Identification of locations susceptible to osteoarthritis in patients with anterior cruciate ligament reconstruction: Combining knee joint computational modelling with follow-up T1ρ and T2 imaging

Abstract

Background: Finite element modelling can be used to evaluate altered loading conditions and failure locations in knee joint tissues. One limitation of this modelling approach has been experimental comparison. The aims of this proof-of-concept study were: 1) identify areas susceptible to osteoarthritis progression in anterior cruciate ligament reconstructed patients using finite element modelling; 2) compare the identified areas against changes in T 2 and T 1ρ values between 1-year and 3-year follow-up timepoints. Methods: Two patient-specific finite element models of knee joints with anterior cruciate ligament reconstruction were created. The knee geometry was based on clinical magnetic resonance imaging and joint loading was obtained via motion capture. We evaluated biomechanical parameters linked with cartilage degeneration and compared the identified risk areas against T 2 and T 1ρ maps. Findings: The risk areas identified by the finite element models matched the follow-up magnetic resonance imaging findings. For Patient 1, excessive values of maximum principal stresses and shear strains were observed in the posterior side of the lateral tibial and femoral cartilage. For Patient 2, high values of maximum principal stresses and shear strains of cartilage were observed in the posterior side of the medial joint compartment. For both patients, increased T 2 and T 1ρ values between the follow-up times were observed in the same areas. Interpretation: Finite element models with patient-specific geometries and motions and relatively simple material models of tissues were able to identify areas susceptible to post-traumatic knee osteoarthritis. We suggest that the methodology presented here may be applied in large cohort studies.

Evaluation of articular cartilage with quantitative MRI in an equine model of post‐traumatic osteoarthritis

“…3 Thus, early detection of articular cartilage damage can constitute an advantage in the prevention and treatment of the respective joint disease. 4 In addition to direct visualization of articular cartilage, quantitative magnetic resonance imaging (qMRI) provides numerical outcome measures that can be used to nondestructively evaluate early PTOA changes in the tissue. 5,6 MRI relaxation time mapping sequences such as T 1 , T 2 , continuous-wave T 1ρ (CWT 1ρ ), adiabatic T 1ρ (AdT 1ρ ), adiabatic T 2ρ (AdT 2ρ ), and relaxation along a fictitious field (T RAFF ) have been proposed as quantitative biomarkers for the assessment of articular cartilage.…”

An EMG-assisted Muscle-Force Driven Finite Element Analysis Pipeline to Investigate Joint- and Tissue-Level Mechanical Responses in Functional Activities: Towards a Rapid Assessment Toolbox

“…The EMG-assisted MS model enables the inclusion of subject-specific muscle activation patterns that may alter in subjects with MS disorders [24–27, 76, 77]. In addition, the FE model utilized a highly-detailed FRPVE soft tissue material model that has shown potentials if tissue-level mechanical responses, such as collagen fibril and nonfibrillar matrix strain, related to mechanically-induced cartilage adaptation and regeneration, are of interest [6, 37–41, 43, 46–48]. To assess and validate the developed pipeline, we investigated the knee joint loading and tissue mechanical responses during different daily activities of the individuals with KOA.…”

“…Summarizing, FE models utilizing subjectspecific joint geometries and complex FRPVE material models have shown great potential for estimating highly-detailed tissue mechanics and predicting cartilage damage and degeneration [6,39,43,[46][47][48]. However, creating the above-mentioned FRPVE FE models is a cumbersome manual task requiring several weeks of high-level expertise [48]. This process entails image segmentation, meshing, material model incorporation, estimation and application of loading and boundary conditions, and getting a converged solution.…”

Expediting Finite Element Analyses for Subject-Specific Studies of Knee Osteoarthritis: A Literature Review

“…For instance, by using a biphasic transversely isotropic description, different authors were able to reproduce experimental cartilage stress-relaxation tests [92][93][94]. Bolcos et al [95] used a biphasic transversely isotropic model [60] to identify zones of knee cartilage susceptible to post-traumatic osteoarthritis. This demonstrated that constitutive models with this complexity level could simulate realistic responses of the tissue.…”