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Subject-specific knee joint geometry improves predictions of medial tibiofemoral contact forces
Authors:Pauline Gerus  Massimo Sartori  Thor F Besier  Benjamin J Fregly  Scott L Delp  Scott A Banks  Marcus G Pandy  Darryl D D'Lima  David G Lloyd
Institution:1. Centre for Musculoskeletal Research, Griffith Health Institute, Griffith University, Southport, QLD, Australia;2. Bernstein Center for Computational Neuroscience, Georg-August University, Göttingen, Germany;3. Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand;4. Department of Mechanical & Aerospace Engineering, University of Florida, Gainesville, FL, USA;5. Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA;6. Department of Orthopedics & Rehabilitation, University of Florida, Gainesville, FL, USA;g Department of Mechanical Engineering, Stanford University, Stanford, CA, USA;h Department of Mechanical Engineering, University of Melbourne, Melbourne, VIC, Australia;i Shiley Center for Orthopedic Research & Education at Scripps Clinic, La Jolla, CA, USA
Abstract:Estimating tibiofemoral joint contact forces is important for understanding the initiation and progression of knee osteoarthritis. However, tibiofemoral contact force predictions are influenced by many factors including muscle forces and anatomical representations of the knee joint. This study aimed to investigate the influence of subject-specific geometry and knee joint kinematics on the prediction of tibiofemoral contact forces using a calibrated EMG-driven neuromusculoskeletal model of the knee. One participant fitted with an instrumented total knee replacement walked at a self-selected speed while medial and lateral tibiofemoral contact forces, ground reaction forces, whole-body kinematics, and lower-limb muscle activity were simultaneously measured. The combination of generic and subject-specific knee joint geometry and kinematics resulted in four different OpenSim models used to estimate muscle–tendon lengths and moment arms. The subject-specific geometric model was created from CT scans and the subject-specific knee joint kinematics representing the translation of the tibia relative to the femur was obtained from fluoroscopy. The EMG-driven model was calibrated using one walking trial, but with three different cost functions that tracked the knee flexion/extension moments with and without constraint over the estimated joint contact forces. The calibrated models then predicted the medial and lateral tibiofemoral contact forces for five other different walking trials. The use of subject-specific models with minimization of the peak tibiofemoral contact forces improved the accuracy of medial contact forces by 47% and lateral contact forces by 7%, respectively compared with the use of generic musculoskeletal model.
Keywords:EMG-driven modeling  Knee joint model  Contact force  Muscle force
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