Evaluation of a subject-specific musculoskeletal modelling framework for load prediction in total knee arthroplasty. Issue 8 (August 2016)

• Record Type: Journal Article
• Authors: Chen, Zhenxian; Zhang, Zhifeng; Wang, Ling; Li, Dichen; Zhang, Yuanzhi; Jin, Zhongmin
• Is Part Of: Medical engineering & physics. Volume 38:Issue 8(2016:Aug.)
• Page Start: 708
• Page End: 716
• Publication Date: 2016-08
• Subjects: Subject-specific musculoskeletal modelling -- Force-dependent kinematics -- Total knee arthroplasty -- Multibody dynamics -- Contact force; Biomedical engineering -- Periodicals; Biomedical Engineering -- Periodicals; Physics -- Periodicals; Génie biomédical -- Périodiques; Biomedical engineering; Electronic journals; Periodicals; 610.28
• DOI: 10.1016/j.medengphy.2016.04.010
• Languages: English
• ISSNs: 1350-4533

Abstract

Highlights: A subject-specific musculoskeletal modelling framework was evaluated over a range of patients. Knee contact forces were predicted with reasonable accuracy. Use of the bone morphing scaling method in modelling improved the predictions. Consideration of knee strength reductions in modelling improved the predictions. Abstract: Musculoskeletal (MSK) multibody dynamics (MBD) models have been used to predict in vivo biomechanics in total knee arthroplasty (TKA). However, a full lower limb MSK MBD modelling approach for TKA that combines subject-specific skeletal and prosthetic knee geometry has not yet been applied and evaluated over a range of patients. This study evaluated a subject-specific MSK MBD modelling framework for TKA using force-dependent kinematics (FDK) and applied it to predict knee contact forces during gait trials for three patients implanted with instrumented prosthetic knees. The prediction accuracy was quantified in terms of the mean absolute deviation ( MAD ), root mean square error ( RMSE ), Pearson correlation coefficient ( ρ ), and Sprague and Geers metrics of magnitude ( M ), phase ( P ) and combined error ( C ). Generally good agreements were found between the predictions and the experimental measurements from all patients for the medial contact forces (150 N < MAD < 178 N, 174 N < RMSE < 224 N, 0.87 < ρ < 0.95, −0.04 < M < 0.20, 0.06 < P < 0.09, 0.08 < C < 0.22) and the lateral contact force (113 N < MAD < 195 N, 131 N < RMSE < 240 N, 0.41 < ρ < 0.82, −0.25 < M < 0.34, 0.08 < P < 0.22, 0.13 < C < 0.36). The results suggest that the subject-specific MSK MBD modelling framework for TKA using FDK has potential as a powerful tool for investigating the functional outcomes of knee implants.