In vivo kinematical validated knee model for preclinical testing of total knee replacement

BACKGROUND AND OBJECTIVE A computational knee model facilitates efficient component design evaluations and preclinical testing under various dynamic loadings. However, the development of a highly mimicked dynamic whole knee model with specified ligament constraints that provides high predictive accuracy with in-vivo experiments remains a challenge. METHODS In the present study, a musculoskeletal integrated force-driven explicit finite-element knee model with tibiofemoral and patellofemoral joints constrained with detailed soft tissue was developed. A proportional-integral-derivative controller was concurrently added to the knee model to track the boundary conditions. The actuations of the quadriceps and hamstrings were predicted via a subject-specific musculoskeletal model and matched with electromyography results. RESULTS Compared to in-vivo fluoroscopic results in a gait cycle, the predicted results of the kinematics of the tibiofemoral joint exhibited an agreement in terms of tendency and magnitude (anterior-posterior translation: RMSE = 1.1 mm, r2 = 0.87; inferior-superior translation: RMSE = 0.83 mm, r2 = 0.84; medial-lateral translation: RMSE = 0.82 mm, r2 = 0.05; flexion-extension rotation: RMSE = 0.23°, r2 = 1; internal-external rotation: RMSE = 1.85°, r2 = 0.65; varus-valgus rotation: RMSE = 1.39°, r2 = 0.08). Contact mechanics, including the contact area, pressure, and stress, were synchronously simulated on the tibiofemoral and patellofemoral joints. CONCLUSIONS The study provides a calibrated knee model and a kinematical validation approach that can be widely used in preclinical testing and knee prosthesis design.

[1]  Joon Ho Wang,et al.  Relative role changing of lateral collateral ligament on the posterolateral rotatory instability according to the knee flexion angles: a biomechanical comparative study of role of lateral collateral ligament and popliteofibular ligament , 2012, Archives of Orthopaedic and Trauma Surgery.

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

[3]  Naohiko Sugita,et al.  Systematic review of computational modelling for biomechanics analysis of total knee replacement , 2020, Biosurface and Biotribology.

[4]  L. Nolte,et al.  Mechanical Tensile Properties of the Quadriceps Tendon and Patellar Ligament in Young Adults , 1999, The American journal of sports medicine.

[5]  Xijin Hua,et al.  Development of a finite element musculoskeletal model with the ability to predict contractions of three-dimensional muscles. , 2019, Journal of biomechanics.

[6]  Benjamin J Fregly,et al.  Experimental evaluation of an elastic foundation model to predict contact pressures in knee replacements. , 2003, Journal of biomechanics.

[7]  Nico Verdonschot,et al.  The influence of ligament modelling strategies on the predictive capability of finite element models of the human knee joint. , 2017, Journal of biomechanics.

[8]  F. Flandry,et al.  Normal Anatomy and Biomechanics of the Knee , 2011, Sports medicine and arthroscopy review.

[9]  Clare K Fitzpatrick,et al.  The role of patient, surgical, and implant design variation in total knee replacement performance. , 2012, Journal of biomechanics.

[10]  Clare K Fitzpatrick,et al.  Dynamic finite element knee simulation for evaluation of knee replacement mechanics. , 2012, Journal of biomechanics.

[11]  Clare K Fitzpatrick,et al.  Comparison of patellar bone strain in the natural and implanted knee during simulated deep flexion , 2011, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[12]  S. McLean,et al.  Development and validation of a 3-D model to predict knee joint loading during dynamic movement. , 2003, Journal of biomechanical engineering.

[13]  LP 2Maletsky,et al.  Evaluating Knee Replacement Mechanics during ADL with PID-Controlled Dynamic Finite Element Analysis , 2011 .

[14]  Richard J. Beckman,et al.  A Comparison of Three Methods for Selecting Values of Input Variables in the Analysis of Output From a Computer Code , 2000, Technometrics.

[15]  M Beaugonin,et al.  Simulation of a knee joint replacement during a gait cycle using explicit finite element analysis. , 2002, Journal of biomechanics.

[16]  Sandipan Roy,et al.  Finite-Element analysis of a lateral femoro-tibial impact on the total knee arthroplasty , 2020, Comput. Methods Programs Biomed..

[17]  Sean D Smith,et al.  Characterization of robotic system passive path repeatability during specimen removal and reinstallation for in vitro knee joint testing. , 2014, Medical engineering & physics.

[18]  Shota Hashimoto,et al.  Enhanced In-Silico Polyethylene Wear Simulation of Total Knee Replacements During Daily Activities , 2020, Annals of Biomedical Engineering.

[19]  Claudio Belvedere,et al.  Wear simulation of total knee prostheses using load and kinematics waveforms from stair climbing. , 2015, Journal of biomechanics.

[20]  T. Goswami,et al.  Knee implants – Review of models and biomechanics , 2009 .

[21]  J. Hughston The importance of the posterior oblique ligament in repairs of acute tears of the medial ligaments in knees with and without an associated rupture of the anterior cruciate ligament. Results of long-term follow-up. , 1994, The Journal of bone and joint surgery. American volume.

[22]  Marcus G Pandy,et al.  Grand challenge competition to predict in vivo knee loads , 2012, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[23]  Jason P. Halloran,et al.  Verification of predicted knee replacement kinematics during simulated gait in the Kansas knee simulator. , 2010, Journal of biomechanical engineering.

