Abstract
In vivo knee ligament forces are important to consider for informing rehabilitation or clinical interventions. However, they are difficult to directly measure during functional activities. Musculoskeletal models and simulations have become the primary methods by which to estimate in vivo ligament loading. Previous estimates of anterior cruciate ligament (ACL) forces range widely, suggesting that individualized anatomy may have an impact on these predictions. Using ten subject-specific (SS) lower limb musculoskeletal models, which include individualized musculoskeletal geometry, muscle architecture, and six degree-of-freedom knee joint kinematics from dynamic biplane radiography (DBR), this study provides SS estimates of ACL force (anteromedial-aACL; and posterolateral-pACL bundles) during the full gait cycle of treadmill walking. These forces are compared to estimates from scaled-generic (SG) musculoskeletal models to assess the effect of musculoskeletal knee joint anatomy on predicted forces and the benefit of SS modeling in this context. On average, the SS models demonstrated a double force peak during stance (0.39–0.43 xBW per bundle), while only a single force peak during stance was observed in the SG aACL. No significant differences were observed between continuous SG and SS ACL forces; however, root mean-squared differences between SS and SG predictions ranged from 0.08 xBW to 0.27 xBW, suggesting SG models do not reliably reflect forces predicted by SS models. Force predictions were also found to be highly sensitive to ligament resting length, with ±10% variations resulting in force differences of up to 84%. Overall, this study demonstrates the sensitivity of ACL force predictions to SS anatomy, specifically musculoskeletal joint geometry and ligament resting lengths, as well as the feasibility for generating SS musculoskeletal models for a group of subjects to predict in vivo tissue loading during functional activities.
Issue Section:
Research Papers
References
1.
Fleming
,
B. C.
, and
Beynnon
,
B. D.
, 2004
, “
In Vivo Measurement of Ligament/Tendon Strains and Forces: A Review
,” Ann. Biomed. Eng.
,
32
(3
), pp. 318
–328
.10.1023/B:ABME.0000017542.75080.862.
Shelburne
,
K. B.
,
Pandy
,
M. G.
,
Anderson
,
F. C.
, and
Torry
,
M. R.
, 2004
, “
Pattern of Anterior Cruciate Ligament Force in Normal Walking
,” J. Biomech.
,
37
(6
), pp. 797
–805
.10.1016/j.jbiomech.2003.10.0103.
Wu
,
J. L.
,
Hosseini
,
A.
,
Kozanek
,
M.
,
Gadikota
,
H. R.
,
Gill
,
T. J. T.
, and
Li
,
G.
, 2010
, “
Kinematics of the Anterior Cruciate Ligament During Gait
,” Am. J. Sports Med.
,
38
(7
), pp. 1475
–1482
.10.1177/03635465103642404.
Taylor
,
K. A.
,
Cutcliffe
,
H. C.
,
Queen
,
R. M.
,
Utturkar
,
G. M.
,
Spritzer
,
C. E.
,
Garrett
,
W. E.
, and
DeFrate
,
L. E.
, 2013
, “
In Vivo Measurement of ACL Length and Relative Strain During Walking
,” J. Biomech.
,
46
(3
), pp. 478
–483
.10.1016/j.jbiomech.2012.10.0315.
Toutoungi
,
D. E.
,
Lu
,
T. W.
,
Leardini
,
A.
,
Catani
,
F.
, and
O'Connor
,
J. J.
, 2000
, “
Cruciate Ligament Forces in the Human Knee During Rehabilitation Exercises
,” Clin. Biomech.
,
15
(3
), pp. 176
–187
.10.1016/S0268-0033(99)00063-76.
Collins
,
J. J.
, and
O'Connor
,
J. J.
, 1991
, “
Muscle-Ligament Interactions at the Knee During Walking
,” Proc. Inst. Mech. Eng., Part H
,
205
(1
), pp. 11
–18
.10.1243/PIME_PROC_1991_205_256_027.
Collins
,
J. J.
, 1995
, “
The Redundant Nature of Locomotor Optimization Laws
,” J. Biomech.
,
28
(3
), pp. 251
–267
.10.1016/0021-9290(94)00072-C8.
Serpas
,
F.
,
Yanagawa
,
T.
, and
Pandy
,
M.
, 2002
, “
Forward-Dynamics Simulation of Anterior Cruciate Ligament Forces Developed During Isokinetic Dynamometry
,” Comput. Methods Biomech. Biomed. Eng.
