Biomechanical influence of deficient posterolateral corner structures on knee joint kinematics: A computational study

Abstract

The posterolateral corner (PLC) structures including the popliteofibular ligament (PFL), popliteus tendon (PT) and lateral collateral ligament (LCL) are important soft tissues for posterior translational, external rotational, and varus angulation knee joint instabilities. The purpose of this study was to determine the effects of deficient PLC structures on the kinematics of the knee joint under gait and squat loading conditions. We developed subject-specific computational models with full 12-degree-of-freedom tibiofemoral and patellofemoral joints for four male subjects and one female subject. The subject-specific knee joint models were validated with computationally predicted muscle activation, electromyography data, and experimental data from previous study. According to our results, deficiency of the PFL did not significantly influence knee joint kinematics compared to an intact model under gait loading conditions. Compared with an intact model under gait and squat loading conditions, deficiency of the PT led to significant increases in external rotation and posterior translation, while LCL deficiency increased varus angulation. Deficiency of all PLC structures led to the greatest increases in external rotation, varus angulation, and posterior translation. These results suggest that the PT is an important structure for external rotation and posterior translation, while the LCL is important for varus angulation under dynamic loading conditions. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 9999:1-8, 2018.

Biomechanical effect of tibial slope on the stability of medial unicompartmental knee arthroplasty in posterior cruciate ligament-deficient knees

“…Thus, it was proved that PCL injury significantly influences posterior stability during high flexion in UKA. 44 Our results showed that an increased posterior tibial slope maintained posterior stability in PCL-deficient UKA. This implies that decreased posterior tibial slope maintains anterior stability in the ACL-deficient UKA.…”

“…Furthermore, the contact stress on the articular cartilage and the kinematics are consistent with the results reported in previous studies. 44 , 45 In addition, this study has two strengths compared to other studies. First, in contrast to those of previous UKA studies, the tibia, femur, and related soft tissues were included in the FE model.…”

Restoration of normal knee kinematics with respect to tibial insert design in mobile bearing lateral unicompartmental arthroplasty using computational simulation

“…The patient-specific lateral UKA insert was designed using a previously existing 3D knee joint model. 20 - 22 CT and MRI scans were initially performed. The image data were imported into Mimics version 14.1 (Materialise, Leuven, Belgium) for 3D reconstruction.…”

“…The previously mentioned 3D medical imaging data used for a patient-specific lateral mobile UKA development were used in the development of the finite element (FE) model ( Figure 2 ). 20 - 23 3D bone and soft tissue models were reconstructed from CT and MRI, as described in previous studies. 18 , 23 , 24 All the ligament bundles were modelled as non-linear springs, and the material properties were obtained from previous studies.…”

“… 31 , 32 A proportional-integral-derivative controller was incorporated into the computational model to control the quadriceps in a manner similar to that used in a previous experiment. 20 A control system was used to evaluate the instantaneous displacement of the quadriceps muscle, which was required to match the same target flexion profile as that in the experiment. IE and varus-valgus torques were applied to the tibia, while the remaining tibial degrees-of-freedom were constrained.…”