FE models. There may however be an effect on the metaphysis. Confirmation of these findings is required in a larger cohort of children.
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Affiliation(s)
- A. P. G. Castro
- INSIGNEO Institute, Dept. of Mechanical Engineering, University of Sheffield, Sheffield, United Kingdom
- IDMEC, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal
| | - Z. Altai
- INSIGNEO Institute, Dept. of Mechanical Engineering, University of Sheffield, Sheffield, United Kingdom
| | - A. C. Offiah
- Dept. of Oncology and Human Metabolism, University of Sheffield, Sheffield, United Kingdom
| | - S. C. Shelmerdine
- Dept. of Radiology, Great Ormond Street Hospital for Children, London, United Kingdom
- UCL Great Ormond Street Institute for Child Health, University College London, London, United Kingdom
| | - O. J. Arthurs
- Dept. of Radiology, Great Ormond Street Hospital for Children, London, United Kingdom
- UCL Great Ormond Street Institute for Child Health, University College London, London, United Kingdom
| | - X. Li
- INSIGNEO Institute, Dept. of Mechanical Engineering, University of Sheffield, Sheffield, United Kingdom
| | - D. Lacroix
- INSIGNEO Institute, Dept. of Mechanical Engineering, University of Sheffield, Sheffield, United Kingdom
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Bishop PJ, Hocknull SA, Clemente CJ, Hutchinson JR, Barrett RS, Lloyd DG. Cancellous bone and theropod dinosaur locomotion. Part II-a new approach to inferring posture and locomotor biomechanics in extinct tetrapod vertebrates. PeerJ 2018; 6:e5779. [PMID: 30402348 PMCID: PMC6215447 DOI: 10.7717/peerj.5779] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 09/18/2018] [Indexed: 01/31/2023] Open
Abstract
This paper is the second of a three-part series that investigates the architecture of cancellous bone in the main hindlimb bones of theropod dinosaurs, and uses cancellous bone architectural patterns to infer locomotor biomechanics in extinct non-avian species. Cancellous bone is widely known to be highly sensitive to its mechanical environment, and therefore has the potential to provide insight into locomotor biomechanics in extinct tetrapod vertebrates such as dinosaurs. Here in Part II, a new biomechanical modelling approach is outlined, one which mechanistically links cancellous bone architectural patterns with three-dimensional musculoskeletal and finite element modelling of the hindlimb. In particular, the architecture of cancellous bone is used to derive a single 'characteristic posture' for a given species-one in which bone continuum-level principal stresses best align with cancellous bone fabric-and thereby clarify hindlimb locomotor biomechanics. The quasi-static approach was validated for an extant theropod, the chicken, and is shown to provide a good estimate of limb posture at around mid-stance. It also provides reasonable predictions of bone loading mechanics, especially for the proximal hindlimb, and also provides a broadly accurate assessment of muscle recruitment insofar as limb stabilization is concerned. In addition to being useful for better understanding locomotor biomechanics in extant species, the approach hence provides a new avenue by which to analyse, test and refine palaeobiomechanical hypotheses, not just for extinct theropods, but potentially many other extinct tetrapod groups as well.
