title: Femur, tibia and fibula bone templates to estimate subject-specific knee ligament attachment site locations.
abstract: In-vivo estimates of the positions of knee ligament attachment sites are crucial for subject-specific knee modelling. The present study provides template digital models of femur, tibia and fibula that embed the positions of centroids of the origins and insertions of cruciate and collateral ligaments, along with information on their dispersion related to inter-individual variability. By using a shape transformation procedure of choice, these templates can be made to match anatomical information measured on a subject under analysis. Generic bone digital models of the femur, tibia and fibula were first chosen as bone templates. Ligament attachment areas were accurately identified through dissection on the bones of 11 knee specimens, and marked using radio opaque paint. Digital models of these bones embedding the positions of the centroids of the identified ligament attachment areas were thereafter obtained using medical imaging techniques. These centroids were mapped onto the relevant bone template, thus obtaining a cloud of 11 points for each attachment site, and descriptive statistics of the position of these points were thereafter determined. Dispersion of these positions, essentially due to inter-individual variability, was below 6mm for all attachment areas. The accuracy with which subject-specific ligament attachment site positions may be estimated using the bone template models provided in this paper was also assessed using the above-mentioned 11 specimens data set, and a leave-one-out cross validation approach. Average accuracy was found to be 3.3±1.5mm and 5.8±2.9mm for femoral and tibial/fibular attachment sites, respectively.
authors.affiliation: Arts et Metiers ParisTech, Laboratoire de Biomécanique (LBM)/Institut de Biomécanique Humaine Georges Charpak, Paris, France. Electronic address: helene.pillet@ensam.eu.
authors.forename: Hélène
authors.initials: H
authors.lastname: Pillet
authors.affiliation: Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System (BOHNES), Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Bergamini
authors.affiliation: Arts et Metiers ParisTech, Laboratoire de Biomécanique (LBM)/Institut de Biomécanique Humaine Georges Charpak, Paris, France; Département d'Orthopédie et Traumatologie, INSERM U1075 COMETE «Mobilité: Attention, Orientation & Chronobiologie», Université de Caen, France.
authors.forename: Goulven
authors.initials: G
authors.lastname: Rochcongar
authors.affiliation: Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System (BOHNES), Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Camomilla
authors.affiliation: Arts et Metiers ParisTech, Laboratoire de Biomécanique (LBM)/Institut de Biomécanique Humaine Georges Charpak, Paris, France; Service de Chirurgie Orthopédique et Traumatologique, Hôpital Avicenne - Université Paris 13, Sorbonne Paris Cité, Bobigny, France.
authors.forename: Patricia
authors.initials: P
authors.lastname: Thoreux
authors.affiliation: Arts et Metiers ParisTech, Laboratoire de Biomécanique (LBM)/Institut de Biomécanique Humaine Georges Charpak, Paris, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Rouch
authors.affiliation: Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System (BOHNES), Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy.
authors.forename: Aurelio
authors.initials: A
authors.lastname: Cappozzo
authors.affiliation: Arts et Metiers ParisTech, Laboratoire de Biomécanique (LBM)/Institut de Biomécanique Humaine Georges Charpak, Paris, France.
authors.forename: Wafa
authors.initials: W
authors.lastname: Skalli
mesh_terms: D000368:Aged; D017885:Collateral Ligaments / Q000502:physiology*; D005269:Femur / Q000502:physiology*; D005360:Fibula / Q000502:physiology*; D006801:Humans; D007719:Knee Joint / Q000502:physiology*; D008875:Middle Aged; D008954:Models, Biological; D013977:Tibia / Q000502:physiology*
keywords: Bone templates; Generic model; Knee ligaments; Ligament footprint; Scaling