Subject-Specific Analysis of Joint Contact Mechanics: Application to the Study of Osteoarthritis and Surgical Planning

Abstract

Advances in computational mechanics, constitutive modeling, and techniques for subject-specific modeling have opened the door to patient-specific simulation of the relationships between joint mechanics and osteoarthritis (OA), as well as patient-specific preoperative planning. This article reviews the application of computational biomechanics to the simulation of joint contact mechanics as relevant to the study of OA. This review begins with background regarding OA and the mechanical causes of OA in the context of simulations of joint mechanics. The broad range of technical considerations in creating validated subject-specific whole joint models is discussed. The types of computational models available for the study of joint mechanics are reviewed. The types of constitutive models that are available for articular cartilage are reviewed, with special attention to choosing an appropriate constitutive model for the application at hand. Issues related to model generation are discussed, including acquisition of model geometry from volumetric image data and specific considerations for acquisition of computed tomography and magnetic resonance imaging data. Approaches to model validation are reviewed. The areas of parametric analysis, factorial design, and probabilistic analysis are reviewed in the context of simulations of joint contact mechanics. Following the review of technical considerations, the article details insights that have been obtained from computational models of joint mechanics for normal joints; patient populations; the study of specific aspects of joint mechanics relevant to OA, such as congruency and instability; and preoperative planning. Finally, future directions for research and application are summarized.

Finite Element Prediction of Transchondral Stress and Strain in the Human Hip

“…(4), (5), and (6). This method is slightly different from the method used in our previous study, where experimental data from each sample were fit individually and then material coefficients were averaged [57]. The method used in the present study resulted in better agreement in the compressive response of the EFD and Veronda Westmann constitutive models than the method in the previous study.…”

“…Results for transchondral mechanics in the femoral cartilage were compared using repeated t tests within activity and location. Patterns of E 1 and s max were evaluated within constitutive model using random effects linear regression, accounting for the nonindependence of data clustered within each specimen and loading scenario, with the resulting p values corrected for multiple comparisons via Finner's procedure [57,62]. Significance was set at p 0.05.…”

Multiscale cartilage biomechanics: technical challenges in realizing a high-throughput modelling and simulation workflow

“…Similar submodelling can be performed for the extracellular matrix, for example, to evaluate microstructural-level loading of collagen fibres, which may provide the relationship between macroscopic tissue damage accumulation and microscale fibre failure [31]. At all spatial scales, it is also possible to increase the fidelity of mechanical representation; in terms of physics (nonlinear elasticity, multiphasic response) [32], with additional anatomical components, and by using more advanced constitutive relationships [24,33]. Utilization of open source and freely accessible software, e.g.…”

“…A fundamental assumption is the required consistency of the tissue mechanical behaviour between the joint-tissue and tissue-cell scales. At the higher spatial scale, the cartilage may be represented by homogenized material properties [24]. This constitutive response should be equivalent to the average response of the tissue-cell scale model, which represents the cartilage in more detail, including the delineation of chondrocytes, pericellular matrix and the extracellular matrix.…”

“…At the spatial of scale of the musculoskeletal joint, simulations using a finite-element (FE) representation of the complete joint anatomy [24], e.g. the tibiofemoral joint, including its substructures such as the ligaments and meniscus, can provide the necessary information to define loading and boundary conditions of the aforementioned joint-tissue scale model.…”