multimodal and multiscale modeling of the human knee...

MultiScaleHuman

Marie Curie Research training network

Andra Chincisan

MIRALab, University of Geneva

[email protected]

Supervisor: Prof. Nadia Magnenat Thalmann

Multimodal and multiscale modeling

of the human knee articulation

IMI Research Seminar17 June 2014

1MIRALab, University of Genevawww.miralab.ch

mailto:[email protected]

MultiScaleHuman


Introduction

Background

• Knee joint

– largest joint

– very complex

– two articulations

• Musculoskeletal disorders (MSDs)

– most widespread occupational-related illness in the EU

• Computational modeling: multi-scale biological modalities



www.fotolibra.com

Molecular Cellular Tissue Organ Behavior

MultiScaleHuman


Motivation

Computational modeling – in silico medicine

• Advantage

– Noninvasive technique

– Understand complex interactions

• Role:

– Aid in diagnosis

– Test the effectiveness of different therapies

• Ligaments:

– instability in the knee -> ligament surgery (94%)

– preinjury activity level -> ACL reconstruction (50-60%)



[1] S.C. Sibole, A. Erdemir, “Chondrocyte Deformations as a Function of Tibiofemoral Joint Loading Predicted by a Generalized High-Throughput Pipeline of Multi-Scale

Simulations”, PlosOne, 2012

[2] S. Lyman et al.: “Epidemiology of Anterior Cruciate Ligament Reconstruction Trends, Readmissions, and Subsequent Knee Surgery.” JBJS, 2009

[3] C.L. Ardern et al.: “Return-to-sport outcomes at 2 to 7 years after anterior cruciate ligament reconstruction surgery”. Am J Sports Med 40, 2012

[1]

[2]

[3]

MultiScaleHuman


State of the Art



Knee joint

[1] Pena et al., A three-dimensional finite element analysis of the combined behavior of ligaments and menisci in the healthy human knee joint, 2006

[2] Shiem et al., Simulating In-Vivo Knee Kinetics and Kinematics of Tibio-Femoral Articulation with a Subject-Specific Finite Element Model, 2010

[3] Erdemier er at., Chondrocyte Deformations as a Function of Tibiofemoral Joint Loading Predicted by a Generalized High-Throughput Pipeline of Multi-Scale Simulations

Open Knee, 2012; [4] Weiss et al., Three-dimensional finite element modeling of ligaments: Technical aspects , 2007

[5] C. Dopico-Gonzalez et al. , Parametric Study On The Effect Of Modelling Meniscal Attachment, 2012

[1] [2]

[3] [4]

[5]

Research question

Computational models

• complex anatomy

• complex scenarios

• multiple individuals

– Soft tissue OpenKnee

– Gait simulation Ligament study

– More individuals

MultiScaleHuman


Method

• Overview



Medical images Computational model

Finite Element simulation

In vitro data / Model validation

Kinetics and Kinematics

MultiScaleHuman


Computational model

Anatomical knee joint model

• Model reconstruction from magnetic resonance images (MRIs)



3D anatomical model

Bones

Soft tissue

MRI data

3T scanner

High resolution

knee

Segmentation

Automatic, manual

Medical expert validation

MultiScaleHuman


Computational model

Mesh

– Volumetric

– Tetrahedral



Fiber orientation

– Laplace equation

– Attachments position

Reconstruc

ted modelMeshing

Volumetric

mesh

Fiber

Orientation

http://improvesmylife.com/

MultiScaleHuman


Computational model

Biomechanical model

– mechanical behavior

• Material properties

– boundary conditions

– center of rotation - kinematics



[1] D.L. Miranda et al.: “Automatic Determination of Anatomical Coordinate Systems for Three-Dimensional Bone Models of the Isolated Human Knee ”, J Biomech, 2010

• Forces: Fx, Fy, Fz

• Rotations: Rx, Ry, Rz

MultiScaleHuman


Motion data

• Kinematics and Kinetics

– Forces

– Rotation angles

– neuromuscular simulation

– 3D kinematics



Rx Ry Rz

Forces, rotation degrees

MultiScaleHuman


Motion data

• 3D kinematics

– XYZ directions data vs flexion angle

• xyz: rotations and translations

• multiple center of rotations

– Specimen experiments

– Accuracy



http://secondsightdigital.com

MultiScaleHuman


Finite element analysis

• FE software packages:

