Length of anterior cruciate ligament affects knee kinematics and kinetics using a musculoskeletal computer simulation model

Tanaka, Yoshihisa; Nakamura, Shinichiro; Kuriyama, Shinichi; Nishitani, Kohei; Watanabe, Mutsumi; Song, Young Dong; Ikebe, Satoru; Higaki, Hidehiko; Matsuda, Shinya

doi:10.1016/j.jor.2020.08.002

Cited by 3 publications

(20 citation statements)

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“…According to the quality assessment results presented in Table 2 , several articles had limited modelling technique descriptions [ 15 , 16 , 19 , 20 , 27 , 33 ] and validation methods [ 16 , 18 , 25 , 27 , 35 , 37 , 38 ]. In 12 of the selected studies [ 14 – 17 , 20 , 24 – 27 , 31 , 37 , 38 ], the sensitivity of the model outputs on ligament model parameters has not been assessed.…”

Section: Resultsmentioning

confidence: 99%

“…A range of musculoskeletal modelling software packages has been used across the selected studies ( Fig 2A and Table 3 ). 14 studies [ 15 – 17 , 20 – 25 , 27 , 29 , 32 , 34 , 35 ] used OpenSim [ 39 ], four studies [ 18 , 36 – 38 ] used SIMM [ 40 ], two studies [ 26 , 28 ] used AnyBody Modelling System (AnyBody Technology, Aalborg, Denmark), one study [ 30 ] used ADAMS [ 41 ], one study [ 14 ] used SimWise-4D platform (Design Simulation Technologies, DST, Canton, MI, USA), one study [ 19 ] used KneeSIM (LifeModeler Inc., San Clemente, CA), one study [ 33 ] used Musculoskeletal Joint Modeler [ 42 ], and one study [ 31 ] used Working Model 3D (Working Model 3D, MSC, Software Corp., Santa Ana, CA, USA).…”

Section: Resultsmentioning

confidence: 99%

“…Out of the 25 studies included, 20 studies were designed to simulate the intact knee joint [ 14 – 17 , 19 – 22 , 24 – 27 , 29 – 34 , 37 , 38 ], two studies modelled both intact and ACL-deficient knee [ 35 , 36 ], one study modelled the intact and PCL-deficient knees [ 28 ], one study modelled the ACL-reconstructed knee [ 18 ], and one study modelled the lateral extra-articular reconstructed knee [ 23 ] ( Fig 2B and Table 3 ). Nine studies modelled one leg [ 19 , 21 , 23 , 24 , 29 – 31 , 33 , 36 ], eight studies developed the whole-body models [ 15 , 16 , 20 , 22 , 26 – 28 , 34 ] and eight studies modelled the lower-body [ 14 , 17 , 18 , 25 , 32 , 35 , 37 , 38 ] ( Fig 2C and Table 3 ).…”

Section: Resultsmentioning

confidence: 99%

“…Intact knee geometries were extracted fully or partially from segmented medical imaging (CT or MRI) of cadaveric specimens [ 25 , 26 , 30 ], participants [ 14 , 21 , 23 , 24 , 29 , 31 , 36 ], patients [ 18 , 22 ], saw bone [ 33 ] or by scaling the generic reference models based on anthropometric data of study participants [ 15 – 17 , 20 , 21 , 27 , 28 , 32 , 34 , 35 , 37 ] ( Fig 2D and Table 3 ). In the rest of the studies, the geometry was taken from available data in the literature [ 19 , 38 ].…”

Section: Resultsmentioning

confidence: 99%

“…Models were used to simulate various active motions including walking [ 14 , 17 – 19 , 21 , 26 , 28 , 35 , 36 ], running [ 16 , 35 ], squatting [ 19 , 23 , 28 , 37 ], stepping [ 19 ], side cutting[ 22 ], stop jumping-height [ 34 ], single-leg landing [ 15 ], drop-landing [ 20 , 27 ], and passive motions including passive knee flexion [ 24 , 25 , 29 – 33 , 38 ], internal rotation [ 25 , 29 , 32 ], hyper-extension [ 31 ], adduction [ 25 , 29 , 31 , 32 ], passive squatting [ 31 ], drawer test [ 31 , 38 ], and free hung [ 31 ].…”

Section: Resultsmentioning

confidence: 99%

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The effect of modelling parameters in the development and validation of knee joint models on ligament mechanics: A systematic review