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Affiliation(s)
- Peter J. Bishop
- Geosciences Program, Queensland Museum, Brisbane, QLD, Australia
- School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia
- Gold Coast Orthopaedic Research, Engineering and Education Alliance, Menzies Health Institute Queensland, Gold Coast, QLD, Australia
- Current affiliation: Structure and Motion Laboratory, Department of Comparative Biomedical Sciences, Royal Veterinary College, Hatfield, Hertfordshire, UK
| | - Scott A. Hocknull
- Geosciences Program, Queensland Museum, Brisbane, QLD, Australia
- School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia
- School of Biosciences, University of Melbourne, Melbourne, VIC, Australia
| | - Christofer J. Clemente
- School of Science and Engineering, University of the Sunshine Coast, Maroochydore, QLD, Australia
- School of Biological Sciences, University of Queensland, Brisbane, QLD, Australia
| | - John R. Hutchinson
- Structure and Motion Laboratory, Department of Comparative Biomedical Sciences, Royal Veterinary College, Hatfield, Hertfordshire, UK
| | - Rod S. Barrett
- School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia
- Gold Coast Orthopaedic Research, Engineering and Education Alliance, Menzies Health Institute Queensland, Gold Coast, QLD, Australia
| | - David G. Lloyd
- School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia
- Gold Coast Orthopaedic Research, Engineering and Education Alliance, Menzies Health Institute Queensland, Gold Coast, QLD, Australia
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14
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Arjmand H, Nazemi M, Kontulainen SA, McLennan CE, Hunter DJ, Wilson DR, Johnston JD. Mechanical Metrics of the Proximal Tibia are Precise and Differentiate Osteoarthritic and Normal Knees: A Finite Element Study. Sci Rep 2018; 8:11478. [PMID: 30065276 PMCID: PMC6068127 DOI: 10.1038/s41598-018-29880-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 07/14/2018] [Indexed: 11/28/2022] Open
Abstract
Our objective was to identify precise mechanical metrics of the proximal tibia which differentiated OA and normal knees. We developed subject-specific FE models for 14 participants (7 OA, 7 normal) who were imaged three times each for assessing precision (repeatability). We assessed various mechanical metrics (minimum principal and von Mises stress and strain as well as structural stiffness) across the proximal tibia for each subject. In vivo precision of these mechanical metrics was assessed using CV%RMS. We performed parametric and non-parametric statistical analyses and determined Cohen's d effect sizes to explore differences between OA and normal knees. For all FE-based mechanical metrics, average CV%RMS was less than 6%. Minimum principal stress was, on average, 75% higher in OA versus normal knees while minimum principal strain values did not differ. No difference was observed in structural stiffness. FE modeling could precisely quantify and differentiate mechanical metrics variations in normal and OA knees, in vivo. This study suggests that bone stress patterns may be important for understanding OA pathogenesis at the knee.
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Affiliation(s)
- Hanieh Arjmand
- Department of Mechanical Engineering, University of Saskatchewan, Saskatoon, SK, Canada
| | - Majid Nazemi
- Department of Mechanical Engineering, University of Saskatchewan, Saskatoon, SK, Canada
| | | | | | - David J Hunter
- Institute of Bone and Joint Research, Kolling Institute, University of Sydney and Rheumatology Department, Royal North Shore Hospital, Sydney, NSW, Australia
| | - David R Wilson
- Department of Orthopaedics and Centre for Hip Health and Mobility, University of British Columbia and Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
| | - James D Johnston
- Department of Mechanical Engineering, University of Saskatchewan, Saskatoon, SK, Canada.
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15
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Pianigiani S, Croce D, D'Aiuto M, Pascale W, Innocenti B. Sensitivity analysis of the material properties of different soft-tissues: implications for a subject-specific knee arthroplasty. Muscles Ligaments Tendons J 2018; 7:546-557. [PMID: 29721456 DOI: 10.11138/mltj/2017.7.4.546] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction While developing a subject-specific knee model, different kinds of data-inputs are required. If information about geometries can be definitely obtained from images, more effort is necessary for the in vivo properties. Consequently, such information are recruited from the literature as common habit. However, the effects of the combined sources still need to be evaluated. Methods This work aims at developing an intact native subject-specific knee model for performing a sensitivity analysis on soft-tissues. The impacts on the biomechanical outputs were analysed during a daily activity for which articular knee kinetics and kinematics were compared among the different configurations. Prior to the sensitivity analysis, experimental and literature data were checked for the model reliability. Results Average values of mixed sources allowed the agreement with experimental data for personalized outputs. From the sensitivity analysis, knee kinematics did not significantly change in the selected ranges of properties for the soft-tissues (in rotation less than 0.5°), while contact stresses were greatly affected, especially for the articular cartilage (with differences in the results more than 100%). Conclusion In conclusion, during the development of a personalized knee model, the selection of the correct material properties is fundamental because wrong values could highly affect the numerical results. Level of evidence III a.
