Finite Element Modeling of Knee and Shoulder Ligaments

The medial collateral ligament (MCL) is the primary restraint to knee valgus rotation and a secondary restraint to anterior tibial translation. The anterior cruciate ligament (ACL) is a primary restraint to anterior tibial translation, but its contribution to valgus restraint was debated. To address this, a combined experimental and computational study was conducted to determine the effect of ACL injury on MCL insertion site and contact forces during valgus loading and anterior tibial loading. Six finite element (FE) models were constructed and used to simulate boundary and loading conditions from corresponding cadaveric experiments. It was shown that in the ACL-deficient knee, the MCL is indeed subjected to higher insertion site and contact forces in response to an anterior load. However, MCL forces due to a valgus torque were not significantly increased in the ACL-deficient knee. It follows that the MCL resists anterior tibial translation when the ACL is intact, but the ACL is not a restraint to valgus rotation when a healthy MCL is present.

Physical diagnostic exams are the most crucial step for diagnosis of the location of injury to the shoulder capsule, but the exams are relatively imprecise and the joint positions used for these exams are not standardized between physicians. Due to the complexity of the strains in the capsule during joint motion, a method to correlate joint positions and the capsule strains produced by these positions was needed. To address this discrepancy, a methodology for three-dimensional, subject-specific FE modeling of the inferior glenohumeral ligament (IGHL) as a continuous structure was developed. This FE model was then used to develop a method for evaluating the region of the glenohumeral capsule being tested by clinical exams for shoulder instability. Finally, for the clinical exam known as the simple translation test it was shown that regions of localized strain created by the exam indicate that the joint positions can be used to test the glenoid side of the IGHL, but are not useful for assessing the humeral side of the IGHL.

Year	Entry
2007	Anderson AE, Ellis BJ, Weiss JA. Verification, validation and sensitivity studies in computational biomechanics. Comput Methods Biomech Biomed Eng. June 2007;10(3):171-184.
1992	Bigliani LU, Pollock RG, Soslowsky LJ, Flatow EL, Pawluk RJ, Mow VC. Tensile properties of the inferior glenohumeral ligament. J Orthop Res. March 1992;10(2):187-197.
1983	Grood ES, Suntay WJ. A joint coordinate system for the clinical description of three-dimensional motions: application to the knee. J Biomech Eng. May 1983;105(2):136-144.
1987	Woo SL-Y, Hollis JM, Roux RD, Gomez MA, Inoue M, Kleiner JB, Akeson WH. Effects of knee flexion on the structural properties of the rabbit femur-anterior cruciate ligament-tibia complex (FATC). J Biomech. 1987;20(6):557-563.
1996	Ticker JB, Bigliani LU, Soslowsky LJ, Pawluk RJ, Flatow EL, Mow VC. Inferior glenohumeral ligament: geometric and strain-rate dependent properties. J Shoulder Elbow Surg. July–August 1996;5(4):269-279.
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Year

Entry

2007

Anderson AE, Ellis BJ, Weiss JA. Verification, validation and sensitivity studies in computational biomechanics. Comput Methods Biomech Biomed Eng. June 2007;10(3):171-184.

1992

Bigliani LU, Pollock RG, Soslowsky LJ, Flatow EL, Pawluk RJ, Mow VC. Tensile properties of the inferior glenohumeral ligament. J Orthop Res. March 1992;10(2):187-197.

1983

Grood ES, Suntay WJ. A joint coordinate system for the clinical description of three-dimensional motions: application to the knee. J Biomech Eng. May 1983;105(2):136-144.

1987

Woo SL-Y, Hollis JM, Roux RD, Gomez MA, Inoue M, Kleiner JB, Akeson WH. Effects of knee flexion on the structural properties of the rabbit femur-anterior cruciate ligament-tibia complex (FATC). J Biomech. 1987;20(6):557-563.

1996

Ticker JB, Bigliani LU, Soslowsky LJ, Pawluk RJ, Flatow EL, Mow VC. Inferior glenohumeral ligament: geometric and strain-rate dependent properties. J Shoulder Elbow Surg. July–August 1996;5(4):269-279.