1
|
Killen BA, Van Rossom S, Burg F, Vander Sloten J, Jonkers I. In-silico techniques to inform and improve the personalized prescription of shoe insoles. Front Bioeng Biotechnol 2024; 12:1351403. [PMID: 38464541 PMCID: PMC10920237 DOI: 10.3389/fbioe.2024.1351403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 02/08/2024] [Indexed: 03/12/2024] Open
Abstract
Background: Corrective shoe insoles are prescribed for a range of foot deformities and are typically designed based on a subjective assessment limiting personalization and potentially leading to sub optimal treatment outcomes. The incorporation of in silico techniques in the design and customization of insoles may improve personalized correction and hence insole efficiency. Methods: We developed an in silico workflow for insole design and customization using a combination of measured motion capture, inverse musculoskeletal modelling as well as forward simulation approaches to predict the kinematic response to specific insole designs. The developed workflow was tested on twenty-seven participants containing a combination of healthy participants (7) and patients with flatfoot deformity (20). Results: Average error between measured and simulated kinematics were 4.7 ± 3.1, 4.5 ± 3.1, 2.3 ± 2.3, and 2.3 ± 2.7° for the chopart obliquity, chopart anterior-posterior axis, tarsometatarsal first ray, and tarsometatarsal fifth ray joints respectively. Discussion: The developed workflow offers distinct advantages to previous modeling workflows such as speed of use, use of more accessible data, use of only open-source software, and is highly automated. It provides a solid basis for future work on improving predictive accuracy by adapting the currently implemented insole model and incorporating additional data such as plantar pressure.
Collapse
Affiliation(s)
- Bryce A. Killen
- Human Movement Biomechanics Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | | | - Fien Burg
- Materialise Motion, Materialise, Leuven, Belgium
| | - Jos Vander Sloten
- Biomechanics Section, Department of Mechanical Engineering, Faculty of Engineering Sciences, KU Leuven, Heverlee (Leuven), Belgium
| | - Ilse Jonkers
- Human Movement Biomechanics Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
| |
Collapse
|
2
|
Konrath JM, Killen BA, Saxby DJ, Pizzolato C, Kennedy BA, Vertullo CJ, Barrett RS, Lloyd DG. Hamstring harvest results in significantly reduced knee muscular protection during side-step cutting two years after anterior cruciate ligament reconstruction. PLoS One 2023; 18:e0292867. [PMID: 37824493 PMCID: PMC10569629 DOI: 10.1371/journal.pone.0292867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 10/02/2023] [Indexed: 10/14/2023] Open
Abstract
The purpose of this study was to determine the effect of donor muscle morphology following tendon harvest in anterior cruciate ligament (ACL) reconstruction on muscular support of the tibiofemoral joint during sidestep cutting. Magnetic resonance imaging (MRI) was used to measure peak cross-sectional area (CSA) and volume of the semitendinosus (ST) and gracilis (GR) muscles and tendons (bilaterally) in 18 individuals following ACL reconstruction. Participants performed sidestep cutting tasks in a biomechanics laboratory during which lower-limb electromyography, ground reaction loads, whole-body motions were recorded. An EMG driven neuro-musculoskeletal model was subsequently used to determine force from 34 musculotendinous units of the lower limb and the contribution of the ST and GR to muscular support of the tibiofemoral joint based on a normal muscle-tendon model (Standard model). Then, differences in peak CSA and volume between the ipsilateral/contralateral ST and GR were used to adjust their muscle-tendon parameters in the model followed by a recalibration to determine muscle force for 34 musculotendinous units (Adjusted model). The combined contribution of the donor muscles to muscular support about the medial and lateral compartments were reduced by 52% and 42%, respectively, in the adjusted compared to standard model. While the semimembranosus (SM) increased its contribution to muscular stabilisation about the medial and lateral compartment by 23% and 30%, respectively. This computer simulation study demonstrated the muscles harvested for ACL reconstruction reduced their support of the tibiofemoral joint during sidestep cutting, while the SM may have the potential to partially offset these reductions. This suggests donor muscle impairment could be a factor that contributes to ipsilateral re-injury rates to the ACL following return to sport.