et al. 2022

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Background The ligaments in the knee are prone to injury especially during dynamic activities. The resulting instability can have a profound impact on a patient’s daily activities and functional capacity. Musculoskeletal knee modelling provides a non-invasive tool for investigating ligament force-strain behaviour in various dynamic scenarios, as well as potentially complementing existing pre-planning tools to optimise surgical reconstructions. However, despite the development and validation of many musculoskeletal knee models, the effect of modelling parameters on ligament mechanics has not yet been systematically reviewed. Objectives This systematic review aimed to investigate the results of the most recent studies using musculoskeletal modelling techniques to create models of the native knee joint, focusing on ligament mechanics and modelling parameters in various simulated movements. Data sources PubMed, ScienceDirect, Google Scholar, and IEEE Xplore. Eligibility criteria for selecting studies Databases were searched for articles containing any numerical ligament strain or force data on the intact, ACL-deficient, PCL-deficient, or lateral extra-articular reconstructed (LER) knee joints. The studies had to derive these results from musculoskeletal modelling methods. The dates of the publications were between 1 January 1995 and 30 November 2021. Method A customised data extraction form was created to extract each selected study’s critical musculoskeletal model development parameters. Specific parameters of the musculoskeletal knee model development used in each eligible study were independently extracted, including the (1) musculoskeletal model definition (i.e., software used for modelling, knee type, source of geometry, the inclusion of cartilage and menisci, and articulating joints and joint boundary conditions (i.e., number of degrees of freedom (DoF), subjects, type of activity, collected data and type of simulation)), (2) specifically ligaments modelling techniques (i.e., ligament bundles, attachment points, pathway, wrapping surfaces and ligament material properties such as stiffness and reference length), (3) sensitivity analysis, (4) validation approaches, (5) predicted ligament mechanics (i.e., force, length or strain) and (6) clinical applications if available. The eligible papers were then discussed quantitatively and qualitatively with respect to the above parameters. Results and discussion From the 1004 articles retrieved by the initial electronic search, only 25 met all inclusion criteria. The results obtained by aggregating data reported in the eligible studies indicate that considerable variability in the predicted ligament mechanics is caused by differences in geometry, boundary conditions and ligament modelling parameters. Conclusion This systematic review revealed that there is currently a lack of consensus on knee ligament mechanics. Despite this lack of consensus, some papers highlight the potential of developing translational tools using musculoskeletal modelling. Greater consistency in model design, incorporation of sensitivity assessment of the model outcomes and more rigorous validation methods should lead to better agreement in predictions for ligament mechanics between studies. The resulting confidence in the musculoskeletal model outputs may lead to the development of clinical tools that could be used for patient-specific treatments.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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The effect of modelling parameters in the development and validation of knee joint models on ligament mechanics: A systematic review

et al. 2022

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Biomechanical Comparison of Kinematic and Mechanical Knee Alignment Techniques in a Computer Simulation Medial Pivot Total Knee Arthroplasty Model

et al. 2021

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Several concepts may be used to restore normal knee kinematics after total knee arthroplasty. One is a kinematically aligned (KA) technique, which restores the native joint line and limb alignment, and the other is the use of a medial pivot knee (MPK) design, with a ball and socket joint in the medial compartment. This study aimed to compare motions, contact forces, and contact stress between mechanically aligned (MA) and KA (medial tilt 3° [KA3] and 5° [KA5]) models in MPK. An MPK design was virtually implanted with MA, KA3, and KA5 in a validated musculoskeletal computer model of a healthy knee, and the simulation of motion and contact forces was implemented. Anteroposterior (AP) positions, mediolateral positions, external rotation angles of the femoral component relative to the tibial insert, and tibiofemoral contact forces were evaluated at different knee flexion angles. Contact stresses on the tibial insert were calculated using finite element analysis. The AP position at the medial compartment was consistent for all models. From 0° to 120°, the femoral component in KA models showed larger posterior movement at the lateral compartment (0.3, 6.8, and 17.7 mm in MA, KA3, and KA5 models, respectively) and larger external rotation (4.2°, 12.0°, and 16.8° in the MA, KA3, and KA5 models, respectively) relative to the tibial component. Concerning the mediolateral position of the femoral component, the KA5 model was positioned more medially. The contact forces at the lateral compartment of all models were larger than those at the medial compartment at >60° of knee flexion. The peak contact stresses on the tibiofemoral joint at 90° and 120° of knee flexion were higher in the KA models. However, the peak contact stresses of the KA models at every flexion angle were <20 MPa. The KA technique in MPK can successfully achieve near-normal knee kinematics; however, there may be a concern for higher contact stresses on the tibial insert.

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Anteromedial Tibial Attachment in Single-Bundle Anterior Cruciate Ligament Reconstruction Can Represent Normal Kinematics in Computer Simulation

et al. 2022

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Tunnel position during anterior cruciate ligament (ACL) reconstruction is considered as an important factor to restore normal knee kinematics and to gain better clinical outcomes. It is still unknown where the optimal femoral and tibial tunnel position is located in single-bundle (SB) ACL reconstruction. The purposes of this study were to analyze the knee kinematics with various graft positions and to propose the optimal graft position during SB ACL reconstruction. A musculoskeletal computer simulation was used to analyze knee kinematics. Four attachments on the femoral side (anteromedial [AM], mid, posterolateral [PL], and over-the-top positions) and three attachments on the tibial side (AM, middle, and PL positions) were determined. The middle-bundle attachment was placed at the midpoint of the AM and PL bundle attachments for the femoral and tibial attachments. SB ACL reconstruction models were constructed to combine each of the four femoral attachments with each of three tibial attachments. Kinematic comparison was made among a double-bundle (DB) model and 12 SB reconstruction models during deep knee bend and stair descent activity. The tunnel position of the tibia had greater effect of knee kinematics than that of the femur. AM tibial attachment models showed similar medial and lateral anteroposterior positions to the DB model for both activities. Axial rotation in the AM tibial attachment models was similar to the DB model regardless of the femoral attachment, whereas greater maximum axial rotation was exhibited in the PL tibial attachment models, especially during stair descent activity. AM tibial attachment can represent normal knee kinematics, whereas the PL tibial attachment can induce residual rotational instability during high-demand activities. The AM tibial tunnel is recommended for SB ACL reconstruction.

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Length of anterior cruciate ligament affects knee kinematics and kinetics using a musculoskeletal computer simulation model

Cited by 3 publications

References 25 publications

The effect of modelling parameters in the development and validation of knee joint models on ligament mechanics: A systematic review

The effect of modelling parameters in the development and validation of knee joint models on ligament mechanics: A systematic review

Biomechanical Comparison of Kinematic and Mechanical Knee Alignment Techniques in a Computer Simulation Medial Pivot Total Knee Arthroplasty Model

Anteromedial Tibial Attachment in Single-Bundle Anterior Cruciate Ligament Reconstruction Can Represent Normal Kinematics in Computer Simulation

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