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Clin Biomech (Bristol, Avon). 2019 Aug 9. pii: S0268-0033(18)31029-5. doi: 10.1016/j.clinbiomech.2019.08.004. [Epub ahead of print]

Identification of locations susceptible to osteoarthritis in patients with anterior cruciate ligament reconstruction: Combining knee joint computational modelling with follow-up T and T2 imaging.

Author information

1
Department of Applied Physics, University of Eastern Finland, POB 1627, FI-70211 Kuopio, Finland. Electronic address: paul.bolcos@uef.fi.
2
Department of Applied Physics, University of Eastern Finland, POB 1627, FI-70211 Kuopio, Finland.
3
Department of Radiology and Biomedical Imaging, University of California San Francisco, CA-94158 San Francisco, United States of America.
4
Department of Biomedical Engineering, Cleveland Clinic, OH-44195 Cleveland, United States of America.
5
Department of Clinical Radiology, Kuopio University Hospital, POB 100, FI-70029 KUH Kuopio, Finland.
6
Department of Applied Physics, University of Eastern Finland, POB 1627, FI-70211 Kuopio, Finland; Research Unit of Medical Imaging, Physics and Technology, University of Oulu, POB 8000, FI-90014 Oulu, Finland.
7
Department of Applied Physics, University of Eastern Finland, POB 1627, FI-70211 Kuopio, Finland; Diagnostic Imaging Centre, Kuopio University Hospital, POB 100, FI-70029 KUH Kuopio, Finland; School of Information Technology and Electrical Engineering, The University of Queensland, Brisbane, QLD 4072, Australia.
8
Department of Applied Physics, University of Eastern Finland, POB 1627, FI-70211 Kuopio, Finland; Diagnostic Imaging Centre, Kuopio University Hospital, POB 100, FI-70029 KUH Kuopio, Finland. Electronic address: rami.korhonen@uef.fi.

Abstract

BACKGROUND:

Finite element modelling can be used to evaluate altered loading conditions and failure locations in knee joint tissues. One limitation of this modelling approach has been experimental comparison. The aims of this proof-of-concept study were: 1) identify areas susceptible to osteoarthritis progression in anterior cruciate ligament reconstructed patients using finite element modelling; 2) compare the identified areas against changes in T2 and T values between 1-year and 3-year follow-up timepoints.

METHODS:

Two patient-specific finite element models of knee joints with anterior cruciate ligament reconstruction were created. The knee geometry was based on clinical magnetic resonance imaging and joint loading was obtained via motion capture. We evaluated biomechanical parameters linked with cartilage degeneration and compared the identified risk areas against T2 and T maps.

FINDINGS:

The risk areas identified by the finite element models matched the follow-up magnetic resonance imaging findings. For Patient 1, excessive values of maximum principal stresses and shear strains were observed in the posterior side of the lateral tibial and femoral cartilage. For Patient 2, high values of maximum principal stresses and shear strains of cartilage were observed in the posterior side of the medial joint compartment. For both patients, increased T2 and T values between the follow-up times were observed in the same areas.

INTERPRETATION:

Finite element models with patient-specific geometries and motions and relatively simple material models of tissues were able to identify areas susceptible to post-traumatic knee osteoarthritis. We suggest that the methodology presented here may be applied in large cohort studies.

KEYWORDS:

Articular cartilage; Finite-element analysis; Gait; Knee joint; Magnetic resonance imaging

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