Subject-specific biomechanical analysis to estimate locations susceptible to osteoarthritis:​ finite element modeling and MRI follow-up of ACL reconstructed patients

Bolcos, Paul O.; Mononen, Mika E.; Roach, Koren E.; Tanaka, Matthew S.; Suomalainen, Juha-Sampo; Mikkonen, Santtu; Nissi, Mikko J.; Töyräs, Juha; Link, Thomas M.; Souza, Richard B.; Majumdar, Sharmila; Ma, C. Benjamin; Li, Xiaojuan; Korhonen, Rami K.

Affiliations

¹Department of Applied Physics, University of Eastern Finland, Kuopio, Finland

²Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA

³Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland

⁴Research Unit of Medical Imaging, Physics, and Technology, University of Oulu, Oulu, Finland

⁵School of Information Technology and Electrical Engineering, The University of Queensland, Brisbane, Queensland, Australia

⁶Science Service Center, Kuopio University Hospital, Kuopio, Finland

⁷Department of Physical Therapy and Rehabilitation Science, University of California San Francisco, San Francisco, California, USA

⁸Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, California, USA

⁹Department of Biomedical Engineering, Cleveland Clinic, Cleveland, Ohio, USA

Abstract and keywords

The aims of this case-control study were to: (1) Identify cartilage locations and volumes at risk of osteoarthritis (OA) using subject-specific finite element (FE) models; (2) Quantify the relationships between the simulated biomechanical parameters and T₂ and T_1ρ relaxation times of magnetic resonance imaging (MRI). We created subject-specific FE models for seven patients with anterior cruciate ligament (ACL) reconstruction and six controls based on a previous proof-of-concept study. We identified locations and cartilage volumes susceptible to OA, based on maximum principal stresses and absolute maximum shear strains in cartilage exceeding thresholds of 7 MPa and 32%, respectively. The locations and volumes susceptible to OA were compared qualitatively and quantitatively against 2-year longitudinal changes in T₂ and T_1ρ relaxation times. The degeneration volumes predicted by the FE models, based on excessive maximum principal stresses, were significantly correlated (r = 0.711, p < 0.001) with the degeneration volumes determined from T₂ relaxation times. There was also a significant correlation between the predicted stress values and changes in T₂ relaxation time (r = 0.649, p < 0.001). Absolute maximum shear strains and changes in T_1ρ relaxation time were not significantly correlated. Five out of seven patients with ACL reconstruction showed excessive maximum principal stresses in either one or both tibial cartilage compartments, in agreement with follow-up information from MRI. Expectedly, for controls, the FE models and follow-up information showed no degenerative signs. Our results suggest that the presented modelling methodology could be applied to prospectively identify ACL reconstructed patients at risk of biomechanically driven OA, particularly by the analysis of maximum principal stresses of cartilage.

Keywords: biomechanics; cartilage; finite eelement analysis; gait; osteoarthritis—posttraumatic; reconstruction

Links

DOI: 10.1002/jor.25218

PubMed: 34820897

WoS: 000722074800001

History

Received: 2021-02-15

Revised: 2021-09-16

Accepted: 2021-11-09

Cited Works (2)

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