The Effect of Ligament Modeling Technique on Knee Joint Kinematics: A Finite Element Study

Finite element (FE) analysis has become an increasingly popular technique in the study of human joint biomechanics, as it allows for detailed analysis of the joint/tissue behavior under complex, clinically relevant loading conditions. A wide variety of modeling techniques have been utilized to model knee joint ligaments. However, the effect of a selected constitutive model to simulate the ligaments on knee kinematics remains unclear. The purpose of the current study was to determine the effect of two most common techniques utilized to model knee ligaments on joint kinematics under functional loading conditions. We hypothesized that anatomic representations of the knee ligaments with anisotropic hyperelastic properties will result in more realistic kinematics. A previously developed, extensively validated anatomic FE model of the knee developed from a healthy, young female athlete was used. FE models with 3D anatomic and simplified uniaxial representations of main knee ligaments were used to simulate four functional loading conditions. Model predictions of tibiofemoral joint kinematics were compared to experimental measures. Results demonstrated the ability of the anatomic representation of the knee ligaments (3D geometry along with anisotropic hyperelastic material) in more physiologic prediction of the human knee motion with strong correlation (r ≥ 0.9 for all comparisons) and minimum deviation (0.9° ≤ RMSE ≤ 2.29°) from experimental findings. In contrast, non-physiologic uniaxial elastic representation of the ligaments resulted in lower correlations (r ≤ 0.6 for all comparisons) and substantially higher deviation (2.6°≤ RMSE ≤ 4.2°) from experimental results. Findings of the current study support our hypothesis and highlight the critical role of soft tissue modeling technique on the resultant FE predicted joint kinematics.

Optimization of Material Coefficients in the Holzapfel-Gasser-Ogden Material Model for the Main Four Ligaments of the Knee Joint-A Finite Element Study

Accurate representation of soft tissue material properties plays a crucial role in computational biomechanics. Several material models have been used for knee ligaments in finite element (FE) studies, including the neo-Hookean model (widely used) and the Holzapfel-Gasser-Ogden (HGO) model (seldom used). While the coefficients of neo-Hookean models for the knee ligaments are available in the literature, limited data exists for the HGO model. Furthermore, no peer-reviewed comparison of these two material models for the knee ligaments while including the 3D representation of the ligaments for both material models is present in the literature. We used mechanical properties from the tensile test experiments in the literature for each ligament to obtain the HGO material coefficients while accounting for the ligaments’ viscoelastic behavior. Resultant coefficients were then used in an Abaqus/explicit knee model to simulate bipedal landing from a jump. The simulations were repeated with neo-Hookean values from the literature. Knee kinematics plus ACL and MCL strains were evaluated and compared for these two material models. The outputs from the simulations with HGO properties were predominantly within 1.5 standard deviations from the mean in-vitro data. When the material properties changed to Neo-Hookean, the outputs for kinematics and strain values were higher than the HGO case, and in most instances, they were outside the experimental range for ACL and MCL strains (by up to 11.35 SD) as well as some ITR angles (by up to 2.86 SD). Reported HGO material model with optimized coefficients produces a more realistic representation of the ligaments’ material properties, and will help improve the outcomes of FE models for more accurate predictions of knee behavior.

The Endplate Morphology Changes with Change in Biomechanical Environment Following Discectomy

Bone is a dynamic structure and is known to respond to changes in the load over time, in accordance with Wolff’s law. It states that the bone changes its shape and internal architecture in response to stresses acting on it [1]. Therefore, any structural changes in the spine may lead to bone remodeling due to changes in the optimal stress pattern. The changes in apparent density and thickness of the endplates following discectomy of varying amounts were analyzed. The study design coupled a bone remodeling algorithm based on strain energy density theory of adaptive remodeling with an experimentally validated 3D ligamentous finite element model of the spine. The apparent density and thickness of the index level endplates decreased above and below the region of discectomy. On the other hand, these parameters showed increases at the remaining regions of the endplate. There were no correlations between the amount of nucleus removed and the average percentage changes in apparent density and thickness of endplate above and below the discectomy region. However, the average percentage changes in apparent density and thickness at endplate in the other region increased with increase in amount of nucleus removed. These predictions are in agreement with the clinical observations [2-6].