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Affiliation(s)
- Silvia Pianigiani
- BEAMS Department, École polytechnique de Bruxelles, Université Libre de Bruxelles, Belgium.,IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Davide Croce
- Dipartimento di Chimica, Materiali ed Ingegneria Chimica "G. Natta", Politecnico di Milano, Milan, Italy
| | - Marta D'Aiuto
- Dipartimento di Chimica, Materiali ed Ingegneria Chimica "G. Natta", Politecnico di Milano, Milan, Italy
| | | | - Bernardo Innocenti
- BEAMS Department, École polytechnique de Bruxelles, Université Libre de Bruxelles, Belgium
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16
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Szczęsna A. Verification of the blobby quaternion model of human joint limits. Biomed Signal Process Control 2018. [DOI: 10.1016/j.bspc.2017.07.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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17
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Zheng L, Carey R, Thorhauer E, Tashman S, Harner C, Zhang X. In vivo tibiofemoral skeletal kinematics and cartilage contact arthrokinematics during decline walking after isolated meniscectomy. Med Eng Phys 2017; 51:41-48. [PMID: 29122451 DOI: 10.1016/j.medengphy.2017.10.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Revised: 10/16/2017] [Accepted: 10/29/2017] [Indexed: 10/18/2022]
Abstract
We investigated the effects of isolated meniscectomy on tibiofemoral skeletal kinematics and cartilage contact arthrokinematics in vivo. We recruited nine patients who had undergone isolated medial or lateral meniscectomy, and used a dynamic stereo-radiography (DSX) system to image the patients' knee motion during decline walking. A volumetric model-based tracking process determined 3D tibiofemoral kinematics from the recorded DSX images. Cartilage contact arthrokinematics was derived from the intersection between tibial and femoral cartilage models co-registered to the bones. The kinematics and arthrokinematics were analyzed for early stance and loading response phase (30% of a gait cycle), comparing the affected and intact knees. Results showed that four patients with medial meniscectomy had significantly greater contact centroid excursions in the meniscectomized medial compartments while five patients with lateral meniscectomy had significantly greater cartilage contact area and lateral shift of contact centroid path in the meniscectomized lateral compartments, comparing to those of the same compartments in the contralateral intact knees. No consistent difference however was identified in the skeletal kinematics. The current study demonstrated that cartilage-based intra-articular arthrokinematics is more sensitive and insightful than the skeletal kinematics in assessing the meniscectomy effects.
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Affiliation(s)
- Liying Zheng
- Department of Mechanical Engineering and Materials Science, University of Pittsburgh, Pittsburgh, PA, USA; Health Effects Lab Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - Robert Carey
- Department of Mechanical Engineering and Materials Science, University of Pittsburgh, Pittsburgh, PA, USA
| | - Eric Thorhauer
- Department of Mechanical Engineering, University of Washington, Seattle, WA, USA
| | - Scott Tashman
- Department of Orthopaedic Surgery, University of Texas, Houston, TX, USA
| | - Christopher Harner
- Department of Orthopaedic Surgery, University of Texas, Houston, TX, USA
| | - Xudong Zhang
- Department of Mechanical Engineering and Materials Science, University of Pittsburgh, Pittsburgh, PA, USA; Department of Industrial & Systems Engineering, Texas A&M University, College Station, TX, USA; Department of Mechanical Engineering, Texas A&M University, College Station, TX, USA.
