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$$^{\circ }$$ ∘ 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.

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 OpenKnee 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 degrees 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.

The use of virtual reality (VR) techniques for industrial training provides a safe and cost effective solution that contributes to increased engagement and knowledge retention levels. However, the process of experiential learning in a virtual world without biophysical constraints might contribute to muscle strain and discomfort, if ergonomic risk factors are not considered in advance. Under this scope, we have developed a digital platform which employs extended reality (XR) technologies for the creation and delivery of industrial training programs, by taking into account the users and workplace specificities through the adaptation of the 3D virtual world to the real environment. Our conceptual framework is composed of several inter-related modules: 1) the XR tutorial creation module, for automatic recognition of the sequence of actions composing a complex scenario while this is demonstrated by the educator in VR, 2) the XR tutorial execution module, for the delivery of visually guided and personalized XR training experiences, 3) the digital human model (DHM) based simulation module for creation and demonstration of job task simulations avoiding the need of an actual user and 4) the biophysics assessment module for ergonomics analysis given the input received from the other modules. Three-dimensional reconstruction and aligned projection of the objects situated in the real scene facilitated the imposition of inherent physical constraints, thereby allowed to seamlessly blend the virtual with the real world without losing the sense of presence.

Virtual simulations of operating tasks provide knowledge on a variety of parameters, useful for preventive ergonomic analysis, that helps to improve safety, quality and promote human-centered design. This paper presents the development of a biophysics-based simulation tool that is used for the evaluation of virtual interactions in different synthetic 3D scenes. Evaluation is based on the simulation of the motion of a digital human skeletal model interacting with virtual 3D objects, followed by inverse dynamics simulation of multi-body systems. This tool can be used for the estimation of body joints loads and energy expenditure during tasks' operation in different environments, thereby allowing to detect potential risks in repetitive movement patterns and to adjust accordingly the object's arrangement. Comparative results of spatiotemporal energy distribution support the validity of the simulation framework.

The Anterior Cruciate Ligament (ACL) rupture is a very common knee injury during sport activities. Landing after jump is one of the most prominent human body movements that can lead to such an injury. The landing-related ACL injury risk factors have been in the spotlight of research interest. Over the years, researchers and clinicians acquire knowledge about human movement during daily-life activities by organizing complex in vivo studies that feature high complexity, costs and technical and most importantly physical challenges. In an attempt to overcome these limitations, this paper introduces a computational modeling and simulation pipeline that aims to predict and identify key parameters of interest that are related to ACL injury during single-leg landings. We examined the following conditions: a) landing height, b) hip internal and external rotation, c) lumbar forward and backward leaning, d) lumbar medial and lateral bending, e) muscle forces permutations and f) effort goal weight. Identified on related research studies, we evaluated the following risk factors: vertical Ground Reaction Force (vGRF), knee joint Anterior force (AF), Medial force (MF), Compressive force (CF), Abduction moment (AbdM), Internal rotation moment (IRM), quadricep and hamstring muscle forces and Quadriceps/Hamstrings force ratio (Q/H force ratio). Our study clearly demonstrated that ACL injury is a rather complicated mechanism with many associated risk factors which are evidently correlated. Nevertheless, the results were mostly in agreement with other research studies regarding the ACL risk factors. The presented pipeline showcased promising potential of predictive simulations to evaluate different aspects of complicated phenomena, such as the ACL injury.