Abstract
Preclinical evaluation of total knee arthroplasty (TKA) components is essential to understanding their mechanical behavior and developing strategies for improving joint stability. While preclinical testing of TKA components has been useful in quantifying their effectiveness, such testing can be criticized for lacking clinical relevance, as the important contributions of surrounding soft tissues are either neglected or greatly simplified. The purpose of our study was to develop and determine if subject-specific virtual ligaments reproduce a similar behavior as native ligaments surrounding TKA joints. Six TKA knees were mounted to a motion simulator. Each was subjected to tests of anterior–posterior (AP), internal–external (IE), and varus–valgus (VV) laxity. The forces transmitted through major ligaments were measured using a sequential resection technique. By tuning the measured ligament forces and elongations to a generic nonlinear elastic ligament model, virtual ligaments were designed and used to simulate the soft tissue envelope around isolated TKA components. The average root-mean-square error (RMSE) between the laxity results of TKA joints with native versus virtual ligaments was 3.5 ± 1.8 mm during AP translation, 7.5 ± 4.2 deg during IE rotations, and 2.0 ± 1.2 deg during VV rotations. Interclass correlation coefficients (ICCs) indicated a good level of reliability for AP and IE laxity (0.85 and 0.84). To conclude, the advancement of virtual ligament envelopes as a more realistic representation of soft tissue constraint around TKA joints is a valuable approach for obtaining clinically relevant kinematics when testing TKA components on joint motion simulators.
Issue Section:
Research Papers
References
1.
Carr
,
A. J.
,
Robertsson
,
O.
,
Graves
,
S.
,
Price
,
A. J.
,
Arden
,
N. K.
,
Judge
,
A.
, and
Beard
,
D. J.
, 2012
, “
Knee Replacement
,” Lancet
,
379
(9823
), pp. 1331
–1340
.10.1016/S0140-6736(11)60752-62.
Scott
,
D. F.
, 2018
, “
Prospective Randomized Comparison of Posterior-Stabilized Versus Condylar-Stabilized Total Knee Arthroplasty: Final Report of a Five-Year Study
,” J Arthroplasty
,
33
(5
), pp. 1384
–1388
.10.1016/j.arth.2017.11.0373.
Sur
,
Y.-J.
,
Koh
,
I.-J.
,
Park
,
S.-W.
,
Kim
,
H.-J.
, and
In
,
Y.
, 2015
, “
Condylar-Stabilizing Tibial Inserts Do Not Restore Anteroposterior Stability After Total Knee Arthroplasty
,” J Arthroplasty
,
30
(4
), pp. 587
–591
.10.1016/j.arth.2014.11.0184.
Song
,
E.-K.
,
Lim
,
H.-A.
,
Joo
,
S.-D.
,
Kim
,
S.-K.
,
Lee
,
K.-B.
, and
Seon
,
J.-K.
, 2017
, “
Total Knee Arthroplasty Using Ultra-Congruent Inserts Can Provide Similar Stability and Function Compared With Cruciate-Retaining Total Knee Arthroplasty
,” Knee Surg., Sports Traumatol., Arthroscopy
,
25
(11
), pp. 3530
–3535
.10.1007/s00167-017-4553-35.
Bae
,
J.-H.
,
Yoon
,
J.-R.
,
Sung
,
J.-H.
, and
Shin
,
Y.-S.
, 2018
, “
Posterior-Stabilized Inserts Are Preferable to Cruciate-Substituting Ultracongruent Inserts Due to More Favourable Kinematics and Stability
,” Knee Surg., Sports Traumatol., Arthroscopy
,
26
(11
), pp. 3300
–3310
.10.1007/s00167-018-4872-z6.
Willing
,
R.
,
Moslemian
,
A.
,
Yamomo
,
G.
,
Wood
,
T.
,
Howard
,
J.
, and
Lanting
,
B.
, 2019
, “
Condylar‐Stabilized TKR May Not Fully Compensate for PCL‐Deficiency: An In Vitro Cadaver Study
,” J. Orthop. Res.
,
37
(10
), pp. 2172
–2181
.10.1002/jor.243927.
Dolan
,
M. M.
,
Kelly
,
N. H.
,
Nguyen
,
J. T.
,
Wright
,
T. M.
, and
Haas
,
S. B.
, 2011
, “
Implant Design Influences Tibial Post Wear Damage in Posterior-Stabilized Knees
,” Clin. Orthop. Relat. Res.