,
5
(1
), pp. 33
–43
.10.1080/10255840210000016149.
Shelburne
,
K. B.
, and
Pandy
,
M. G.
, 1997
, “
A Musculoskeletal Model of the Knee for Evaluating Ligament Forces During Isometric Contractions
,” J. Biomech.
,
30
(2
), pp. 163
–176
.10.1016/S0021-9290(96)00119-410.
Shelburne
,
K. B.
, and
Pandy
,
M. G.
, 1998
, “
Determinants of Cruciate-Ligament Loading During Rehabilitation Exercise
,” Clin. Biomech.
,
13
(6
), pp. 403
–413
.10.1016/S0268-0033(98)00094-111.
Shelburne
,
K. B.
, and
Pandy
,
M. G.
, 2002
, “
A Dynamic Model of the Knee and Lower Limb for Simulating Rising Movements
,” Comput. Methods Biomech. Biomed. Eng.
,
5
(2
), pp. 149
–159
.10.1080/1025584029001026512.
Moissenet
,
F.
,
Cheze
,
L.
, and
Dumas
,
R.
, 2014
, “
A 3D Lower Limb Musculoskeletal Model for Simultaneous Estimation of Musculo-Tendon, Joint Contact, Ligament and Bone Forces During Gait
,” J. Biomech.
,
47
(1
), pp. 50
–58
.10.1016/j.jbiomech.2013.10.01513.
Harrington
,
I. J.
, 1976
, “
A Bioengineering Analysis of Force Actions at the Knee in Normal and Pathological Gait
,” Biomed. Eng.
,
11
(5
), pp. 167
–172
.https://pubmed.ncbi.nlm.nih.gov/1276337/14.
Scheys
,
L.
,
Spaepen
,
A.
,
Suetens
,
P.
, and
Jonkers
,
I.
, 2008
, “
Calculated Moment-Arm and Muscle-Tendon Lengths During Gait Differ Substantially Using MR Based Versus Rescaled Generic Lower-Limb Musculoskeletal Models
,” Gait Posture
,
28
(4
), pp. 640
–648
.10.1016/j.gaitpost.2008.04.01015.
Scheys
,
L.
,
Loeckx
,
D.
,
Spaepen
,
A.
,
Suetens
,
P.
, and
Jonkers
,
I.
, 2009
, “
Atlas-Based Non-Rigid Image Registration to Automatically Define Line-of-Action Muscle Models: A Validation Study
,” J. Biomech.
,
42
(5
), pp. 565
–572
.10.1016/j.jbiomech.2008.12.01416.
Scheys
,
L.
,
Desloovere
,
K.
,
Suetens
,
P.
, and
Jonkers
,
I.
, 2011
, “
Level of Subject-Specific Detail in Musculoskeletal Models Affects Hip Moment Arm Length Calculation During Gait in Pediatric Subjects With Increased Femoral Anteversion
,” J. Biomech.
,
44
(7
), pp. 1346
–1353
.10.1016/j.jbiomech.2011.01.00117.
Valente
,
G.
,
Pitto
,
L.
,
Testi
,
D.
,
Seth
,
A.
,
Delp
,
S. L.
,
Stagni
,
R.
,
Viceconti
,
M.
, and
Taddei
,
F.
, 2014
, “
Are Subject-Specific Musculoskeletal Models Robust to the Uncertainties in Parameter Identification?
,” PLoS One
,
9
(11
), p. e112625
.10.1371/journal.pone.011262518.
Prinold
,
J. A.
,
Mazzà
,
C.
,
Di Marco
,
R.
,
Hannah
,
I.
,
Malattia
,
C.
,
Magni-Manzoni
,
S.
,
Petrarca
,
M.
,
Ronchetti
,
A. B.
,
Tanturri de Horatio
,
L.
,
van Dijkhuizen
,
E. H.
,
Wesarg
,
S.
,
Viceconti
,
M.
, and
Consortium
,
M.-P.
, 2016
, “
A Patient-Specific Foot Model for the Estimate of Ankle Joint Forces in Patients With Juvenile Idiopathic Arthritis
,” Ann. Biomed. Eng.
,
44
(1
), pp. 247
–257
.10.1007/s10439-015-1451-z19.
Ackland
,
D. C.
,
Lin
,
Y. C.
, and
Pandy
,
M. G.
, 2012
, “
Sensitivity of Model Predictions of Muscle Function to Changes in Moment Arms and Muscle-Tendon Properties: A Monte Carlo Analysis
,” J. Biomech.
