Simulation-based medicine and the development of complex computer models of biological structures is becoming ubiquitous for advancing biomedical engineering and clinical research. Finite element analysis (FEA) has been widely used in the last few decades to understand and predict biomechanical phenomena. Modeling and simulation approaches in biomechanics are highly interdisciplinary, involving novice and skilled developers in all areas of biomedical engineering and biology. While recent advances in model development and simulation platforms offer a wide range of tools to investigators, the decision making process during modeling and simulation has become more opaque. Hence, reliability of such models used for medical decision making and for driving multiscale analysis comes into question. Establishing guidelines for model development and dissemination is a daunting task, particularly with the complex and convoluted models used in FEA. Nonetheless, if better reporting can be established, researchers will have a better understanding of a model’s value and the potential for reusability through sharing will be bolstered. Thus, the goal of this document is to identify resources and considerate reporting parameters for FEA studies in biomechanics. These entail various levels of reporting parameters for model identification, model structure, simulation structure, verification, validation, and availability. While we recognize that it may not be possible to provide and detail all of the reporting considerations presented, it is possible to establish a level of confidence with selective use of these parameters. More detailed reporting, however, can establish an explicit outline of the decision-making process in simulation-based analysis for enhanced reproducibility, reusability, and sharing.

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Combining musculoskeletal simulations with anatomical joint models capable of predicting cartilage contact mechanics would provide a valuable tool for studying the relationships between muscle force and cartilage loading. As a step towards producing multibody musculoskeletal models that include representation of cartilage tissue mechanics, this research developed a subject-specific multibody knee model that represented the tibia plateau cartilage as discrete rigid bodies that interacted with the femur through deformable contacts. Parameters for the compliant contact law were derived using three methods: (1) simplified Hertzian contact theory, (2) simplified elastic foundation contact theory and (3) parameter optimisation from a finite element (FE) solution. The contact parameters and contact friction were evaluated during a simulated walk in a virtual dynamic knee simulator, and the resulting kinematics were compared with measured in vitro kinematics. The effects on predicted contact pressures and cartilage-bone interface shear forces during the simulated walk were also evaluated. The compliant contact stiffness parameters had a statistically significant effect on predicted contact pressures as well as all tibio-femoral motions except flexion-extension. The contact friction was not statistically significant to contact pressures, but was statistically significant to medial-lateral translation and all rotations except flexion-extension. The magnitude of kinematic differences between model formulations was relatively small, but contact pressure predictions were sensitive to model formulation. The developed multibody knee model was computationally efficient and had a computation time 283 times faster than a FE simulation using the same geometries and boundary conditions.

Detailed knowledge of knee kinematics and dynamic loading is essential for improving the design and outcomes of surgical procedures, tissue engineering applications, prosthetics design, and rehabilitation. This study used publicly available data provided by the "Grand Challenge Competition to Predict in-vivo Knee Loads" for the 2013 American Society of Mechanical Engineers Summer Bioengineering Conference (Fregly et al., 2012, "Grand Challenge Competition to Predict in vivo Knee Loads," J. Orthop. Res., 30, pp. 503-513) to develop a full body, musculoskeletal model with subject specific right leg geometries that can concurrently predict muscle forces, ligament forces, and knee and ground contact forces. The model includes representation of foot/floor interactions and predicted tibiofemoral joint loads were compared to measured tibial loads for two different cycles of treadmill gait. The model used anthropometric data (height and weight) to scale the joint center locations and mass properties of a generic model and then used subject bone geometries to more accurately position the hip and ankle. The musculoskeletal model included 44 muscles on the right leg, and subject specific geometries were used to create a 12 degrees-of-freedom anatomical right knee that included both patellofemoral and tibiofemoral articulations. Tibiofemoral motion was constrained by deformable contacts defined between the tibial insert and femoral component geometries and by ligaments. Patellofemoral motion was constrained by contact between the patellar button and femoral component geometries and the patellar tendon. Shoe geometries were added to the feet, and shoe motion was constrained by contact between three shoe segments per foot and the treadmill surface. Six-axis springs constrained motion between the feet and shoe segments. Experimental motion capture data provided input to an inverse kinematics stage, and the final forward dynamics simulations tracked joint angle errors for the left leg and upper body and tracked muscle length errors for the right leg. The one cycle RMS errors between the predicted and measured tibia contact were 178 N and 168 N for the medial and lateral sides for the first gait cycle and 209 N and 228 N for the medial and lateral sides for the faster second gait cycle. One cycle RMS errors between predicted and measured ground reaction forces were 12 N, 13 N, and 65 N in the anterior-posterior, medial-lateral, and vertical directions for the first gait cycle and 43 N, 15 N, and 96 N in the anterior-posterior, medial-lateral, and vertical directions for the second gait cycle.

This study presents a subject-specific method of determining the zero-load lengths of the cruciate and collateral ligaments in computational knee modeling. Three cadaver knees were tested in a dynamic knee simulator. The cadaver knees also underwent manual envelope of motion testing to find their passive range of motion in order to determine the zero-load lengths for each ligament bundle. Computational multibody knee models were created for each knee and model kinematics were compared to experimental kinematics for a simulated walk cycle. One-dimensional non-linear spring damper elements were used to represent cruciate and collateral ligament bundles in the knee models. This study found that knee kinematics were highly sensitive to altering of the zero-load length. The results also suggest optimal methods for defining each of the ligament bundle zero-load lengths, regardless of the subject. These results verify the importance of the zero-load length when modeling the knee joint and verify that manual envelope of motion measurements can be used to determine the passive range of motion of the knee joint. It is also believed that the method described here for determining zero-load length can be used for in vitro or in vivo subject-specific computational models.