Chen Zhenxian, Zhang Xuan, Ardestani Marzieh M, Wang Ling, Liu Yaxiong, Lian Qin, He Jiankang, Li Dichen, Jin Zhongmin
State Key Laboratory for Manufacturing Systems Engineering, School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, China.
State Key Laboratory for Manufacturing Systems Engineering, School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, China
Proc Inst Mech Eng H. 2014 Jun;228(6):564-575. doi: 10.1177/0954411914537476. Epub 2014 May 30.
Lower extremity musculoskeletal computational models play an important role in predicting joint forces and muscle activation simultaneously and are valuable for investigating functional outcomes of the implants. However, current computational musculoskeletal models of total knee replacement rarely consider the bearing surface geometry of the implant. Therefore, these models lack detailed information about the contact loading and joint motion which are important factors for evaluating clinical performances. This study extended a rigid multi-body dynamics simulation of a lower extremity musculoskeletal model to incorporate an artificial knee joint, based upon a novel force-dependent kinematics method, and to characterize the in vivo joint contact mechanics during gait. The developed musculoskeletal total knee replacement model integrated the rigid skeleton multi-body dynamics and the flexible contact mechanics of the tibiofemoral and patellofemoral joints. The predicted contact forces and muscle activations are compared against those in vivo measurements obtained from a single patient with good agreements for the medial contact force (root-mean-square error = 215 N, ρ = 0.96) and lateral contact force (root-mean-square error = 179 N, ρ = 0.75). Moreover, the developed model also predicted the motion of the tibiofemoral joint in all degrees of freedom. This new model provides an important step toward the development of a realistic dynamic musculoskeletal total knee replacement model to predict in vivo knee joint motion and loading simultaneously. This could offer a better opportunity to establish a robust virtual modeling platform for future pre-clinical assessment of knee prosthesis designs, surgical procedures and post-operation rehabilitation.
下肢肌肉骨骼计算模型在同时预测关节力和肌肉激活方面发挥着重要作用，对于研究植入物的功能结果具有重要价值。然而，目前全膝关节置换的计算肌肉骨骼模型很少考虑植入物的承载表面几何形状。因此，这些模型缺乏关于接触载荷和关节运动的详细信息，而接触载荷和关节运动是评估临床性能的重要因素。本研究基于一种新的力相关运动学方法，扩展了下肢肌肉骨骼模型的刚体多体动力学模拟，以纳入人工膝关节，并表征步态期间的体内关节接触力学。所开发的肌肉骨骼全膝关节置换模型整合了刚体骨骼多体动力学以及胫股关节和髌股关节的柔性接触力学。将预测的接触力和肌肉激活与从一名患者获得的体内测量结果进行比较，内侧接触力（均方根误差 = 215 N，ρ = 0.96）和外侧接触力（均方根误差 = 179 N，ρ = 0.75）具有良好的一致性。此外，所开发的模型还预测了胫股关节在所有自由度上的运动。这个新模型朝着开发一个逼真的动态肌肉骨骼全膝关节置换模型迈出了重要一步，该模型能够同时预测体内膝关节运动和载荷。这可能为建立一个强大的虚拟建模平台提供更好的机会，用于未来膝关节假体设计、手术程序和术后康复的临床前评估。