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18
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Guo H, Santner TJ, Lerner AL, Maher SA. Reducing uncertainty when using knee-specific finite element models by assessing the effect of input parameters. J Orthop Res 2017; 35:2233-2242. [PMID: 28059475 PMCID: PMC5500444 DOI: 10.1002/jor.23513] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 12/28/2016] [Indexed: 02/04/2023]
Abstract
Little is known about knee-specific factors that influence contact mechanics. Finite Element (FE) models offer a powerful tool to study contact mechanics, but there often exists ambiguity in the exact values of the inputs (e.g., tissue properties), which can result in a range of output values. Our objective was to quantify the reduction in the range of output values (defined herein as "uncertainty") from FE models of the human knee joint when known pre-defined values are used for clinically measurable inputs. To achieve this goal, we applied a statistically augmented FE approach to three human cadaveric knees for which full geometric and kinematic data were available. Two sets of conditions were simulated: All model inputs, clinically measurable or not, were varied to represent a "normal" patient population (Condition 1); subsets of clinically measurable variable inputs were fixed at specific values (called "patient derived inputs," or PDIs) while the other variables were varied over "normal" values (Condition 2). We found that by fixing body mass index and the anterior-posterior position of the meniscal-bony insertion points, model output uncertainty was reduced by one- to three-fifths. The magnitude of uncertainty reduction was strongly influenced by the individual knee. It was observed that knees with great anterior-posterior translation during gait had greater reductions in uncertainty when PDIs were used. This study represents the first step in developing FE models of the human knee joint based on inputs that can be derived from patients in a clinical setting. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2233-2242, 2017.
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Affiliation(s)
- Hongqiang Guo
- Department of Biomechanics, Hospital for Special Surgery, New York, NY 10021 United States,Tissue Engineering, Regeneration and Repair Program, Hospital for Special Surgery, New York, NY 10021 United States
| | - Thomas J. Santner
- Department of Statistics, The Ohio State University, Columbus, OH 43210 United States
| | - Amy L. Lerner
- Department of Biomedical Engineering, University of Rochester, Rochester, NY 14627 United States
| | - Suzanne A. Maher
- Department of Biomechanics, Hospital for Special Surgery, New York, NY 10021 United States,Tissue Engineering, Regeneration and Repair Program, Hospital for Special Surgery, New York, NY 10021 United States
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19
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Kang KT, Kim SH, Son J, Lee YH, Chun HJ. Computational model-based probabilistic analysis of in vivo material properties for ligament stiffness using the laxity test and computed tomography. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2016; 27:183. [PMID: 27787809 DOI: 10.1007/s10856-016-5797-z] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Accepted: 10/14/2016] [Indexed: 06/06/2023]
Abstract
The objective of this paper was to evaluate in vivo material properties in order to address technical aspects of computational modeling of ligaments in the tibiofemoral joint using a probabilistic method. The laxity test was applied to the anterior-posterior drawer under 30° and 90° of flexion with a series of stress radiographs, a Telos device, and computed tomography. Ligament stiffness was investigated using sensitivity analysis based on the Monte-Carlo method with a subject-specific finite element model generated from in vivo computed tomography and magnetic resonance imaging data, subjected to laxity test conditions. The material properties of ligament stiffness and initial ligament strain in a subject-specific finite element model were optimized to minimize the differences between the movements of the tibia and femur in the finite element model and the computed tomography images in the laxity test. The posterior cruciate ligament was the most significant factor in flexion and posterior drawer, while the anterior cruciate ligament primarily was the most significant factor for the anterior drawer. The optimized material properties model predictions in simulation and the laxity test were more accurate than predictions based on the initial material properties in subject-specific computed tomography measurement. Thus, this study establishes a standard for future designs in allograft, xenograft, and artificial ligaments for anterior cruciate ligament and posterior cruciate ligament injuries.
