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Development and validation of a kinematically-driven discrete element model of the patellofemoral joint |
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| Affiliation: | 1. Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA;2. Department of Research, Cleveland Clinic Akron General, Akron, OH, USA;3. Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA;4. DOD-VA Extremity Trauma and Amputation Center of Excellence, Naval Medical Center San Diego, CA, USA;1. Department of Orthopedic Surgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China;2. Institute of Orthopedic Research, Zhejiang University, Hangzhou, Zhejiang, China;1. Biomedical Engineering Research Group, Department of Mechanical and Mechatronic Engineering, Stellenbosch University, Stellenbosch 7600, South Africa;2. MediClinic, Stellenbosch 7600, South Africa;1. Department of Vision Sciences, School of Optometry, University of Alabama at Birmingham, Birmingham, Alabama;2. University of Texas M.D. Anderson Cancer Center, Houston, Texas;3. Department of Ophthalmology and Visual Sciences, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama;1. School of Human Kinetics, University of Ottawa, Canada;2. Department of Engineering, University of Ottawa, Canada;3. School of Rehabilitation Sciences, University of Ottawa, Canada;1. Department of Physical Therapy, University of Nevada, Las Vegas, NV, USA;2. Department of Radiological Sciences, University of California, Irvine, CA, USA;3. Department of Mechanical and Aerospace Engineering, University of California, Irvine, CA, USA;4. Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, USA;1. Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA, USA;2. Department of Biomedical Engineering, University of Iowa, Iowa City, IA, USA |
| Abstract: | Quantifying the complex loads at the patellofemoral joint (PFJ) is vital to understanding the development of PFJ pain and osteoarthritis. Discrete element analysis (DEA) is a computationally efficient method to estimate cartilage contact stresses with potential application at the PFJ to better understand PFJ mechanics. The current study validated a DEA modeling framework driven by PFJ kinematics to predict experimentally-measured PFJ contact stress distributions. Two cadaveric knee specimens underwent quadriceps muscle [215 N] and joint compression [350 N] forces at ten discrete knee positions representing PFJ positions during early gait while measured PFJ kinematics were used to drive specimen-specific DEA models. DEA-computed contact stress and area were compared to experimentally-measured data. There was good agreement between computed and measured mean and peak stress across the specimens and positions (r = 0.63–0.85). DEA-computed mean stress was within an average of 12% (range: 1–47%) of the experimentally-measured mean stress while DEA-computed peak stress was within an average of 22% (range: 1–40%). Stress magnitudes were within the ranges measured (0.17–1.26 MPa computationally vs 0.12–1.13 MPa experimentally). DEA-computed areas overestimated measured areas (average error = 60%; range: 4–117%) with magnitudes ranging from 139 to 307 mm2 computationally vs 74–194 mm2 experimentally. DEA estimates of the ratio of lateral to medial patellofemoral stress distribution predicted the experimental data well (mean error = 15%) with minimal measurement bias. These results indicate that kinematically-driven DEA models can provide good estimates of relative changes in PFJ contact stress. |
| Keywords: | Patellofemoral Discrete element analysis Joint contact Modeling Stress |
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