Collapse
Affiliation(s)
- Jason M. Konrath
- School of Allied Health Sciences and Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
- Principia Technology, Crawley, Western Australia, Australia
| | - Bryce A. Killen
- School of Allied Health Sciences and Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - David J. Saxby
- School of Allied Health Sciences and Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Claudio Pizzolato
- School of Allied Health Sciences and Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | | | - Christopher J. Vertullo
- School of Allied Health Sciences and Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
- Knee Research Australia, Gold Coast, Queensland, Australia
| | - Rod S. Barrett
- School of Allied Health Sciences and Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - David G. Lloyd
- School of Allied Health Sciences and Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| |
Collapse
|
3
|
Fallon Verbruggen F, Killen BA, Burssens A, Boey H, Vander Sloten J, Jonkers I. Unique shape variations of hind and midfoot bones in flatfoot subjects-A statistical shape modeling approach. Clin Anat 2023; 36:848-857. [PMID: 36373980 DOI: 10.1002/ca.23969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 10/06/2022] [Accepted: 10/17/2022] [Indexed: 11/16/2022]
Abstract
Flatfoot deformity is a prevalent hind- and midfoot disorder. Given its complexity, single-plane radiological measurements omit case-specific joint interaction and bone shape variations. Three-dimensional medical imaging assessment using statistical shape models provides a complete approach in characterizing bone shape variations unique to flatfoot condition. This study used statistical shape models to define specific bone shape variations of the subtalar, talonavicular, and calcaneocuboid joints that characterize flatfoot deformity, that differentiate them from healthy controls. Bones of the aforementioned joints were segmented from computed tomography scans of 40 feet. The three-dimensional hindfoot alignment angle categorized the population into 18 flatfoot subjects (≥7° valgus) and 22 controls. Statistical shape models for each joint were defined using the entire study cohort. For each joint, an average weighted shape parameter was calculated for each mode of variation, and then compared between flatfoot and controls. Significance was set at p < 0.05, with values between 0.05 ≤ p < 0.1 considered trending towards significance. The flatfoot population showed a more adducted talar head, inferiorly inclined talar neck, and posteriorly orientated medial subtalar articulation compare to controls, coupled with more navicular eversion, shallower navicular cup, and more prominent navicular tuberosity. The calcaneocuboid joint presented trends of a more adducted calcaneus, more abducted cuboid, narrower calcaneal roof, and less prominent cuboid beak compared to controls. Statistical shape model analysis identified unique shape variations which may enhance understanding and computer-aided models of the intricacies of flatfoot, leading to better diagnosis and, ultimately, surgical treatment.