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Affiliation(s)
- Kyoung-Tak Kang
- Department of Mechanical Engineering, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Sung-Hwan Kim
- Department of Orthopedic Surgery, Arthroscopy and Joint Research Institute, Yonsei University College of Medicine, Gangnam Severance Hospital, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, Republic of Korea
| | - Juhyun Son
- Department of Mechanical Engineering, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Young Han Lee
- Department of Radiology, Research Institute of Radiological Science, Medical Convergence Research Institute, and Severance Biomedical Science Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Heoung-Jae Chun
- Department of Mechanical Engineering, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
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20
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Aznar JMG, Valero C, Borau C, Garijo N. Computational mechano-chemo-biology: a tool for the design of tissue scaffolds. ACTA ACUST UNITED AC 2016. [DOI: 10.1007/s40898-016-0002-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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21
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Garijo N, Verdonschot N, Engelborghs K, García-Aznar JM, Pérez MA. Subject-specific musculoskeletal loading of the tibia: Computational load estimation. J Mech Behav Biomed Mater 2016; 65:334-343. [PMID: 27631171 DOI: 10.1016/j.jmbbm.2016.08.026] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 07/07/2016] [Accepted: 08/19/2016] [Indexed: 10/21/2022]
Abstract
The systematic development of subject-specific computer models for the analysis of personalized treatments is currently a reality. In fact, many advances have recently been developed for creating virtual finite element-based models. These models accurately recreate subject-specific geometries and material properties from recent techniques based on quantitative image analysis. However, to determine the subject-specific forces, we need a full gait analysis, typically in combination with an inverse dynamics simulation study. In this work, we aim to determine the subject-specific forces from the computer tomography images used to evaluate bone density. In fact, we propose a methodology that combines these images with bone remodelling simulations and artificial neural networks. To test the capability of this novel technique, we quantify the personalized forces for five subject-specific tibias using our technique and a gait analysis. We compare both results, finding that similar vertical loads are estimated by both methods and that the dominant part of the load can be reliably computed. Therefore, we can conclude that the numerical-based technique proposed in this work has great potential for estimating the main forces that define the mechanical behaviour of subject-specific bone.
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Affiliation(s)
- N Garijo
- Multiscale in Mechanical and Biological Engineering (M2BE), Aragón Institute of Engineering Research (I3A), Mechanical Engineering Department, University of Zaragoza, Spain
| | - N Verdonschot
- Laboratory for Biomechanical Engineering, University of Twente, Enschede, The Netherlands; Radboud University Medical Center, Radboud Institute for Health Sciences, Orthopaedic Research Laboratory, Nijmegen, The Netherlands
| | - K Engelborghs
- Biomedical Engineering Department, Materialise NV, Leuven, Belgium
| | - J M García-Aznar
- Multiscale in Mechanical and Biological Engineering (M2BE), Aragón Institute of Engineering Research (I3A), Mechanical Engineering Department, University of Zaragoza, Spain
| | - M A Pérez
- Multiscale in Mechanical and Biological Engineering (M2BE), Aragón Institute of Engineering Research (I3A), Mechanical Engineering Department, University of Zaragoza, Spain.
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22
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Kang KT, Kim SH, Son J, Lee YH, Kim S, Chun HJ. Probabilistic evaluation of the material properties of the in vivo subject-specific articular surface using a computational model. J Biomed Mater Res B Appl Biomater 2016; 105:1390-1400. [PMID: 27080324 DOI: 10.1002/jbm.b.33666] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Revised: 02/14/2016] [Accepted: 03/10/2016] [Indexed: 11/06/2022]
Abstract
This article used probabilistic analysis to evaluate material properties of the in vivo subject-specific tibiofemoral (TF) joint model. Sensitivity analysis, based on a Monte Carlo (MC) method, was performed using a subject-specific finite element (FE) model generated from in vivo computed tomography (CT) and magnetic resonance imaging (MRI) data, subjected to two different loading conditions. Specifically, the effects of inherent uncertainty in ligament stiffness, horn attachment stiffness, and articular surface material properties were assessed using multifactorial global sensitivity analysis. The MRI images were taken before and after axial compression, and when the flexion condition had been maintained at up to 90 degree flexion in the subject-specific knee joint. The loading conditions of the probabilistic subject-specific FE model (axial compression and 90 degree flexion) were similar to the MRI acquisition setup. We were able to detect the influence of material parameters while maintaining the potential effect of parametric interactions. Throughout the in silico property optimization, a subject-specific FE model was used and less sensitive parameters were eliminated in the global sensitivity method. Soft tissue material properties were estimated using an optimization procedure that involved the minimization of the differences between the kinematics predicted by the subject-specific model and those obtained through in vivo subject-specific data. The results of this approach suggest that the articular surface mechanical properties could be found by using in vivo measurements, which clarifies the valuable tool for future subject-specific studies related to TF joint scaffolds, allografts and biologics. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 1390-1400, 2017.