,
45
(8
), pp. 1463
–1471
.10.1016/j.jbiomech.2012.02.02320.
Navacchia
,
A.
,
Myers
,
C. A.
,
Rullkoetter
,
P. J.
, and
Shelburne
,
K. B.
, 2016
, “
Prediction of In Vivo Knee Joint Loads Using a Global Probabilistic Analysis
,” ASME J. Biomech. Eng.
,
138
(3
), p. 031002
.10.1115/1.403237921.
Charles
,
J. P.
,
Cappellari
,
O.
,
Spence
,
A. J.
,
Wells
,
D. J.
, and
Hutchinson
,
J. R.
, 2016
, “
Muscle Moment Arms and Sensitivity Analysis of a Mouse Hindlimb Musculoskeletal Model
,” J. Anat.
,
229
(4
), pp. 514
–535
.10.1111/joa.1246122.
Imani Nejad
,
Z.
,
Khalili
,
K.
,
Hosseini Nasab
,
S. H.
,
Schutz
,
P.
,
Damm
,
P.
,
Trepczynski
,
A.
,
Taylor
,
W. R.
, and
Smith
,
C. R.
, 2020
, “
The Capacity of Generic Musculoskeletal Simulations to Predict Knee Joint Loading Using the CAMS-Knee Datasets
,” Ann. Biomed. Eng.
,
48
(4
), pp. 1442
–1442
.10.1007/s10439-020-02480-623.
Charles
,
J. P.
,
Grant
,
B.
,
D'Août
,
K.
, and
Bates
,
K. T.
, 2020
, “
Subject-Specific Muscle Properties From Diffusion Tensor Imaging Significantly Improve the Accuracy of Musculoskeletal Models
,” J. Anatomy
, 237
, pp. 941
–959
.10.1111/joa.1326124.
Anderst
,
W.
,
Zauel
,
R.
,
Bishop
,
J.
,
Demps
,
E.
, and
Tashman
,
S.
, 2009
, “
Validation of Three-Dimensional Model-Based Tibio-Femoral Tracking During Running
,” Med. Eng. Phys.
,
31
(1
), pp. 10
–16
.10.1016/j.medengphy.2008.03.00325.
Zheng
,
L.
,
Li
,
K.
,
Shetye
,
S.
, and
Zhang
,
X.
, 2014
, “
Integrating Dynamic Stereo-Radiography and Surface-Based Motion Data for Subject-Specific Musculoskeletal Dynamic Modeling
,” J. Biomech.
,
47
(12
), pp. 3217
–3221
.10.1016/j.jbiomech.2014.08.00926.
Guess
,
T. M.
,
Liu
,
H.
,
Bhashyam
,
S.
, and
Thiagarajan
,
G.
, 2013
, “
A Multibody Knee Model With Discrete Cartilage Prediction of Tibio-Femoral Contact Mechanics
,” Comput. Methods Biomech. Biomed. Eng.
,
16
(3
), pp. 256
–270
.10.1080/10255842.2011.61700427.
Charles
,
J. P.
,
Suntaxi
,
F.
, and
Anderst
,
W. J.
, 2019
, “
In Vivo Human Lower Limb Muscle Architecture Dataset Obtained Using Diffusion Tensor Imaging
,” PLoS One
,
14
(10
), p. e0223531
.10.1371/journal.pone.022353128.
Charles
,
J. P.
,
Moon
,
C. H.
, and
Anderst
,
W.
, 2019
, “
Determining Subject-Specific Lower-Limb Muscle Architecture Data for Musculoskeletal Models Using Diffusion Tensor MRI
,” ASME J. Biomech. Eng.
,
141
(6
), p. 060905
.10.1115/1.404094629.
Valente
,
G.
,
Crimi
,
G.
,
Vanella
,
N.
,
Schileo
,
E.
, and
Taddei
,
F.
, 2017
, “
nmsBuilder: Freeware to Create Subject-Specific Musculoskeletal Models for OpenSim
,” Comput. Methods Programs Biomed.
,
152
, pp. 85
–92
.10.1016/j.cmpb.2017.09.01230.
Delp
,
S. L.
,
Loan
,
J. P.
,
Hoy
,
M. G.
,
Zajac
,
F. E.
,
Topp
,
E. L.
, and
Rosen
,
J. M.
, 1990
, “
An Interactive Graphics-Based Model of the Lower Extremity to Study Orthopaedic Surgical Procedures
,” IEEE Trans. Biomed. Eng.