Collapse
Affiliation(s)
- Ferdia Fallon Verbruggen
- Human Movement Biomechanics Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | - Bryce A Killen
- Human Movement Biomechanics Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | - Arne Burssens
- Department of Orthopaedics, UZ Ghent, Ghent, Belgium
| | - Hannelore Boey
- Human Movement Biomechanics Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | - Jos Vander Sloten
- Biomechanics Section, Department of Mechanical Engineering, KU Leuven, Leuven, Belgium
| | - Ilse Jonkers
- Human Movement Biomechanics Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
| |
Collapse
|
4
|
Mohout I, Elahi SA, Esrafilian A, Killen BA, Korhonen RK, Verschueren S, Jonkers I. Signatures of disease progression in knee osteoarthritis: insights from an integrated multi-scale modeling approach, a proof of concept. Front Bioeng Biotechnol 2023; 11:1214693. [PMID: 37576991 PMCID: PMC10413555 DOI: 10.3389/fbioe.2023.1214693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 07/13/2023] [Indexed: 08/15/2023] Open
Abstract
Introduction: Knee osteoarthritis (KOA) is characterized by articular cartilage degeneration. It has been widely accepted that the mechanical joint environment plays a significant role in the onset and progression of this disease. In silico models have been used to study the interplay between mechanical loading and cartilage degeneration, hereby relying mainly on two key mechanoregulatory factors indicative of collagen degradation and proteoglycans depletion. These factors are the strain in collagen fibril direction (SFD) and maximum shear strain (MSS) respectively. Methods: In this study, a multi-scale in silico modeling approach was used based on a synergy between musculoskeletal and finite element modeling to evaluate the SFD and MSS. These strains were evaluated during gait based on subject-specific gait analysis data collected at baseline (before a 2-year follow-up) for a healthy and progressive early-stage KOA subject with similar demographics. Results: The results show that both SFD and MSS factors allowed distinguishing between a healthy subject and a KOA subject, showing progression at 2 years follow-up, at the instance of peak contact force as well as during the stance phase of the gait cycle. At the peak of the stance phase, the SFD were found to be more elevated in the KOA patient with the median being 0.82% higher in the lateral and 0.4% higher in the medial compartment of the tibial cartilage compared to the healthy subject. Similarly, for the MSS, the median strains were found to be 3.6% higher in the lateral and 0.7% higher in the medial tibial compartment of the KOA patient compared to the healthy subject. Based on these intersubject SFD and MSS differences, we were additionally able to identify that the tibial compartment of the KOA subject at risk of progression. Conclusion/discussion: We confirmed the mechanoregulatory factors as potential biomarkers to discriminate patients at risk of disease progression. Future studies should evaluate the sensitivity of the mechanoregulatory factors calculated based on this multi-scale modeling workflow in larger patient and control cohorts.
Collapse
Affiliation(s)
- Ikram Mohout
- Department of Movement Science, Human Movement Biomechanics Research Group, Leuven, Belgium
| | - Seyed Ali Elahi
- Department of Movement Science, Human Movement Biomechanics Research Group, Leuven, Belgium
- Mechanical Engineering Department, Soft Tissue Biomechanics Group, Leuven, Belgium
| | - Amir Esrafilian
- Department of Technical Physics, Biophysics of Bone and Cartilage Research Group, University of Eastern Finland, Kuopio, Finland
| | - Bryce A. Killen
- Department of Movement Science, Human Movement Biomechanics Research Group, Leuven, Belgium
| | - Rami K. Korhonen
- Department of Technical Physics, Biophysics of Bone and Cartilage Research Group, University of Eastern Finland, Kuopio, Finland
| | - Sabine Verschueren
- Department of Rehabilitation Science, Research Group for Musculoskeletal Rehabilitation, Leuven, Belgium
| | - Ilse Jonkers
- Department of Movement Science, Human Movement Biomechanics Research Group, Leuven, Belgium
| |
Collapse
|
5
|
Davico G, Lloyd DG, Carty CP, Killen BA, Devaprakash D, Pizzolato C. Multi-level personalization of neuromusculoskeletal models to estimate physiologically plausible knee joint contact forces in children. Biomech Model Mechanobiol 2022; 21:1873-1886. [PMID: 36229699 DOI: 10.1007/s10237-022-01626-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 08/05/2022] [Indexed: 11/02/2022]
Abstract
Neuromusculoskeletal models are a powerful tool to investigate the internal biomechanics of an individual. However, commonly used neuromusculoskeletal models are generated via linear scaling of generic templates derived from elderly adult anatomies and poorly represent a child, let alone children with a neuromuscular disorder whose musculoskeletal structures and muscle activation patterns are profoundly altered. Model personalization can capture abnormalities and appropriately describe the underlying (altered) biomechanics of an individual. In this work, we explored the effect of six different levels of neuromusculoskeletal model personalization on estimates of muscle forces and knee joint contact forces to tease out the importance of model personalization for normal and abnormal musculoskeletal structures and muscle activation patterns. For six children, with and without cerebral palsy, generic scaled models were developed and progressively personalized by (1) tuning and calibrating musculotendon units' parameters, (2) implementing an electromyogram-assisted approach to synthesize muscle activations, and (3) replacing generic anatomies with image-based bony geometries, and physiologically and physically plausible muscle kinematics. Biomechanical simulations of gait were performed in the OpenSim and CEINMS software on ten overground walking trials per participant. A mixed-ANOVA test, with Bonferroni corrections, was conducted to compare all models' estimates. The model with the highest level of personalization produced the most physiologically plausible estimates. Model personalization is crucial to produce physiologically plausible estimates of internal biomechanical quantities. In particular, personalization of musculoskeletal anatomy and muscle activation patterns had the largest effect overall. Increased research efforts are needed to ease the creation of personalized neuromusculoskeletal models.