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Affiliation(s)
- Kyoung-Tak Kang
- Department of Mechanical Engineering, Yonsei University, Seoul, 03722, Republic of Korea
| | - Sung-Hwan Kim
- Department of Orthopedic Surgery, Gangnam Severance Hospital, Arthroscopy and Joint Research Institute, Yonsei University College of Medicine, Seoul, 06273, Republic of Korea
| | - Juhyun Son
- Department of Mechanical Engineering, Yonsei University, Seoul, 03722, Republic of Korea
| | - Young Han Lee
- Department of Radiology, Research Institute of Radiological Science, Medical Convergence Research Institue, and Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Shinil Kim
- Department of Orthopedic Surgery, Jeju National University Hospital, Jeju, 63241, Republic of Korea
| | - Heoung-Jae Chun
- Department of Mechanical Engineering, Yonsei University, Seoul, 03722, Republic of Korea
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23
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Arner JW, Irvine JN, Zheng L, Gale T, Thorhauer E, Hankins M, Abebe E, Tashman S, Zhang X, Harner CD. The Effects of Anterior Cruciate Ligament Deficiency on the Meniscus and Articular Cartilage: A Novel Dynamic In Vitro Pilot Study. Orthop J Sports Med 2016; 4:2325967116639895. [PMID: 27104208 PMCID: PMC4826955 DOI: 10.1177/2325967116639895] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background: Anterior cruciate ligament (ACL) injury increases the risk of meniscus and articular cartilage damage, but the causes are not well understood. Previous in vitro studies were static, required extensive knee dissection, and likely altered meniscal and cartilage contact due to the insertion of pressure sensing devices. Hypothesis: ACL deficiency will lead to increased translation of the lateral meniscus and increased deformation of the medial meniscus as well as alter cartilage contact location, strain, and area. Study Design: Descriptive laboratory study. Methods: With minimally invasive techniques, six 1.0-mm tantalum beads were implanted into the medial and lateral menisci of 6 fresh-frozen cadaveric knees. Dynamic stereo x-rays (DSXs) were obtained during dynamic knee flexion (from 15° to 60°, simulating a standing squat) with a 46-kg load in intact and ACL-deficient states. Knee kinematics, meniscal movement and deformation, and cartilage contact were compared by novel imaging coregistration. Results: During dynamic knee flexion from 15° to 60°, the tibia translated 2.6 mm (P = .05) more anteriorly, with 2.3° more internal rotation (P = .04) with ACL deficiency. The medial and lateral menisci, respectively, translated posteriorly an additional 0.7 mm (P = .05) and 1.0 mm (P = .03). Medial and lateral compartment cartilage contact location moved posteriorly (2.0 mm [P = .05] and 2.0 mm [P = .04], respectively). Conclusion: The lateral meniscus showed greater translation with ACL deficiency compared with the medial meniscus, which may explain the greater incidences of acute lateral meniscus tears and chronic medial meniscus tears. Furthermore, cartilage contact location moved further posteriorly than that of the meniscus in both compartments, possibly imparting more meniscal stresses that may lead to early degeneration. This new, minimally invasive, dynamic in vitro model allows the study of meniscus function and cartilage contact and can be applied to evaluate different pathologies and surgical techniques. Clinical Relevance: This novel model illustrates that ACL injury may lead to significant meniscus and cartilage abnormalities acutely, and these parameters are dynamically measurable while maintaining native anatomy.
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Affiliation(s)
- Justin W Arner
- Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - James N Irvine
- Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Liying Zheng
- Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Tom Gale
- Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Eric Thorhauer
- Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Margaret Hankins
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Ermias Abebe
- Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Scott Tashman
- Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Xudong Zhang
- Department of Mechanical Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Christopher D Harner
- Department of Orthopaedic Surgery, University of Texas at Houston, Houston, Texas, USA
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