Influence of Ligament Properties on Tibiofemoral Mechanics in Walking

Abstract

Computational knee models provide a powerful platform to investigate the effects of injury and surgery on functional knee behavior. The objective of this study was to use a multibody knee model to investigate the influence of ligament properties on tibiofemoral kinematics and cartilage contact pressures in the stance phase of walking. The knee model included 14 ligament bundles and articular cartilage contact acting across the tibiofemoral and patellofemoral joints. The knee was incorporated into a lower extremity musculoskeletal model and used to simulate knee mechanics during the stance phase of normal walking. A Monte Carlo approach was employed to assess the influence ligament stiffness and reference strains on knee mechanics. The ACL, MCL and posterior capsule properties exhibited significant influence on anterior tibial translation at heel strike, with the ACL acting as the primary restraint to anterior translation in mid-stance. The MCL and LCL exhibited the greatest influence on tibial rotation from heel strike through mid-stance. Simulated tibial plateau contact location was dependent on the ACL, MCL and LCL properties, while pressure magnitudes were most dependent on the ACL. A decrease in ACL stiffness or reference strain significantly increased average contact pressure in mid-stance, with the pressure migrating posteriorly on the medial tibial plateau. These ligament-dependent shifts in tibiofemoral cartilage contact during walking are potentially relevant to consider when investigating the causes of early onset osteoarthritis following knee ligament injury and surgical treatment.

The Influence of Component Alignment and Ligament Properties on Tibiofemoral Contact Forces in Total Knee Replacement

“…The uncertainty analysis is important as there are currently no viable approaches for measuring ligament elasticity in vivo. As a result, ligament stiffness and reference strains must be estimated from cadaveric studies [23,[34][35][36][37], which contributes to uncertainty in the model. Our results show total knee contact loads varied by 60.2 BW (95% CIs) given our assumed uncertainty in ligament properties (Fig.…”

“…Ellipsoidal wrap objects were included for the sMCL, pmCAP, and LPFL bundles to prevent penetration of the ligament path into the bone and component geometries. A generic ligament force-strain relationship was used, which assumed the ligament force to be quadratic at low strains and linear at high strains [34,35]. For each ligament bundle, linear stiffness and reference strain parameters were defined to scale the generic force-strain curve ( Table 1).…”

American Society of Biomechanics Clinical Biomechanics Award 2015: MRI assessments of cartilage mechanics, morphology and composition following reconstruction of the anterior cruciate ligament

“…This would suggest that other surgical factors, such as graft placement (Abebe et al, 2011; Bedi et al, 2011) and pre-tensioning (Brady et al, 2007; Melby et al, 1991), may contribute to the altered knee mechanics. While greater subject numbers are needed to better test the effects of surgical factors, ultimately computational knee models are important to establish causal relationships between surgical factors and functional knee behavior (Lenhart et al, 2015; Pena et al, 2006; Salehghaffari and Dhaher, 2014; Smith et al, 2015)…”

Development and validation of a subject-specific moving-axis tibiofemoral joint model using MRI and EOS imaging during a quasi-static lunge

“…These simplified generic and subject-specific models allow for computational convenience; but do not capture the elasticity of the joint. At the other end of the spectrum exists computationally complex, 11-12 DOF multibody contact tibiofemoral models (Guess et al, 2014;Hast and Piazza, 2013;Marra et al, 2017Marra et al, , 2015Smith et al, 2016;Thelen et al, 2014) and finite element models (Adouni et al, 2012;Halonen et al, 2017;Kiapour et al, 2013;Mootanah et al, 2014).…”