Collapse
Affiliation(s)
- Giorgio Davico
- Department of Industrial Engineering, Alma Mater Studiorum - University of Bologna, Bologna, Italy. .,Medical Technology Lab, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy. .,School of Allied Health Sciences and Social Work, Griffith University, Gold Coast, Australia.
| | - David G Lloyd
- School of Allied Health Sciences and Social Work, Griffith University, Gold Coast, Australia.,Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
| | - Christopher P Carty
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.,Department of Orthopaedics, Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, Brisbane, Australia
| | - Bryce A Killen
- School of Allied Health Sciences and Social Work, Griffith University, Gold Coast, Australia.,Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | - Daniel Devaprakash
- School of Allied Health Sciences and Social Work, Griffith University, Gold Coast, Australia.,Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
| | - Claudio Pizzolato
- School of Allied Health Sciences and Social Work, Griffith University, Gold Coast, Australia.,Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
| |
Collapse
|
6
|
Wang X, Bennell KL, Wang Y, Fortin K, Saxby DJ, Killen BA, Wrigley TV, Cicuttini FM, Van Ginckel A, Lloyd DG, Feller JA, Vertullo CJ, Whitehead T, Gallie P, Bryant AL. Patellar cartilage increase following ACL reconstruction with and without meniscal pathology: a two-year prospective MRI morphological study. BMC Musculoskelet Disord 2021; 22:909. [PMID: 34711188 PMCID: PMC8555213 DOI: 10.1186/s12891-021-04794-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 10/15/2021] [Indexed: 11/10/2022] Open
Abstract
Background Anterior cruciate ligament reconstruction (ACLR) together with concomitant meniscal injury are risk factors for the development of tibiofemoral (TF) osteoarthritis (OA), but the potential effect on the patellofemoral (PF) joint is unclear. The aim of this study was to: (i) investigate change in patellar cartilage morphology in individuals 2.5 to 4.5 years after ACLR with or without concomitant meniscal pathology and in healthy controls, and (ii) examine the association between baseline patellar cartilage defects and patellar cartilage volume change. Methods Thirty two isolated ACLR participants, 25 ACLR participants with combined meniscal pathology and nine healthy controls underwent knee magnetic resonance imaging (MRI) with 2-year intervals (baseline = 2.5 years post-ACLR). Patellar cartilage volume and cartilage defects were assessed from MRI using validated methods. Results Both ACLR groups showed patellar cartilage volume increased over 2 years (p < 0.05), and isolated ACLR group had greater annual percentage cartilage volume increase compared with controls (mean difference 3.6, 95% confidence interval (CI) 1.0, 6.3%, p = 0.008) and combined ACLR group (mean difference 2.2, 95% CI 0.2, 4.2%, p = 0.028). Patellar cartilage defects regressed in the isolated ACLR group over 2 years (p = 0.02; Z = − 2.33; r = 0.3). Baseline patellar cartilage defect score was positively associated with annual percentage cartilage volume increase (Regression coefficient B = 0.014; 95% CI 0.001, 0.027; p = 0.03) in the pooled ACLR participants. Conclusions Hypertrophic response was evident in the patellar cartilage of ACLR participants with and without meniscal pathology. Surprisingly, the increase in patellar cartilage volume was more pronounced in those with isolated ACLR. Although cartilage defects stabilised in the majority of ACLR participants, the severity of patellar cartilage defects at baseline influenced the magnitude of the cartilage hypertrophic response over the subsequent ~ 2 years. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-021-04794-5.
