Abstract
Recently, robotic assistive leg exoskeletons have gained popularity because an increased number of people crave for powered devices to run faster and longer or carry heavier loads. However, these powered devices have the potential to impair knee ligaments. This work was aimed to develop an instrumented knee joint via rapid prototyping that measures the displacements of the four major knee ligaments—the anterior cruciate ligament (ACL), posterior crucial ligament (PCL), medial collateral ligament (MCL), and lateral collateral ligament (LCL)—to quantify the strain experienced by these ligaments. The knee model consists of a femur, lateral and medial menisci, and a tibia-fibula, which were printed from three dimensional (3D) imaging scans. Nonstretchable cords served as main fiber bundles of the ligaments with their desired stiffnesses provided by springs. The displacement of each cord was obtained via a rotary encoder mechanism, and the leg flexion angle was acquired via a closed-loop four-bar linkage of a diamond shape. The displacements were corroborated by published data, demonstrating the profiles of the displacement curves agreed with known results. The paper shows the feasibility of developing a subject-specific knee joint via rapid prototyping that is capable of quantifying the ligament strain via rapid prototyping.
Issue Section:
Research Papers
References
1.
Morrison
,
J. B.
, 1970
, “
The Mechanics of the Knee Joint in Relation to Normal Walking
,” J. Biomech.
,
3
(1
), pp. 51
–61
.10.1016/0021-9290(70)90050-32.
Robinson
,
J. R.
,
Bull
,
A. M. J.
, and
Amis
,
A. A.
, 2005
, “
Structural Properties of the Medial Collateral Ligament Complex of the Human Knee
,” J. Biomech.
,
38
(5
), pp. 1067
–1074
.10.1016/j.jbiomech.2004.05.0343.
Butler
,
D. L.
,
Grood
,
E. S.
,
Noyes
,
F. R.
,
Zernicke
,
R. F.
, and
Brackett
,
K.
, 1984
, “
Effects of Structure and Strain Measurement Technique on the Material Properties of Young Human Tendons and Fascia
,” J. Biomech.
,
17
(8
), pp. 579
–596
.10.1016/0021-9290(84)90090-34.
Withrow
,
T. J.
,
Huston
,
L. J.
,
Wojtys
,
E. M.
, and
Ashton-Miller
,
J. A.
, 2006
, “
The Relationship Between Quadriceps Muscle Force, Knee Flexion, and Anterior Cruciate Ligament Strain in an in Vitro Simulated Jump Landing
,” Am. J. Sports Med.
,
34
(2
), pp. 269
–274
.10.1177/03635465052809065.
Arms
,
S.
,
Boyle
,
J.
,
Johnson
,
R.
, and
Pope
,
M.
, 1983
, “
Strain Measurement in the Medial Collateral Ligament of the Human Knee: An Autopsy Study
,” J. Biomech.
,
16
(7
), pp. 491
–496
.10.1016/0021-9290(83)90063-56.
Singerman
,
R.
,
Dean
,
J. C.
,
Pagan
,
H. D.
, and
Goldberg
,
V. M.
, 1996
, “
Decreased Posterior Tibial Slope Increases Strain in the Posterior Cruciate Ligament Following Total Knee Arthroplasty
,” J. Arthroplasty
,
11
(1
), pp. 99
–103
.10.1016/S0883-5403(96)80167-77.
Arms
,
S. W.
,
Pope
,
M. H.
,
Johnson
,
R. J.
,
Fischer
,
R. A.
,
Arvidsson
,
I.
, and
Eriksson
,
E.
, 1984
, “
The Biomechanics of Anterior Cruciate Ligament Rehabilitation and Reconstruction
,” Am. J. Sports Med.
,
12
(1
), pp. 8
–18
.10.1177/0363546584012001028.
Fleming
,
B.
,
Beynnon
,
B.
,
Howe
,
J.
,
McLeod
,
W.
, and
Pope
,
M.
, 1992
, “
Effect of Tension and Placement of a Prosthetic Anterior Cruciate Ligament on the Anteroposterior Laxity of the Knee
,” J. Orthop. Res.
,
10
(2
), pp. 177
–186
.10.1002/jor.11001002049.
Ren
,
L.
,
Song
,
G.
,
Conditt
,
M.
,
Noble
,
P. C.
, and
Li
,
H.
