A lower extremity model for muscle-driven simulation of activity using explicit finite element modeling.

A key strength of computational modeling is that it can provide estimates of muscle, ligament, and joint loads, stresses, and strains through non-invasive means. However, simulations that can predict the forces in the muscles during activity while maintaining sufficient complexity to realistically represent the muscles and joint structures can be computationally challenging. For this reason, the current state of the art is to apply separate rigid-body dynamic and finite-element (FE) analyses in series. However, the use of two or more disconnected models often fails to capture key interactions between the joint-level and whole-body scales. Single framework MSFE models have the potential to overcome the limitations associated with disconnected models in series. The objectives of the current study were to create a multi-scale FE model of the human lower extremity that combines optimization, dynamic muscle modeling, and structural FE analysis in a single framework and to apply this framework to evaluate the mechanics of healthy knee specimens during two activities. Two subject-specific FE models (Model 1, Model 2) of the lower extremity were developed in ABAQUS/Explicit including detailed representations of the muscles. Muscle forces, knee joint loading, and articular contact were calculated for two activities using an inverse dynamics approach and static optimization. Quadriceps muscle forces peaked at the onset of chair rise (2174 N, 1962 N) and in early stance phase (510 N, 525 N), while gait saw peak forces in the hamstrings (851 N, 868 N) in midstance. Joint forces were similar in magnitude to available telemetric patient data. This study demonstrates the feasibility of detailed quasi-static, muscle-driven simulations in an FE framework.

[1]  Clare K Fitzpatrick,et al.  Computationally efficient finite element evaluation of natural patellofemoral mechanics. , 2010, Journal of biomechanical engineering.

[2]  Marcus G Pandy,et al.  Simultaneous prediction of muscle and contact forces in the knee during gait. , 2010, Journal of biomechanics.

[3]  D. Thelen,et al.  Co-simulation of neuromuscular dynamics and knee mechanics during human walking. , 2014, Journal of biomechanical engineering.

[4]  Kevin B. Shelburne,et al.  Dependence of Muscle Moment Arms on In Vivo Three-Dimensional Kinematics of the Knee , 2017, Annals of Biomedical Engineering.

[5]  Pascal Schütz,et al.  Subject‐specific modeling of muscle force and knee contact in total knee arthroplasty , 2016, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[6]  M. Nerlich,et al.  Impingement pressure and tension forces of the anterior cruciate ligament , 2003, Knee Surgery, Sports Traumatology, Arthroscopy.

[7]  Mohammad Kia,et al.  Concurrent prediction of muscle and tibiofemoral contact forces during treadmill gait. , 2014, Journal of Biomechanical Engineering.

[8]  Ayman Habib,et al.  OpenSim: Open-Source Software to Create and Analyze Dynamic Simulations of Movement , 2007, IEEE Transactions on Biomedical Engineering.

[9]  A Shirazi-Adl,et al.  Partitioning of knee joint internal forces in gait is dictated by the knee adduction angle and not by the knee adduction moment. , 2014, Journal of biomechanics.

[10]  Marcus G Pandy,et al.  A Dynamic Model of the Knee and Lower Limb for Simulating Rising Movements , 2002, Computer methods in biomechanics and biomedical engineering.

[11]  Michael F. Vignos,et al.  Influence of Ligament Properties on Tibiofemoral Mechanics in Walking , 2015, The Journal of Knee Surgery.

[12]  Lowell M Smoger,et al.  Statistical modeling to characterize relationships between knee anatomy and kinematics , 2015, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[13]  W. Buford,et al.  Muscle balance at the knee--moment arms for the normal knee and the ACL-minus knee. , 1997, IEEE transactions on rehabilitation engineering : a publication of the IEEE Engineering in Medicine and Biology Society.

[14]  M. Pandy,et al.  Muscle, ligament, and joint-contact forces at the knee during walking. , 2005, Medicine and science in sports and exercise.

[15]  Lorin P Maletsky,et al.  Verification of predicted specimen-specific natural and implanted patellofemoral kinematics during simulated deep knee bend. , 2009, Journal of biomechanics.