,
469
(1
), pp. 160
–167
.10.1007/s11999-010-1515-18.
Sharkey
,
P. F.
,
Lichstein
,
P. M.
,
Shen
,
C.
,
Tokarski
,
A. T.
, and
Parvizi
,
J.
, 2014
, “
Why Are Total Knee Arthroplasties Failing Today—Has Anything Changed After 10 Years?
,” J. Arthroplasty
,
29
(9
), pp. 1774
–1778
.10.1016/j.arth.2013.07.0249.
Lombardi
,
A. V.
Jr.
,
Berend
,
K. R.
, and
Adams
,
J. B.
, 2014
, “
Why Knee Replacements Fail in 2013: Patient, Surgeon, or Implant?
,” Bone Jt. J.
,
96-B
(11_Supple_A
), pp. 101
–104
.10.1302/0301-620X.96B11.3435010.
Keeney
,
J. A.
,
Clohisy
,
J. C.
,
Curry
,
M.
, and
Maloney
,
W. J.
, 2005
, “
Revision Total Knee Arthroplasty for Restricted Motion
,” Clin. Orthop. Relat. Res.
,
440
(&NA
), pp. 135
–140
.10.1097/01.blo.0000185312.43955.c811.
Bozic
,
K. J.
,
Kurtz
,
S. M.
,
Lau
,
E.
,
Ong
,
K.
,
Chiu
,
V.
,
Vail
,
T. P.
,
Rubash
,
H. E.
, and
Berry
,
D. J.
, 2010
, “
The Epidemiology of Revision Total Knee Arthroplasty in the United States
,” Clin. Orthop. Relat. Res.
,
468
(1
), pp. 45
–51
.10.1007/s11999-009-0945-012.
Mulhall
,
K. J.
,
Ghomrawi
,
H. M.
,
Scully
,
S.
,
Callaghan
,
J. J.
, and
Saleh
,
K. J.
, 2006
, “
Current Etiologies and Modes of Failure in Total Knee Arthroplasty Revision
,” Clin. Orthop. Relat. Res.
,
446
, pp. 45
–50
.10.1097/01.blo.0000214421.21712.6213.
Haider
,
H.
, and
Walker
,
P. S.
, 2005
, “
Measurements of Constraint of Total Knee Replacement
,” J. Biomech.
,
38
(2
), pp. 341
–348
.10.1016/j.jbiomech.2004.02.01414.
Luger
,
E.
,
Sathasivam
,
S.
, and
Walker
,
P. S.
, 1997
, “
Inherent Differences in the Laxity and Stability Between the Intact Knee and Total Knee Replacements
,” Knee
,
4
(1
), pp. 7
–14
.10.1016/S0968-0160(96)00224-415.
Abdel-Jaber
,
S.
,
Belvedere
,
C.
,
Leardini
,
A.
, and
Affatato
,
S.
, 2015
, “
Wear Simulation of Total Knee Prostheses Using Load and Kinematics Waveforms From Stair Climbing
,” J. Biomech.
,
48
(14
), pp. 3830
–3836
.10.1016/j.jbiomech.2015.09.00716.
Halloran
,
J. P.
,
Clary
,
C. W.
,
Maletsky
,
L. P.
,
Taylor
,
M.
,
Petrella
,
A. J.
, and
Rullkoetter
,
P. J.
, 2010
, “
Verification of Predicted Knee Replacement Kinematics During Simulated Gait in the Kansas Knee Simulator
,” ASME J. Biomech. Eng.
, 132
(8
), p. 081010
.10.1115/1.400167817.
Godest
,
A. C.
,
Beaugonin
,
M.
,
Haug
,
E.
,
Taylor
,
M.
, and
Gregson
,
P. J.
, 2002
, “
Simulation of a Knee Joint Replacement During a Gait Cycle Using Explicit Finite Element Analysis
,” J. Biomech.
,
35
(2
), pp. 267
–275
.10.1016/S0021-9290(01)00179-818.
Willing
,
R.
, and
Walker
,
P. S.
, 2018
, “
Measuring the Sensitivity of Total Knee Replacement Kinematics and Laxity to Soft Tissue Imbalances
,” J. Biomech.
,
77
, pp. 62
–68
.10.1016/j.jbiomech.2018.06.01919.
McKellop
,
H. A.
, and
D'Lima
,
D.
, 2008
, “
How Have Wear Testing and Joint Simulator Studies Helped to Discriminate Among Materials and Designs?
,” JAAOS-J. Am. Acad. Orthop. Surg.