,
37
(8
), pp. 757
–767
.10.1109/10.10279131.
Van der Helm
,
F. C.
,
Veeger
,
H. E.
,
Pronk
,
G. M.
,
Van der Woude
,
L. H.
, and
Rozendal
,
R. H.
, 1992
, “
Geometry Parameters for Musculoskeletal Modelling of the Shoulder System
,” J. Biomech.
,
25
(2
), pp. 129
–144
.10.1016/0021-9290(92)90270-B32.
Arnold
,
E. M.
,
Ward
,
S. R.
,
Lieber
,
R. L.
, and
Delp
,
S. L.
, 2010
, “
A Model of the Lower Limb for Analysis of Human Movement
,” Ann. Biomed. Eng.
,
38
(2
), pp. 269
–279
.10.1007/s10439-009-9852-533.
Nagai
,
K.
,
Gale
,
T.
,
Chiba
,
D.
,
Su
,
F.
,
Fu
,
F.
, and
Anderst
,
W.
, 2019
, “
The Complex Relationship Between In Vivo ACL Elongation and Knee Kinematics During Walking and Running
,” J. Orthop. Res.
,
37
(9
), pp. 1920
–1928
.10.1002/jor.2433034.
Xu
,
H.
,
Bloswick
,
D.
, and
Merryweather
,
A.
, 2015
, “
An Improved OpenSim Gait Model With Multiple Degrees of Freedom Knee Joint and Knee Ligaments
,” Comput. Methods Biomech. Biomed. Eng.
,
18
(11
), pp. 1217
–1224
.10.1080/10255842.2014.88968935.
Stanev
,
D.
,
Moustakas
,
K.
,
Gliatis
,
J.
, and
Koutsojannis
,
C.
, 2016
, “
ACL Reconstruction Decision Support. Personalized Simulation of the Lachman Test and Custom Activities
,” Methods Inf. Med.
,
55
(1
), pp. 98
–105
.10.3414/ME14-02-002236.
Bloemker
,
K. H.
,
Guess
,
T. M.
,
Maletsky
,
L.
, and
Dodd
,
K.
, 2012
, “
Computational Knee Ligament Modeling Using Experimentally Determined Zero-Load Lengths
,” Open Biomed. Eng. J.
,
6
(1
), pp. 33
–41
.10.2174/187412070120601003337.
Rajagopal
,
A.
,
Dembia
,
C. L.
,
DeMers
,
M. S.
,
Delp
,
D. D.
,
Hicks
,
J. L.
, and
Delp
,
S. L.
, 2016
, “
Full-Body Musculoskeletal Model for Muscle-Driven Simulation of Human Gait
,” IEEE Trans. Biomed. Eng.
,
63
(10
), pp. 2068
–2079
.10.1109/TBME.2016.258689138.
Wu
,
G.
,
Siegler
,
S.
,
Allard
,
P.
,
Kirtley
,
C.
,
Leardini
,
A.
,
Rosenbaum
,
D.
,
Whittle
,
M.
,
D'Lima
,
D. D.
,
Cristofolini
,
L.
,
Witte
,
H.
,
Schmid
,
O.
, and
Stokes
,
I.
, 2002
, “
ISB Recommendation on Definitions of Joint Coordinate System of Various Joints for the Reporting of Human Joint Motion–Part I: Ankle, Hip, and Spine. International Society of Biomechanics
,” J. Biomech.
,
35
(4
), pp. 543
–548
.10.1016/S0021-9290(01)00222-639.
Delp
,
S. L.
,
Anderson
,
F. C.
,
Arnold
,
A. S.
,
Loan
,
P.
,
Habib
,
A.
,
John
,
C. T.
,
Guendelman
,
E.
, and
Thelen
,
D. G.
, 2007
, “
OpenSim: Open-Source Software to Create and Analyze Dynamic Simulations of Movement
,” IEEE Trans. Biomed. Eng.
,
54
(11
), pp. 1940
–1950
.10.1109/TBME.2007.90102440.
Gale
,
T.
, and
Anderst
,
W.
, 2019
, “
Asymmetry in Healthy Adult Knee Kinematics Revealed Through Biplane Radiography of the Full Gait Cycle
,” J. Orthop. Res.
,
37
(3
), pp. 609
–614
.10.1002/jor.2422241.
Kutzner
,
I.
,
Stephan
,
D.
,
Dymke
,
J.
,
Bender
,
A.
,
Graichen
,
F.
, and
Bergmann
,
G.