[16]  Clare K Fitzpatrick,et al.  Validation of predicted patellofemoral mechanics in a finite element model of the healthy and cruciate-deficient knee. , 2016, Journal of biomechanics.

[17]  Paul J. Rullkoetter,et al.  Prediction of In Vivo Knee Joint Loads Using a Global Probabilistic Analysis. , 2016, Journal of biomechanical engineering.

[18]  Darryl G. Thelen,et al.  Prediction and Validation of Load-Dependent Behavior of the Tibiofemoral and Patellofemoral Joints During Movement , 2015, Annals of Biomedical Engineering.

[19]  Scott L. Delp,et al.  Fibre operating lengths of human lower limb muscles during walking , 2011, Philosophical Transactions of the Royal Society B: Biological Sciences.

[20]  A Shirazi-Adl,et al.  Evaluation of knee joint muscle forces and tissue stresses‐strains during gait in severe OA versus normal subjects , 2014, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[21]  Clare K Fitzpatrick,et al.  A Combined Experimental and Computational Approach to Subject-Specific Analysis of Knee Joint Laxity. , 2016, Journal of biomechanical engineering.

[22]  J. D. Lunnen,et al.  Relationship between muscle length, muscle activity, and torque of the hamstring muscles. , 1981, Physical therapy.

[23]  M. Pandy,et al.  Individual muscle contributions to support in normal walking. , 2003, Gait & posture.

[24]  Ahmet Erdemir,et al.  Adaptive surrogate modeling for efficient coupling of musculoskeletal control and tissue deformation models. , 2009, Journal of biomechanical engineering.

[25]  Kevin B Shelburne,et al.  The interaction of muscle moment arm, knee laxity, and torque in a multi-scale musculoskeletal model of the lower limb. , 2018, Journal of biomechanics.

[26]  M G Pandy,et al.  Static and dynamic optimization solutions for gait are practically equivalent. , 2001, Journal of biomechanics.

[27]  Marko Ackermann,et al.  Concurrent musculoskeletal dynamics and finite element analysis predicts altered gait patterns to reduce foot tissue loading. , 2010, Journal of biomechanics.

[28]  Marcus G Pandy,et al.  Contributions of muscles, ligaments, and the ground‐reaction force to tibiofemoral joint loading during normal gait , 2006, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[29]  A Shirazi-Adl,et al.  Computational biodynamics of human knee joint in gait: from muscle forces to cartilage stresses. , 2012, Journal of biomechanics.

[30]  R. Crowninshield,et al.  A physiologically based criterion of muscle force prediction in locomotion. , 1981, Journal of biomechanics.

[31]  P J Hunter,et al.  An anatomically based patient-specific finite element model of patella articulation: towards a diagnostic tool , 2005, Biomechanics and modeling in mechanobiology.

[32]  M. Pandy,et al.  Dynamic optimization of human walking. , 2001, Journal of biomechanical engineering.

[33]  Silvia S Blemker,et al.  Rectus femoris knee muscle moment arms measured in vivo during dynamic motion with real-time magnetic resonance imaging. , 2013, Journal of biomechanical engineering.

[34]  Lorin P Maletsky,et al.  Combined measurement and modeling of specimen-specific knee mechanics for healthy and ACL-deficient conditions. , 2017, Journal of biomechanics.

[35]  Scott L Delp,et al.  Knee muscle forces during walking and running in patellofemoral pain patients and pain-free controls. , 2009, Journal of biomechanics.

[36]  Adam J Cyr,et al.  Assessment of Knee Kinematics in Older Adults Using High-Speed Stereo Radiography , 2017, Medicine and science in sports and exercise.

[37]  Marcus G Pandy,et al.  Contribution of tibiofemoral joint contact to net loads at the knee in gait , 2015, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[38]  Peter J. Laz,et al.  A Probabilistic Approach to Quantify the Impact of Uncertainty Propagation in Musculoskeletal Simulations , 2014, Annals of Biomedical Engineering.

[39]  Paul J. Rullkoetter,et al.  Finite element-based probabilistic analysis tool for orthopaedic applications , 2007, Comput. Methods Programs Biomed..

[40]  G. Bergmann,et al.  Standardized Loads Acting in Knee Implants , 2014, PloS one.