Musculoskeletal Model Development of the Elbow Joint with an Experimental Evaluation

Abstract

A dynamic musculoskeletal model of the elbow joint in which muscle, ligament, and articular surface contact forces are predicted concurrently would be an ideal tool for patient-specific preoperative planning, computer-aided surgery, and rehabilitation. Existing musculoskeletal elbow joint models have limited clinical applicability because of idealizing the elbow as a mechanical hinge joint or ignoring important soft tissue (e.g., cartilage) contributions. The purpose of this study was to develop a subject-specific anatomically correct musculoskeletal elbow joint model and evaluate it based on experimental kinematics and muscle electromyography measurements. The model included three-dimensional bone geometries, a joint constrained by multiple ligament bundles, deformable contacts, and the natural oblique wrapping of ligaments. The musculoskeletal model predicted the bone kinematics reasonably accurately in three different velocity conditions. The model predicted timing and number of muscle excitations, and the normalized muscle forces were also in agreement with the experiment. The model was able to predict important in vivo parameters that are not possible to measure experimentally, such as muscle and ligament forces, and cartilage contact pressure. In addition, the developed musculoskeletal model was computationally efficient for body-level dynamic simulation. The maximum computation time was less than 30 min for our 35 s simulation. As a predictive clinical tool, the potential medical applications for this model and modeling approach are significant.

Establishing the Role of Elbow Muscles by Evaluating Muscle Activation and Co-contraction Levels at Maximal External Rotation in Fastball Pitching

“…Elbow flexor and extensor muscles, together with the joint articulation, could also indirectly affect the mechanical resistance of the external valgus torque at the elbow during pitching (Van Trigt et al, 2021 ). In-vitro cadaver studies and forward dynamic model studies showed that the biceps and triceps are important in stabilizing the elbow joint (Morrey et al, 1991 ; Seiber et al, 2009 ; Rahman et al, 2018 ). Our results show co-contraction of elbow flexors and extensors at the instant of MER during fastball pitching.…”

“…Several in-vitro studies showed that simulated loading of the biceps and triceps brachii significantly decreased the ulnohumeral joint space and thus resist the external valgus torque (Morrey et al, 1991 ; Seiber et al, 2009 ). In addition, a forward dynamic musculoskeletal model showed that simulated activation of the triceps brachii and biceps brachii increased joint contact force (Rahman et al, 2018 ). We therefore assume that co-contraction of flexor and extensor elbow muscles could indirectly counteract the external valgus torque indicating an indirect effect.…”

Automatic modelling of human musculoskeletal ligaments – Framework overview and model quality evaluation

“…A common approach here is to employ single or multiple line segments connecting bones (see e.g. for the knee [9,10], forearm [11], or elbow [12]). In these models, the line segments are considered as linear springs; this is straightforward, but has several limitations, such as the inability to describe complex geometry or to predict nonuniform stresses and strains.…”

Automatic Modelling of Human Musculoskeletal Ligaments -- Framework Overview and Model Quality Evaluation

“…A common approach here is to employ single or multiple line segments connecting bones (see e.g. for the knee [9,10], forearm [11], or elbow [12]). In these models, the line segments are considered as linear springs; this is straightforward, but has several limitations, such as the inability to describe complex geometry or to predict nonuniform stresses and strains.…”