,
16
, pp. S111
–S119
.10.5435/00124635-200800001-0002220.
Baldwin
,
M. A.
,
Clary
,
C. W.
,
Fitzpatrick
,
C. K.
,
Deacy
,
J. S.
,
Maletsky
,
L. P.
, and
Rullkoetter
,
P. J.
, 2012
, “
Dynamic Finite Element Knee Simulation for Evaluation of Knee Replacement Mechanics
,” J. Biomech.
,
45
(3
), pp. 474
–483
.10.1016/j.jbiomech.2011.11.05221.
Chen
,
Z.
,
Zhang
,
Z.
,
Wang
,
L.
,
Li
,
D.
,
Zhang
,
Y.
, and
Jin
,
Z.
, 2016
, “
Evaluation of a Subject-Specific Musculoskeletal Modelling Framework for Load Prediction in Total Knee Arthroplasty
,” Med. Eng. Phys.
,
38
(8
), pp. 708
–716
.10.1016/j.medengphy.2016.04.01022.
Halloran
,
J. P.
,
Petrella
,
A. J.
, and
Rullkoetter
,
P. J.
, 2005
, “
Explicit Finite Element Modeling of Total Knee Replacement Mechanics
,” J. Biomech.
,
38
(2
), pp. 323
–331
.10.1016/j.jbiomech.2004.02.04623.
Navacchia
,
A.
,
Rullkoetter
,
P. J.
,
Schütz
,
P.
,
List
,
R. B.
,
Fitzpatrick
,
C. K.
, and
Shelburne
,
K. B.
, 2016
, “
Subject‐Specific Modeling of Muscle Force and Knee Contact in Total Knee Arthroplasty
,” J. Orthop. Res.
,
34
(9
), pp. 1576
–1587
.10.1002/jor.2317124.
Beillas
,
P.
,
Papaioannou
,
G.
,
Tashman
,
S.
, and
Yang
,
K. H.
, 2004
, “
A New Method to Investigate In Vivo Knee Behavior Using a Finite Element Model of the Lower Limb
,” J. Biomech.
,
37
(7
), pp. 1019
–1030
.10.1016/j.jbiomech.2003.11.02225.
Bendjaballah
,
M.
,
Shirazi-Adl
,
A.
, and
Zukor
,
D. J.
, 1997
, “
Finite Element Analysis of Human Knee Joint in Varus-Valgus
,” Clin. Biomech.
,
12
(3
), pp. 139
–148
.10.1016/S0268-0033(97)00072-726.
Blankevoort
,
L.
, and
Huiskes
,
R.
, 1996
, “
Validation of a Three-Dimensional Model of the Knee
,” J. Biomech.
,
29
(7
), pp. 955
–961
.10.1016/0021-9290(95)00149-227.
Yang
,
Z.
,
Wickwire
,
A. C.
, and
Debski
,
R. E.
, 2010
, “
Development of a Subject-Specific Model to Predict the Forces in the Knee Ligaments at High Flexion Angles
,” Med. Biol. Eng. Comput.
,
48
(11
), pp. 1077
–1085
.10.1007/s11517-010-0653-728.
Kazemi
,
M.
,
Dabiri
,
Y.
, and
Li
,
L.
, 2013
, “
Recent Advances in Computational Mechanics of the Human Knee Joint
,” Comput. Math. Methods Med.
,
2013
, pp. 1
–27
.10.1155/2013/71842329.
Harris
,
M. D.
,
Cyr
,
A. J.
,
Ali
,
A. A.
,
Fitzpatrick
,
C. K.
,
Rullkoetter
,
P. J.
,
Maletsky
,
L. P.
, and
Shelburne
,
K. B.
, 2016
, “
A Combined Experimental and Computational Approach to Subject-Specific Analysis of Knee Joint Laxity
,” ASME J. Biomech. Eng.
,
138
(8
), p. 0810041
.10.1115/1.403388230.
DesJardins
,
J. D.
,
Walker
,
P. S.
,
Haider
,
H.
, and
Perry
,
J.
, 2000
, “
The Use of a Force-Controlled Dynamic Knee Simulator to Quantify the Mechanical Performance of Total Knee Replacement Designs During Functional Activity
,” J. Biomech.
,
33
(10
), pp. 1231
–1242
.10.1016/S0021-9290(00)00094-431.
Benson
,
L. C.
,
DesJardins
,
J. D.
, and
LaBerge
,
M.
