“…Nevertheless, both the integral (Eq, (1)) and the differential (Eq, (21)) formulations may be generalized to multiaxial stress states [33], Tendon and ligament anisotropy is rarely considered in whole joint simulations. Recent whole joint FE investigations, such as those of the cervical spine [46,47], the lumbar spine [48,49], the knee [50,51], the sacroiliac joint [52], and the pelvic joint [53] typically model these connective tissues as one-dimensional elastic spring or truss elements in order to reduce computational cost. Three-dimensional, continuum-based material models have been put forth in an attempt to more accurately represent connective tissue anisotropic nonlinear viscoelasticity [54][55][56], However, these continuum formulations require very complicated experimental characterization techniques owing to the relatively large number of required material coefficients and implementation of these anisotropic derivations into whole joint FE model has, to date, been shown to be largely intractable.…”