Collapse
Affiliation(s)
- Xinyang Wang
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne, 161 Barry Street, Carlton, Victoria, 3010, Australia
| | - Kim L Bennell
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne, 161 Barry Street, Carlton, Victoria, 3010, Australia
| | - Yuanyuan Wang
- School of Public Health & Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Karine Fortin
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne, 161 Barry Street, Carlton, Victoria, 3010, Australia.,Faculty of Arts, Monash University, Melbourne, Victoria, Australia
| | - David J Saxby
- School of Allied Health Sciences, Griffith University, Gold Coast, Australia.,Griffith University Centre for Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Gold Coast, Australia
| | - Bryce A Killen
- Human Movement Biomechanics Research Group, KU Leuven, Leuven, Belgium
| | - Tim V Wrigley
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne, 161 Barry Street, Carlton, Victoria, 3010, Australia
| | - Flavia M Cicuttini
- School of Public Health & Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Ans Van Ginckel
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - David G Lloyd
- School of Allied Health Sciences, Griffith University, Gold Coast, Australia.,Griffith University Centre for Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Gold Coast, Australia
| | - Julian A Feller
- OrthoSport Victoria, Melbourne, Australia.,College of Science, Health and Engineering, La Trobe University, Melbourne, Australia
| | - Christopher J Vertullo
- Griffith University Centre for Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Gold Coast, Australia.,Knee Research Australia, Gold Coast, Australia
| | | | | | - Adam L Bryant
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne, 161 Barry Street, Carlton, Victoria, 3010, Australia.
| |
Collapse
|
7
|
Veerkamp K, Kainz H, Killen BA, Jónasdóttir H, van der Krogt MM. Torsion Tool: An automated tool for personalising femoral and tibial geometries in OpenSim musculoskeletal models. J Biomech 2021; 125:110589. [PMID: 34218040 DOI: 10.1016/j.jbiomech.2021.110589] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 06/11/2021] [Accepted: 06/20/2021] [Indexed: 11/18/2022]
Abstract
Common practice in musculoskeletal modelling is to use scaled musculoskeletal models based on a healthy adult, but this does not consider subject-specific geometry, such as tibial torsion and femoral neck-shaft and anteversion angles (NSA and AVA). The aims of this study were to (1) develop an automated tool for creating OpenSim models with subject-specific tibial torsion and femoral NSA and AVA, (2) evaluate the femoral component, and (3) release the tool open-source. The Torsion Tool (https://simtk.org/projects/torsiontool) is a MATLAB-based tool that requires an individual's tibial torsion, NSA and AVA estimates as input and rotates corresponding bones and associated muscle points of a generic musculoskeletal model. Performance of the Torsion Tool was evaluated comparing femur bones as personalised with the Torsion Tool and scaled generic femurs with manually segmented bones as golden standard for six typically developing children and thirteen children with cerebral palsy. The tool generated femur geometries closer to the segmentations, with lower maximum (-19%) and root mean square (-18%) errors and higher Jaccard indices (+9%) compared to generic femurs. Furthermore, the tool resulted in larger improvements for participants with higher NSA and AVA deviations. The Torsion Tool allows an automatic, fast, and user-friendly way of personalising femoral and tibial geometry in an OpenSim musculoskeletal model. Personalisation is expected to be particularly relevant in pathological populations, as will be further investigated by evaluating the effects on simulation outcomes.