, 2001
, “
Effects of In Vitro Wear of Machined and Molded UHMWPE Tibial Inserts on TKR Kinematics
,” J. Biomed. Mater. Res.
,
58
(5
), pp. 496
–504
.10.1002/jbm.104632.
Bauer
,
L.
,
Kistler
,
M.
,
Steinbrück
,
A.
,
Ingr
,
K.
,
Müller
,
P. E.
,
Jansson
,
V.
,
Schröder
,
C.
, and
Woiczinski
,
M.
, 2021
, “
Different ISO Standards' Wear Kinematic Profiles Change the TKA Inlay Load
,” Appl. Sci.
,
11
(7
), p. 3161
.10.3390/app1107316133.
Kretzer
,
J. P.
,
Jakubowitz
,
E.
,
Sonntag
,
R.
,
Hofmann
,
K.
,
Heisel
,
C.
, and
Thomsen
,
M.
, 2010
, “
Effect of Joint Laxity on Polyethylene Wear in Total Knee Replacement
,” J. Biomech.
,
43
(6
), pp. 1092
–1096
.10.1016/j.jbiomech.2009.12.01634.
Sharifi Kia
,
D.
, and
Willing
,
R.
, 2018
, “
Applying a Hybrid Experimental-Computational Technique to Study Elbow Joint Ligamentous Stabilizers
,” ASME J. Biomech. Eng.
,
140
(6
), p. 061012
.10.1115/1.403967435.
Sidhu
,
S. P.
,
Moslemian
,
A.
,
Yamomo
,
G.
,
Vakili
,
S.
,
Kelly
,
P.
,
Willing
,
R. T.
, and
Lanting
,
B. A.
, 2020
, “
Lateral Subvastus Lateralis Versus Medial Parapatellar Approach for Total Knee Arthroplasty: A Cadaveric Biomechanical Study
,” Knee
,
27
(6
), pp. 1735
–1745
.10.1016/j.knee.2020.09.02236.
Zaylor
,
W.
,
Stulberg
,
B. N.
, and
Halloran
,
J. P.
, 2019
, “
Use of Distraction Loading to Estimate Subject-Specific Knee Ligament Slack Lengths
,” J. Biomech.
,
92
, pp. 1
–5
.10.1016/j.jbiomech.2019.04.04037.
Sakane
,
M.
,
Fox
,
R. J.
,
Glen
,
S. L. W.
,
Livesay
,
A.
,
Li
,
G.
, and
Fu
,
F. H.
, 1997
, “
In Situ Forces in the Anterior Cruciate Ligament and Its Bundles in Response to Anterior Tibial Loads
,” J. Orthop. Res.
,
15
(2
), pp. 285
–293
.10.1002/jor.110015021938.
Willing
,
R. T.
,
Lalone
,
E. A.
,
Shannon
,
H.
,
Johnson
,
J. A.
, and
King
,
G. J. W.
, 2013
, “
Validation of a Finite Element Model of the Human Elbow for Determining Cartilage Contact Mechanics
,” J. Biomech.
,
46
(10
), pp. 1767
–1771
. 10.1016/j.jbiomech.2013.04.00139.
Lalone
,
E. A.
,
Willing
, R. T.
,
Shannon
, H. L.
,
King
, G. J. W.
, and
Johnson
, J. A.
, 2015
, “Accuracy Assessment of 3D Bone Reconstructions Using CT: An Intro Comparison
,” Med. Eng. Phys.
, 37
(8
), pp. 729
–738
.10.1016/j.medengphy.2015.04.01040.
*
Besl
,
P. J.
, and
McKay
,
N. D.
, 1992
, “Method for Registration of 3-D Shapes
,” Proceedings SPIE 1611, Sensor Fusion IV: Control Paradigms and Data Structures
, Boston, MA
, pp. 586
–606
.10.1117/12.5795541.
Athwal
,
K. K.
,
Willinger
,
L.
,
Shinohara
,
S.
,
Ball
,
S.
,
Williams
,
A.
, and
Amis
,
A. A.
, 2020
, “
The Bone Attachments of the Medial Collateral and Posterior Oblique Ligaments Are Defined Anatomically and Radiographically
,” Knee Surg. Sports Traumatol. Arthroscopy
,
28
(12
), pp. 3709
–3719
.10.1007/s00167-020-06139-642.
Bedi
,
A.
