Development and Validation of a Tibiofemoral Joint Finite Element Model and Subsequent Gait Analysis of Intact ACL and ACL Deficient Individuals

Osteoarthritis (OA) is a degenerative condition of articular cartilage that affects more than 25 million people in the US. Joint injuries, like anterior cruciate ligament (ACL) tears, can lead to OA due to a change in articular cartilage loading. Gait analysis combined with knee joint finite element modeling (FEM) has been used to predict the articular cartilage loading. To predict the change of articular cartilage loading during gait due to various ACL injuries, a tibiofemoral FEM was developed from magnetic resonance images (MRIs) of a 33 year male, with no prior history of knee injuries. The FEM was validated for maximum contact pressure and anterior tibial translation using cadaver knee studies. The FEM was used to model gait of knees with an intact ACL, anteromedial (AM) bundle injury, posterolateral (PL) bundle injury, complete ACL injury, AM deficiency, PL deficiency, complete ACL rupture, as well as a bone-patellar tendon-bone (BPTB) graft. Generally, the predicted maximum contact pressure and contact area increased for all the ACL injuries when compared to intact ACLs. While an increase in maximum contact pressure and contact area is an indication of an increased risk of the development of OA, the percent of increase was typically small suggesting that walking is a safe activity for individuals with ACL injuries.

Keywords: Osteoarthritis; finite element; gait analysis; articular cartilage; anterior cruciate ligament; human knee-joint