[24]  Paul J. Rullkoetter,et al.  Development of subject-specific and statistical shape models of the knee using an efficient segmentation and mesh-morphing approach , 2010, Comput. Methods Programs Biomed..

[25]  Zhan Liu,et al.  Biomechanical responses of temporomandibular joints during the lateral protrusions: A 3D finite element study , 2020, Comput. Methods Programs Biomed..

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

[27]  Clare K Fitzpatrick,et al.  The influence of total knee arthroplasty geometry on mid-flexion stability: an experimental and finite element study. , 2013, Journal of biomechanics.

[28]  Yukihide Iwamoto,et al.  Lateral Soft Tissue Laxity Increases but Medial Laxity Does Not Contract With Varus Deformity in Total Knee Arthroplasty , 2013, Clinical orthopaedics and related research.

[29]  D. D’Lima,et al.  In vivo contact kinematics and contact forces of the knee after total knee arthroplasty during dynamic weight-bearing activities. , 2008, Journal of biomechanics.

[30]  Nico Verdonschot,et al.  A three-dimensional finite-element model of gluteus medius muscle incorporating inverse-dynamics-based optimization for simulation of non-uniform muscle contraction. , 2021, Medical engineering & physics.

[31]  C. Luring,et al.  Two-year follow-up on joint stability and muscular function comparing rotating versus fixed bearing TKR , 2006, Knee Surgery, Sports Traumatology, Arthroscopy.

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

[33]  M. Ritter,et al.  The effect of alignment and BMI on failure of total knee replacement. , 2011, The Journal of bone and joint surgery. American volume.

[34]  Clare K Fitzpatrick,et al.  Validation of a new computational 6-DOF knee simulator during dynamic activities. , 2016, Journal of biomechanics.

[35]  Clare K Fitzpatrick,et al.  Developing simulations to reproduce in vivo fluoroscopy kinematics in total knee replacement patients. , 2014, Journal of biomechanics.

[36]  Madalina Fiterau,et al.  Machine learning in human movement biomechanics: Best practices, common pitfalls, and new opportunities. , 2018, Journal of biomechanics.

[37]  Benjamin J. Ellis,et al.  Continuum description of the Poisson's ratio of ligament and tendon under finite deformation. , 2014, Journal of biomechanics.

[38]  E Y Chao,et al.  Hamstrings cocontraction reduces internal rotation, anterior translation, and anterior cruciate ligament load in weight‐bearing flexion , 1999, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[39]  Naohiko Sugita,et al.  Symmetrical cruciate-retaining versus medial pivot prostheses: The effect of intercondylar sagittal conformity on knee kinematics and contact mechanics , 2019, Comput. Biol. Medicine.

[40]  R. Strachan,et al.  The popliteofibular ligament. An anatomical study of the posterolateral corner of the knee. , 1999, The Journal of bone and joint surgery. British volume.

[41]  E S Grood,et al.  A joint coordinate system for the clinical description of three-dimensional motions: application to the knee. , 1983, Journal of biomechanical engineering.

[42]  L Blankevoort,et al.  Recruitment of knee joint ligaments. , 1991, Journal of biomechanical engineering.

[43]  Johan Bellemans,et al.  Anatomy of the anterolateral ligament of the knee , 2013, Journal of anatomy.

[44]  L. Blankevoort,et al.  Hamstrings and iliotibial band forces affect knee kinematics and contact pattern , 2000, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[45]  Lars Engebretsen,et al.  Force Measurements on the Posterior Oblique Ligament and Superficial Medial Collateral Ligament Proximal and Distal Divisions to Applied Loads , 2009, The American journal of sports medicine.

[46]  R. LaPrade,et al.  Force Measurements on the Fibular Collateral Ligament, Popliteofibular Ligament, and popliteus Tendon to Applied Loads , 2004, The American journal of sports medicine.

[47]  Francesco Migliavacca,et al.  Contact stresses and fatigue life in a knee prosthesis: comparison between in vitro measurements and computational simulations. , 2004, Journal of biomechanics.

[48]  Mamoru Mitsuishi,et al.  A subject-specific finite element musculoskeletal framework for mechanics analysis of a total knee replacement. , 2018, Journal of biomechanics.

[49]  F.E. Zajac,et al.  An interactive graphics-based model of the lower extremity to study orthopaedic surgical procedures , 1990, IEEE Transactions on Biomedical Engineering.

[50]  A. V. von Keudell,et al.  Patient satisfaction after primary total and unicompartmental knee arthroplasty: an age-dependent analysis. , 2014, The Knee.

[51]  M Solomonow,et al.  Muscular co-contraction and control of knee stability. , 1991, Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology.

[52]  Lowell M Smoger,et al.  Computational framework for population-based evaluation of TKR-implanted patellofemoral joint mechanics , 2020, Biomechanics and Modeling in Mechanobiology.

[53]  Jason P. Halloran,et al.  Comparison of deformable and elastic foundation finite element simulations for predicting knee replacement mechanics. , 2005, Journal of biomechanical engineering.

[54]  Ali Tavakoli Golpaygani,et al.  Biomechanical role of posterior cruciate ligament in total knee arthroplasty: A finite element analysis , 2020, Comput. Methods Programs Biomed..