Collapse
Affiliation(s)
- Kirsten Veerkamp
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Rehabilitation Medicine, Amsterdam Movement Sciences, de Boelelaan 1117, Amsterdam, the Netherlands; School of Allied Health Sciences, Griffith University, Gold Coast, Australia; Griffith Centre for Biomedical & Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, and Advanced Design and Prototyping Technologies Institute (ADAPT), Griffith University Gold Coast, Australia.
| | - Hans Kainz
- Centre for Sport Science and University Sports, Department of Biomechanics, Kinesiology and Computer Science in Sport, University of Vienna, Vienna, Austria
| | - Bryce A Killen
- Human Movement Biomechanics Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | - Hulda Jónasdóttir
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Rehabilitation Medicine, Amsterdam Movement Sciences, de Boelelaan 1117, Amsterdam, the Netherlands; Department of Biomechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering (3mE), Delft University of Technology, Delft, the Netherlands
| | - Marjolein M van der Krogt
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Rehabilitation Medicine, Amsterdam Movement Sciences, de Boelelaan 1117, Amsterdam, the Netherlands
| |
Collapse
|
8
|
Grant TM, Diamond LE, Pizzolato C, Killen BA, Devaprakash D, Kelly L, Maharaj JN, Saxby DJ. Development and validation of statistical shape models of the primary functional bone segments of the foot. PeerJ 2020; 8:e8397. [PMID: 32117607 PMCID: PMC7006516 DOI: 10.7717/peerj.8397] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 12/16/2019] [Indexed: 12/15/2022] Open
Abstract
Introduction Musculoskeletal models are important tools for studying movement patterns, tissue loading, and neuromechanics. Personalising bone anatomy within models improves analysis accuracy. Few studies have focused on personalising foot bone anatomy, potentially incorrectly estimating the foot’s contribution to locomotion. Statistical shape models have been created for a subset of foot-ankle bones, but have not been validated. This study aimed to develop and validate statistical shape models of the functional segments in the foot: first metatarsal, midfoot (second-to-fifth metatarsals, cuneiforms, cuboid, and navicular), calcaneus, and talus; then, to assess reconstruction accuracy of these shape models using sparse anatomical data. Methods Magnetic resonance images of 24 individuals feet (age = 28 ± 6 years, 52% female, height = 1.73 ± 0.8 m, mass = 66.6 ± 13.8 kg) were manually segmented to generate three-dimensional point clouds. Point clouds were registered and analysed using principal component analysis. For each bone segment, a statistical shape model and principal components were created, describing population shape variation. Statistical shape models were validated by assessing reconstruction accuracy in a leave-one-out cross validation. Statistical shape models were created by excluding a participant’s bone segment and used to reconstruct that same excluded bone using full segmentations and sparse anatomical data (i.e. three discrete points on each segment), for all combinations in the dataset. Tali were not reconstructed using sparse anatomical data due to a lack of externally accessible landmarks. Reconstruction accuracy was assessed using Jaccard index, root mean square error (mm), and Hausdorff distance (mm). Results Reconstructions generated using full segmentations had mean Jaccard indices between 0.77 ± 0.04 and 0.89 ± 0.02, mean root mean square errors between 0.88 ± 0.19 and 1.17 ± 0.18 mm, and mean Hausdorff distances between 2.99 ± 0.98 mm and 6.63 ± 3.68 mm. Reconstructions generated using sparse anatomical data had mean Jaccard indices between 0.67 ± 0.06 and 0.83 ± 0.05, mean root mean square error between 1.21 ± 0.54 mm and 1.66 ± 0.41 mm, and mean Hausdorff distances between 3.21 ± 0.94 mm and 7.19 ± 3.54 mm. Jaccard index was higher (P < 0.01) and root mean square error was lower (P < 0.01) in reconstructions from full segmentations compared to sparse anatomical data. Hausdorff distance was lower (P < 0.01) for midfoot and calcaneus reconstructions using full segmentations compared to sparse anatomical data. Conclusion For the first time, statistical shape models of the primary functional segments of the foot were developed and validated. Foot segments can be reconstructed with minimal error using full segmentations and sparse anatomical landmarks. In future, larger training datasets could increase statistical shape model robustness, extending use to paediatric or pathological populations.