,
LaPrade
,
R. F.
, and
Burrus
,
M. T.
, 2018
, “
Radiographic and Anatomic Landmarks of the Major Knee Ligaments
,” JBJS
,
100
(14
), pp. 1241
–1250
.10.2106/JBJS.17.0113543.
Amberg
,
B.
,
Romdhani
,
S.
, and
Vetter
,
T.
, 2007
, “
Optimal Step Nonrigid ICP Algorithms for Surface Registration
,” 2007 IEEE Conference on Computer Vision and Pattern Recognition
,
Minneapolis, MN
, June 17–22
, pp. 1
–8
.10.1109/CVPR.2007.38316544.
Audenaert
,
E. A.
,
van Houcke
,
J.
,
Almeida
,
D. F.
,
Paelinck
,
L.
,
Peiffer
,
M.
,
Steenackers
,
G.
, and
Vandermeulen
,
D.
, 2019
, “
Cascaded Statistical Shape Model Based Segmentation of the Full Lower Limb in CT
,” Comput. Methods Biomech. Biomed. Eng.
,
22
(6
), pp. 644
–657
.10.1080/10255842.2019.157782845.
Qiu
,
D.
, and
Lui
,
L. M.
, 2020
, “
Inconsistent Surface Registration Via Optimization of Mapping Distortions
,” J. Sci. Comput.
,
83
(3
), pp. 1
–31
.10.1007/s10915-020-01246-546.
Dai
,
H.
,
Pears
,
N.
, and
Smith
,
W.
, 2018
, “
Non-Rigid 3D Shape Registration Using an Adaptive Template
,” Proceedings of 18th IEEE European Conference on Computer Vision (ECCV)
, Berlin, Germany
, Sept. 8–14
, pp. 48
–63
.https://openaccess.thecvf.com/content_ECCVW_2018/papers/11132/Dai_Nonrigid_3D_Shape_Registration_using_an_Adaptive_Template_ECCVW_2018_paper.pdf47.
Cheng
,
S.
,
Marras
,
I.
,
Zafeiriou
,
S.
, and
Pantic
,
M.
, 2017
, “
Statistical Non-Rigid ICP Algorithm and Its Application to 3D Face Alignment
,” Image Vis. Comput.
,
58
, pp. 3
–12
.10.1016/j.imavis.2016.10.00748.
Blankevoort
,
L.
,
Kuiper
,
J. H.
,
Huiskes
,
R.
, and
Grootenboer
,
H. J.
, 1991
, “
Articular Contact in a Three-Dimensional Model of the Knee
,” J. Biomech.
,
24
(11
), pp. 1019
–1031
.10.1016/0021-9290(91)90019-J49.
Li
,
G.
,
Suggs
,
J.
, and
Gill
,
T.
, 2002
, “
The Effect of Anterior Cruciate Ligament Injury on Knee Joint Function Under a Simulated Muscle Load: A Three-Dimensional Computational Simulation
,” Ann. Biomed. Eng.
,
30
(5
), pp. 713
–720
.10.1114/1.148421950.
Mommersteeg
,
T. J. A.
,
Blankevoort
,
L.
,
Huiskes
,
R.
,
Kooloos
,
J. G. M.
, and
Kauer
,
J. M. G.
, 1996
, “
Characterization of the Mechanical Behavior of Human Knee Ligaments: A Numerical-Experimental Approach
,” J. Biomech.
,
29
(2
), pp. 151
–160
.10.1016/0021-9290(95)00040-251.
Li
,
G.
,
Gil
,
J.
,
Kanamori
,
A.
, and
Woo
,
S.-Y.
, 1999
, “
A Validated Three-Dimensional Computational Model of a Human Knee Joint
,” ASME J. Biomech. Eng.
, 121(6), pp. 657
–662
.10.1115/1.280087152.
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
.10.2174/187412070120601003353.
Blankevoort
,
L.
,
Huiskes
,
R.
, and
de Lange
,
A.
, 1991
, “
Recruitment of Knee Joint Ligaments
,” ASME J. Biomech. Eng.
, 113
(1
), pp. 94
–103
.10.1115/1.289409054.
Amiri
,
S.
,
Cooke
,
D.
,
Kim
,
I. Y.
, and
Wyss
,
U.
, 2007
, “
Mechanics of the Passive Knee Joint. Part 2: Interaction Between the Ligaments and the Articular Surfaces in Guiding the Joint Motion
,” Proc. Inst. Mech. Eng. H
,
221
(8
), pp. 821
–832
.10.1243/09544119JEIM18155.
Bland
,
J. M.
, and
Altman
,
D.