– Abaqus, Ansys, FEBio, …



Undeformed Deformed

Input

Boundary conditions

• Prescribed displacement

• Prescribed forces

Output

• Stress, strain,

displacement … at

each point P’(x,y)

[1] Dr. H. Jerry Qi, Finite Element Analysis course, http://www.colorado.edu/

[1]

Numerical method

Domain subdivision

FE model• Geometry – mesh

• Material properties

• Boundary conditions

• Analysis

MultiScaleHuman


Finite element

• Physically based simulation– FEBio package [1]

– Non linear finite element analysis - large deformation



[1] S.A. Maas et al.: FEBio: Finite Elements for Biomechanics. Journal of Biomechanical Engineering, 2012

[2] M.D. Harris et al. : “Finite Element Prediction of Cartilage Contact Stresses in Normal Human Hips”, JOR, 2012

Finite element analysis using FEBIo: examples [1] Biomedical application using FEBio [2]

MultiScaleHuman


Validation

• In vitro measurements

• Femur

– fixed

• Tibia

– constrained in rotation

– unconstrained

• medial/lateral

• superior/inferior translation

• Anterior / posterior displacement vs

anterior / posterior reaction force of

100N



LBB, Hannover, Germany

MultiScaleHuman


Case study – Knee ligaments assessment

• Ligament injuries

– most common causes of

• musculoskeletal joint pain

• disability



NFL statistics (USA)

Increasing injuries by year and play type

http://bigcomputing.blogspot.ch/

MultiScaleHuman


Aim



3D FE model = MR + in vitro - evaluate the

mechanical function

Current diagnosis – Anterior Posterior drawer test

http://www.clinicaladvisor.com/

http://www.usatoday.com/

MultiScaleHuman


Case study - Results

• Scenarios

– Flexion 45°

– Internal rotation 15°

– External rotation 15°

• Fiber strain [1]



Fiber strain/

Ligament

Flexion

[MPa]

Int Rot

[MPa]

Ext Rot

[MPa]

ACL 0.22 0.01 0.03

PCL 0.18 0.02 0.03

MCL 0.31 0.10 0.10

LCL 0.06 0.09 0.06

[1] Chincisan et al., Subject-Specific Assessment of Loading Variation in the Knee Ligaments with a View to Preoperative Planning, IEEE BHI EMBS, 2014

[2] Phinit et al., MCL Injuries of the Knee: Current Concepts Review, 2006

clinical results

correlation

MultiScaleHuman


Computational modeling

• Mechanical analysis of the ligament system

– mechanical loading under varying rotational motions

• Map the mechanical stress

– the range of motion that imposes the most risk

• knee destabilization and injury

• In vitro measurements and FE modeling - can be a useful

tool for

– surgical planning

– repairing and rehabilitation strategies



MultiScaleHuman


Conclusions

Computational model :

MRI + in vitro data + FE simulation

• Benefits

– Noninvasive technique

– Understand complex interactions

• Applications

– Knee replacement: patient specific FE model of the prosthesis

– Preoperative planning

– Repairing and rehabilitation strategies

– Aid in diagnosis

– Test the effectiveness of different therapies



MultiScaleHuman


Future work

• Multiscale modeling

– cellular and molecular levels

– articular cartilage

– osteoarthritis (OA): most common form of the arthritis

• 9.6% of men, 18% of women (>60 years)

• many factors + signaling pathways

– tissue engineering


19MIRALab, University of Geneva www.miralab.ch

Tissue Organ BehaviorMolecular Cellular

UMINHO, Braga, Portugal

MultiScaleHuman


Acknowledgments

20IMI Research Seminar

17 June 2014MIRALab, University of Geneva www.miralab.ch

Thank you!

Grant number 289897

Prof. Nadia Magnenat Thalmann

EU Project MultiScaleHuman Grant number 289897

multimodal and multiscale modeling of the human knee...

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