Collapse
Affiliation(s)
- Tamara M Grant
- School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia.,Griffith Centre for Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Laura E Diamond
- School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia.,Griffith Centre for Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Claudio Pizzolato
- School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia.,Griffith Centre for Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Bryce A Killen
- Human Movement Biomechanics Research Group, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Daniel Devaprakash
- School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia.,Griffith Centre for Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Luke Kelly
- School of Human Movement and Nutritional Sciences, University of Queensland, Brisbane, QLD, Australia
| | - Jayishni N Maharaj
- School of Human Movement and Nutritional Sciences, University of Queensland, Brisbane, QLD, Australia
| | - David J Saxby
- School of Allied Health Sciences, Griffith University, Gold Coast, QLD, Australia.,Griffith Centre for Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| |
Collapse
|
9
|
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] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Accepted: 10/25/2019] [Indexed: 11/28/2022]
|
10
|
Bahl JS, Zhang J, Killen BA, Taylor M, Solomon LB, Arnold JB, Lloyd DG, Besier TF, Thewlis D. Statistical shape modelling versus linear scaling: Effects on predictions of hip joint centre location and muscle moment arms in people with hip osteoarthritis. J Biomech 2019; 85:164-172. [DOI: 10.1016/j.jbiomech.2019.01.031] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 12/12/2018] [Accepted: 01/16/2019] [Indexed: 11/29/2022]
|
11
|
Suwarganda EK, Diamond LE, Lloyd DG, Besier TF, Zhang J, Killen BA, Savage TN, Saxby DJ. Minimal medical imaging can accurately reconstruct geometric bone models for musculoskeletal models. PLoS One 2019; 14:e0205628. [PMID: 30742643 PMCID: PMC6370181 DOI: 10.1371/journal.pone.0205628] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 01/18/2019] [Indexed: 12/12/2022] Open
Abstract
Accurate representation of subject-specific bone anatomy in lower-limb musculoskeletal models is important for human movement analyses and simulations. Mathematical methods can reconstruct geometric bone models using incomplete imaging of bone by morphing bone model templates, but the validity of these methods has not been fully explored. The purpose of this study was to determine the minimal imaging requirements for accurate reconstruction of geometric bone models. Complete geometric pelvis and femur models of 14 healthy adults were reconstructed from magnetic resonance imaging through segmentation. From each complete bone segmentation, three sets of incomplete segmentations (set 1 being the most incomplete) were created to test the effect of imaging incompleteness on reconstruction accuracy. Geometric bone models were reconstructed from complete sets, three incomplete sets, and two motion capture-based methods. Reconstructions from (in)complete sets were generated using statistical shape modelling, followed by host-mesh and local-mesh fitting through the Musculoskeletal Atlas Project Client. Reconstructions from motion capture-based methods used positional data from skin surface markers placed atop anatomic landmarks and estimated joint centre locations as target points for statistical shape modelling and linear scaling. Accuracy was evaluated with distance error (mm) and overlapping volume similarity (%) between complete bone segmentation and reconstructed bone models, and statistically compared using a repeated measure analysis of variance (p<0.05). Motion capture-based methods produced significantly higher distance error than reconstructions from (in)complete sets. Pelvis volume similarity reduced significantly with the level of incompleteness: complete set (92.70±1.92%), set 3 (85.41±1.99%), set 2 (81.22±3.03%), set 1 (62.30±6.17%), motion capture-based statistical shape modelling (41.18±9.54%), and motion capture-based linear scaling (26.80±7.19%). A similar trend was observed for femur volume similarity. Results indicate that imaging two relevant bone regions produces overlapping volume similarity >80% compared to complete segmented bone models, and improve analyses and simulation over current standard practice of linear scaling musculoskeletal models.