, 1986
, “
Statistical Methods for Assessing Agreement Between Two Methods of Clinical Measurement
,” Lancet
,
327
(8476
), pp. 307
–310
.10.1016/S0140-6736(86)90837-856.
Koo
,
T. K.
, and
Li
,
M. Y.
, 2016
, “
A Guideline of Selecting and Reporting Intraclass Correlation Coefficients for Reliability Research
,” J. Chiropr. Med..
15
(2
), pp. 155
–163
.10.1016/j.jcm.2016.02.01257.
Ewing
,
J. A.
,
Kaufman
,
M. K.
,
Hutter
,
E. E.
,
Granger
,
J. F.
,
Beal
,
M. D.
,
Piazza
,
S. J.
, and
Siston
,
R. A.
, 2016
, “
Estimating Patient‐Specific Soft‐Tissue Properties in a TKA Knee
,” J. Orthop. Res.
,
34
(3
), pp. 435
–443
.10.1002/jor.2303258.
Guess
,
T. M.
, and
Razu
,
S.
, 2017
, “
Loading of the Medial Meniscus in the ACL Deficient Knee: A Multibody Computational Study
,” Med. Eng. Phys.
,
41
, pp. 26
–34
.10.1016/j.medengphy.2016.12.00659.
Markolf
,
K. L.
,
Mensch
,
J. S.
, and
Amstutz
,
H. C.
, 1976
, “
Stiffness and Laxity of the Knee–the Contributions of the Supporting Structures. A Quantitative In Vitro Study
,” JBJS
,
58
(5
), pp. 583
–594
.10.2106/00004623-197658050-0000160.
Farshidfar
,
S. S.
,
Cadman
,
J.
,
Deng
,
D.
,
Appleyard
,
R.
, and
Dabirrahmani
,
D.
, 2022
, “
The Effect of Modelling Parameters in the Development and Validation of Knee Joint Models on Ligament Mechanics: A Systematic Review
,” PLoS One
,
17
(1
), p. e0262684
.10.1371/journal.pone.026268461.
Blankevoort
,
L.
, and
Huiskes
,
R.
, 1991
, “
Ligament-Bone Interaction in a Three-Dimensional Model of the Knee
,” ASME J. Biomech. Eng.
, 113
(3
), pp. 263
–269
.10.1115/1.289488362.
Hu
,
J.
,
Chen
,
Z.
,
Xin
,
H.
,
Zhang
,
Q.
, and
Jin
,
Z.
, 2018
, “
Musculoskeletal Multibody Dynamics Simulation of the Contact Mechanics and Kinematics of a Natural Knee Joint During a Walking Cycle
,” Proc. Inst. Mech. Eng. H
,
232
(5
), pp. 508
–519
.10.1177/095441191876769563.
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.2003.10.01064.
Moeinzadeh
,
M. H.
, and
Engin
,
A. E.
, 1983
, “
Response of a Two-Dimensional Dynamic Model of the Human Knee to the Externally Applied Forces and Moments
,” J. Biomed. Eng.
,
5
(4
), pp. 281
–291
.10.1016/0141-5425(83)90002-X65.
Moglo
,
K. E.
, and
Shirazi-Adl
,
A.
, 2003
, “
On the Coupling Between Anterior and Posterior Cruciate Ligaments, and Knee Joint Response Under Anterior Femoral Drawer in Flexion: A Finite Element Study
,” Clin. Biomech.
,
18
(8
), pp. 751
–759
.10.1016/S0268-0033(03)00140-266.
Beidokhti
,
H. N.
,
Janssen
,
D.
,
van de Groes
,
S.
, and
Verdonschot
,
N.
, 2018
, “
The Peripheral Soft Tissues Should Not Be Ignored in the Finite Element Models of the Human Knee Joint
,” Med. Biol. Eng. Comput.
,
56
(7
), pp. 1189
–1199
.10.1007/s11517-017-1757-067.
Vakili
,
S.
, 2022
, “
Development of a Combined Experimental-Computational Framework to Study Human Knee Biomechanics
,” Electronic Thesis and Dissertation Repository
. 9056
.https://ir.lib.uwo.ca/etd/905668.
Sekeitto
,
A. R.
, 2021
, “
Kinematics in Total Knee Arthroplasty
,” Electronic Thesis and Dissertation Repository
. 7938
.https://ir.lib.uwo.ca/etd/7938Copyright © 2023 by ASME
You do not currently have access to this content.
