title: Evaluation of a subject-specific musculoskeletal modelling framework for load prediction in total knee arthroplasty.
abstract: Musculoskeletal (MSK) multibody dynamics (MBD) models have been used to predict in vivo biomechanics in total knee arthroplasty (TKA). However, a full lower limb MSK MBD modelling approach for TKA that combines subject-specific skeletal and prosthetic knee geometry has not yet been applied and evaluated over a range of patients. This study evaluated a subject-specific MSK MBD modelling framework for TKA using force-dependent kinematics (FDK) and applied it to predict knee contact forces during gait trials for three patients implanted with instrumented prosthetic knees. The prediction accuracy was quantified in terms of the mean absolute deviation (MAD), root mean square error (RMSE), Pearson correlation coefficient (ρ), and Sprague and Geers metrics of magnitude (M), phase (P) and combined error (C). Generally good agreements were found between the predictions and the experimental measurements from all patients for the medial contact forces (150 N < MAD <178 N, 174 N < RMSE < 224 N, 0.87 < ρ < 0.95, -0.04 < M < 0.20, 0.06 < P < 0.09, 0.08 < C < 0.22) and the lateral contact force (113 N < MAD <195 N, 131 N < RMSE < 240 N, 0.41 < ρ < 0.82, -0.25 < M < 0.34, 0.08 < P < 0.22, 0.13 < C < 0.36). The results suggest that the subject-specific MSK MBD modelling framework for TKA using FDK has potential as a powerful tool for investigating the functional outcomes of knee implants.
authors.affiliation: State Key Laboratory for Manufacturing System Engineering, School of Mechanical Engineering, Xi'an Jiaotong University, 710054 Xi'an, Shaanxi, China.
authors.forename: Zhenxian
authors.initials: Z
authors.lastname: Chen
authors.affiliation: Department of Arthroplasty Surgery, the Second Affiliated Hospital of Inner Mongolia Medical University, 010030 Hohhot, Inner Mongolia, China.
authors.forename: Zhifeng
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: State Key Laboratory for Manufacturing System Engineering, School of Mechanical Engineering, Xi'an Jiaotong University, 710054 Xi'an, Shaanxi, China. Electronic address: menlwang@mail.xjtu.edu.cn.
authors.forename: Ling
authors.initials: L
authors.lastname: Wang
authors.affiliation: State Key Laboratory for Manufacturing System Engineering, School of Mechanical Engineering, Xi'an Jiaotong University, 710054 Xi'an, Shaanxi, China.
authors.forename: Dichen
authors.initials: D
authors.lastname: Li
authors.affiliation: Department of Orthopedics, the Affiliated Hospital of Inner Mongolia Medical University, 010050 Hohhot, Inner Mongolia, China.
authors.forename: Yuanzhi
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: State Key Laboratory for Manufacturing System Engineering, School of Mechanical Engineering, Xi'an Jiaotong University, 710054 Xi'an, Shaanxi, China; Institute of Medical and Biological Engineering, School of Mechanical Engineering, University of Leeds, Leeds LS2 9JT, UK.
authors.forename: Zhongmin
authors.initials: Z
authors.lastname: Jin
mesh_terms: D019645:Arthroplasty, Replacement, Knee; D001696:Biomechanical Phenomena; D001842:Bone and Bones / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D009132:Muscles / Q000502:physiology*; D066230:Patient-Specific Modeling; D016474:Weight-Bearing
keywords: Contact force; Force-dependent kinematics; Multibody dynamics; Subject-specific musculoskeletal modelling; Total knee arthroplasty