Collapse
Affiliation(s)
- Edin K. Suwarganda
- School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia
- Gold Coast Orthopaedic Research, Engineering and Education Alliance, Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
- * E-mail: (EKS); (DJS)
| | - Laura E. Diamond
- School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia
- Gold Coast Orthopaedic Research, Engineering and Education Alliance, Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - David G. Lloyd
- School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia
- Gold Coast Orthopaedic Research, Engineering and Education Alliance, Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Thor F. Besier
- Auckland Bioengineering Institute and Department of Engineering Science, University of Auckland, Auckland, Auckland, New Zealand
| | - Ju Zhang
- Auckland Bioengineering Institute and Department of Engineering Science, University of Auckland, Auckland, Auckland, New Zealand
| | - Bryce A. Killen
- School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia
- Gold Coast Orthopaedic Research, Engineering and Education Alliance, Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Trevor N. Savage
- School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia
- Gold Coast Orthopaedic Research, Engineering and Education Alliance, Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
- Department of Rheumatology, Kolling Institute of Medical Research, Institute of Bone and Joint Research, University of Sydney, Sydney, New South Wales, Australia
| | - David J. Saxby
- School of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia
- Gold Coast Orthopaedic Research, Engineering and Education Alliance, Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
- * E-mail: (EKS); (DJS)
| |
Collapse
|
12
|
Konrath JM, Saxby DJ, Killen BA, Pizzolato C, Vertullo CJ, Barrett RS, Lloyd DG. Muscle contributions to medial tibiofemoral compartment contact loading following ACL reconstruction using semitendinosus and gracilis tendon grafts. PLoS One 2017; 12:e0176016. [PMID: 28423061 PMCID: PMC5397063 DOI: 10.1371/journal.pone.0176016] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 04/04/2017] [Indexed: 01/28/2023] Open
Abstract
Background The muscle-tendon properties of the semitendinosus (ST) and gracilis (GR) are substantially altered following tendon harvest for the purpose of anterior cruciate ligament reconstruction (ACLR). This study adopted a musculoskeletal modelling approach to determine how the changes to the ST and GR muscle-tendon properties alter their contribution to medial compartment contact loading within the tibiofemoral joint in post ACLR patients, and the extent to which other muscles compensate under the same external loading conditions during walking, running and sidestep cutting. Materials and methods Motion capture and electromyography (EMG) data from 16 lower extremity muscles were acquired during walking, running and cutting in 25 participants that had undergone an ACLR using a quadruple (ST+GR) hamstring auto-graft. An EMG-driven musculoskeletal model was used to estimate the medial compartment contact loads during the stance phase of each gait task. An adjusted model was then created by altering muscle-tendon properties for the ST and GR to reflect their reported changes following ACLR. Parameters for the other muscles in the model were calibrated to match the experimental joint moments. Results The medial compartment contact loads for the standard and adjusted models were similar. The combined contributions of ST and GR to medial compartment contact load in the adjusted model were reduced by 26%, 17% and 17% during walking, running and cutting, respectively. These deficits were balanced by increases in the contribution made by the semimembranosus muscle of 33% and 22% during running and cutting, respectively. Conclusion Alterations to the ST and GR muscle-tendon properties in ACLR patients resulted in reduced contribution to medial compartment contact loads during gait tasks, for which the semimembranosus muscle can compensate.
Collapse
Affiliation(s)
- Jason M. Konrath
- School of Allied Health Sciences and Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
- * E-mail:
| | - David J. Saxby
- School of Allied Health Sciences and Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Bryce A. Killen
- School of Allied Health Sciences and Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Claudio Pizzolato
- School of Allied Health Sciences and Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Christopher J. Vertullo
- School of Allied Health Sciences and Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
- Knee Research Australia, Gold Coast, Queensland, Australia
| | - Rod S. Barrett
- School of Allied Health Sciences and Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - David G. Lloyd
- School of Allied Health Sciences and Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| |
Collapse
|