, 2013
, “
The Influence of Footwear on Knee Joint Loading During Walking—In Vivo Load Measurements With Instrumented Knee Implants
,” J. Biomech.
,
46
(4
), pp. 796
–800
.10.1016/j.jbiomech.2012.11.02042.
Pataky
,
T. C.
, 2010
, “
Generalized n-Dimensional Biomechanical Field Analysis Using Statistical Parametric Mapping
,” J. Biomech.
,
43
(10
), pp. 1976
–1982
.10.1016/j.jbiomech.2010.03.00843.
Scanlan
,
S. F.
,
Lai
,
J.
,
Donahue
,
J. P.
, and
Andriacchi
,
T. P.
, 2012
, “
Variations in the Three-Dimensional Location and Orientation of the ACL in Healthy Subjects Relative to Patients After Transtibial ACL Reconstruction
,” J. Orthop. Res.
,
30
(6
), pp. 910
–918
.10.1002/jor.2201144.
Beynnon
,
B.
,
Yu
,
J.
,
Huston
,
D.
,
Fleming
,
B.
,
Johnson
,
R.
,
Haugh
,
L.
, and
Pope
,
M. H.
, 1996
, “
A Sagittal Plane Model of the Knee and Cruciate Ligaments With Application of a Sensitivity Analysis
,” ASME J. Biomech. Eng.
,
118
(2
), pp. 227
–239
.10.1115/1.279596545.
Eby
,
S. F.
,
Song
,
P.
,
Chen
,
S.
,
Chen
,
Q.
,
Greenleaf
,
J. F.
, and
An
,
K. N.
, 2013
, “
Validation of Shear Wave Elastography in Skeletal Muscle
,” J. Biomech.
,
46
(14
), pp. 2381
–2387
.10.1016/j.jbiomech.2013.07.03346.
Hatta
,
T.
,
Giambini
,
H.
,
Itoigawa
,
Y.
,
Hooke
,
A. W.
,
Sperling
,
J. W.
,
Steinmann
,
S. P.
,
Itoi
,
E.
, and
An
,
K. N.
, 2017
, “
Quantifying Extensibility of Rotator Cuff Muscle With Tendon Rupture Using Shear Wave Elastography: A Cadaveric Study
,” J. Biomech.
,
61
, pp. 131
–136
.10.1016/j.jbiomech.2017.07.00947.
Low
,
G.
,
Kruse
,
S. A.
, and
Lomas
,
D. J.
, 2016
, “
General Review of Magnetic Resonance Elastography
,” World J. Radiol.
,
8
(1
), pp. 59
–72
.10.4329/wjr.v8.i1.5948.
Mariappan
,
Y. K.
,
Glaser
,
K. J.
, and
Ehman
,
R. L.
, 2010
, “
Magnetic Resonance Elastography: A Review
,” Clin. Anat.
,
23
(5
), pp. 497
–511
.10.1002/ca.2100649.
Slane
,
L. C.
,
Slane
,
J. A.
,
D'Hooge
,
J.
, and
Scheys
,
L.
, 2017
, “
The Challenges of Measuring In Vivo Knee Collateral Ligament Strains Using Ultrasound
,” J. Biomech.
,
61
, pp. 258
–262
.10.1016/j.jbiomech.2017.07.02050.
Nasseri
,
A.
,
Khataee
,
H.
,
Bryant
,
A. L.
,
Lloyd
,
D. G.
, and
Saxby
,
D. J.
, 2020
, “
Modelling the Loading Mechanics of Anterior Cruciate Ligament
,” Comput. Methods Programs Biomed.
,
184
, p. 105098
.10.1016/j.cmpb.2019.10509851.
van den Bogert
,
A. J.
,
Reinschmidt
,
C.
, and
Lundberg
,
A.
, 2008
, “
Helical Axes of Skeletal Knee Joint Motion During Running
,” J. Biomech.
,
41
(8
), pp. 1632
–1638
.10.1016/j.jbiomech.2008.03.01852.
Duthon
,
V. B.
,
Barea
,
C.
,
Abrassart
,
S.
,
Fasel
,
J. H.
,
Fritschy
,
D.
, and
Menetrey
,
J.
, 2006
, “
Anatomy of the Anterior Cruciate Ligament
,” Knee Surg. Sports Traumatol. Arthrosc.
,
14
(3
), pp. 204
–213
.10.1007/s00167-005-0679-9Copyright © 2021 by ASME
You do not currently have access to this content.