Year	Entry
2001	Huang C-Y, Mow VC, Ateshian GA. The role of flow-independent viscoelasticity in the biphasic tensile and compressive responses of articular cartilage. J Biomech Eng. October 2001;123(5):410-417.
2008	Chaudhari AMW, Briant PL, Bevill SL, Koo S, Andriacchi TP. Knee kinematics, cartilage morphology, and osteoarthritis after ACL injury. Med Sci Sports Exer. February 2008;40(2):215-222.
1993	Kwan MK, Lin TH-C, Woo SL-Y. On the viscoelastic properties of the anteromedial bundle of the anterior cruciate ligament. J Biomech. April–May 1993;26(4-5):447-452.
1995	Bendjaballah MZ, Shirazi-Adl A, Zukor DJ. Biomechanics of the human knee joint in compression: reconstruction, mesh generation and finite element analysis. Knee. June 1995;2(2):69-79.
1994	Johnson GA, Tramaglini DM, Levine RE, Ohno K, Choi N-Y, Woo SL-Y. Tensile and viscoelastic properties of human patellar tendon. J Orthop Res. 1994;12(6):796-803.
2001	DiSilvestro MR, Zhu Q, Wong M, Jurvelin JS, Suh J-KF. Biphasic poroviscoelastic simulation of the unconfined compression of articular cartilage, I: simultaneous prediction of reaction force and lateral displacement. J Biomech Eng. April 2001;123(2):191-197.
2001	DiSilvestro MR, Zhu Q, Suh J-KF. Biphasic poroviscoelastic simulation of the unconfined compression of articular cartilage, II: effect of variable strain rates. J Biomech Eng. April 2001;123(2):198-200.
2007	Delp SL, Anderson FC, Arnold AS, Loan P, Habib A, John CT, Guendelman E, Thelen DG. OpenSim: open-source software to create and analyze dynamic simulations of movement. IEEE Trans Biomed Eng. November 2007;54(11):1940-1950.
2013	Wangerin S. Development and Validation of a Human Knee Joint Finite Element Model for Tissue Stress and Strain Predictions During Exercise [Master's thesis]. California Polytechnic State University; December 2013.
2008	Anderson AE, Ellis BJ, Maas SA, Peters CL, Weiss JA. Validation of finite element predictions of cartilage contact pressure in the human hip joint. J Biomech Eng. October 2008;130(5):051008.
1986	Butler DL, Kay MD, Stouffer DC. Comparison of material properties in fascicle-bone units from human patellar tendon and knee ligaments. J Biomech. 1986;19(6):425-432.
2001	Wren TAL, Yerby SA, Beaupré GS, Carter DR. Mechanical properties of the human Achilles tendon. Clin Biomech (Bristol, Avon). March 2001;16(3):245-251.
1984	Armstrong CG, Lai WM, Mow VC. An analysis of the unconfined compression of articular cartilage. J Biomech Eng. May 1984;106(2):165-173.
1992	Butler DL, Guan Y, Kay MD, Cummings JF, Feder SM, Levy MS. Location-dependent variations in the material properties of the anterior cruciate ligament. J Biomech. May 1992;25(5):511-518.
2006	Chandrashekar N, Mansouri H, Slauterbeck J, Hashemi J. Sex-based differences in the tensile properties of the human anterior cruciate ligament. J Biomech. 2006;39(16):2943-2950.
2002	Haut Donahue TL, Hull ML, Rashid MM, Jacobs CR. A finite element model of the human knee joint for the study of tibio-femoral contact. J Biomech Eng. June 2002;124(3):273-280.
2002	Weiss JA, Gardiner JC, Bonifasi-Lista C. Ligament material behavior is nonlinear, viscoelastic and rate-independent under shear loading. J Biomech. July 2002;35(6):943-950.
2003	Haut Donahue TL, Hull ML, Rashid MM, Jacobs CR. How the stiffness of meniscal attachments and meniscal material properties affect tibio-femoral contact pressure computed using a validated finite element model of the human knee joint. J Biomech. January 2003;36(1):19-34.
1994	Daniel DM, Stone ML, Dobson BE, Fithian DC, Rossman DJ, Kaufman KR. Fate of the ACL-injured patient: a prospective outcome study. Am J Sports Med. September–October 1994;22(5):632-644.
2004	Song Y, Debski RE, Musahl V, Thomas M, Woo SL-Y. A three-dimensional finite element model of the human anterior cruciate ligament: a computational analysis with experimental validation. J Biomech. March 2004;37(3):383-390.
2009	Winby CR, Lloyd DG, Besier TF, Kirk TB. Muscle and external load contribution to knee joint contact loads during normal gait. J Biomech. October 16, 2009;42(14):2294-2300.
1976	Noyes FR, Grood ES. The strength of the anterior cruciate ligament in humans and Rhesus monkeys. J Bone Joint Surg. 1976;58A(8):1074-1082.
2001	Chen SS, Falcovitz YH, Schneiderman R, Maroudas A, Sah RL. Depth-dependent compressive properties of normal aged human femoral head articular cartilage: relationship to fixed charge density. Osteoarthritis Cartilage. August 2001;9(6):561-569.
2001	Hewitt J, Guilak F, Glisson R, Vail TP. Regional material properties of the human hip joint capsule ligaments. J Orthop Res. May 2001;19(4):359-364.
1992	Spilker RL, Donzelli PS, Mow VC. A transversely isotropic biphasic finite element model of the meniscus. J Biomech. September 1992;25(9):1027-1045.

Year

Entry

2001

Huang C-Y, Mow VC, Ateshian GA. The role of flow-independent viscoelasticity in the biphasic tensile and compressive responses of articular cartilage. J Biomech Eng. October 2001;123(5):410-417.

2008

Chaudhari AMW, Briant PL, Bevill SL, Koo S, Andriacchi TP. Knee kinematics, cartilage morphology, and osteoarthritis after ACL injury. Med Sci Sports Exer. February 2008;40(2):215-222.

1993

Kwan MK, Lin TH-C, Woo SL-Y. On the viscoelastic properties of the anteromedial bundle of the anterior cruciate ligament. J Biomech. April–May 1993;26(4-5):447-452.

1995

Bendjaballah MZ, Shirazi-Adl A, Zukor DJ. Biomechanics of the human knee joint in compression: reconstruction, mesh generation and finite element analysis. Knee. June 1995;2(2):69-79.

1994

Johnson GA, Tramaglini DM, Levine RE, Ohno K, Choi N-Y, Woo SL-Y. Tensile and viscoelastic properties of human patellar tendon. J Orthop Res. 1994;12(6):796-803.