, 2007
, “
Fiber Bragg Grating Displacement Sensor for Movement Measurement of Tendons and Ligaments
,” Appl. Opt.
,
46
(28
), pp. 6867
–6871
.10.1364/AO.46.00686710.
Phatak
,
N. S.
,
Sun
,
Q.
,
Kim
,
S.-E.
,
Parker
,
D. L.
,
Kent Sanders
,
R.
,
Veress
,
A. I.
,
Ellis
,
B. J.
, and
Weiss
,
J. A.
, 2007
, “
Noninvasive Determination of Ligament Strain With Deformable Image Registration
,” Ann. Biomed. Eng.
,
35
(7
), pp. 1175
–1187
.10.1007/s10439-007-9287-911.
Fleming
,
B. C.
,
Renstrom
,
P. A.
,
Beynnon
,
B. D.
,
Engstrom
,
B.
,
Peura
,
G. D.
,
Badger
,
G. J.
, and
Johnson
,
R. J.
, 2001
, “
The Effect of Weightbearing and External Loading on Anterior Cruciate Ligament Strain
,” J. Biomech.
,
34
(2
), pp. 163
–170
.10.1016/S0021-9290(00)00154-812.
Fleming
,
B. C.
,
Beynnon
,
B. D.
,
Renstrom
,
P. A.
,
Peura
,
G. D.
,
Nichols
,
C. E.
, and
Johnson
,
R. J.
, 1998
, “
The Strain Behavior of the Anterior Cruciate Ligament During Bicycling
,” Am. J. Sports Med.
,
26
(1
), pp. 109
–118
.10.1177/0363546598026001030113.
Heijne
,
A.
,
Fleming
,
B.
,
Renstrom
,
P.
,
Peura
,
G.
,
Beynnon
,
B.
, and
Werner
,
S.
, 2004
, “
Strain on the Anterior Cruciate Ligament During Closed Kinetic Chain Exercises
,” Med. Sci. Sports Exercise
,
36
(9
), pp. 935
–941
.10.1249/01.MSS.0000128185.55587.A314.
Beynnon
,
B. D.
,
Pope
,
M. H.
,
Wertheimer
,
C. M.
,
Johnson
,
R. J.
,
Fleming
,
B. C.
,
Nichols
,
C. E.
, and
Howe
,
J. G.
, 1992
, “
The Effect of Functional Knee-Braces on Strain on the Anterior Cruciate Ligament In Vivo
,” J. Bone Jt. Surg. Am.
,
74
(9
), pp. 1298
–1312
.10.2106/00004623-199274090-0000315.
Good
,
L.
, and
Gillquist
,
J.
, 1993
, “
The Value of Intraoperative Isometry Measurements in Anterior Cruciate Ligament Reconstruction: An In Vivo Correlation Between Substitute Tension and Length Change
,” Arthroscopy
,
9
(5
), pp. 525
–532
.10.1016/S0749-8063(05)80399-816.
Som
,
M. H. M.
,
Nagamune
,
K.
,
Kamiya
,
T.
,
Kawaguchi
,
S.
,
Takayama
,
K.
,
Matsumoto
,
T.
,
Kuroda
,
R.
, and
Kurosaka
,
M.
, 2014
, “
A Development of Force Distribution Measurement System With High Resolution for Total Knee Arthroplasty
,” J. Adv. Comput. Intell. Intell. Inf.
,
18
(2
), pp. 213
–220
.10.20965/jaciii.2014.p021317.
Nusser
,
M.
,
Fehle
,
A.
, and
Senner
,
V.
, 2012
, “
Preliminary Studies for Validation of a Novel Sensor Fiber to Measure Forces in Artificial Knee Ligaments
,” Procedia Eng.
,
34
, pp. 236
–241
.10.1016/j.proeng.2012.04.19118.
Hattori
,
K.
,
Mori
,
K.
,
Habata
,
T.
,
Takakura
,
Y.
, and
Ikeuchi
,
K.
, 2003
, “
Measurement of the Mechanical Condition of Articular Cartilage With an Ultrasonic Probe: Quantitative Evaluation Using Wavelet Transformation
,” Clin. Biomech.
,
18
(6
), pp. 553
–557
.10.1016/S0268-0033(03)00048-219.
Krishna
,
K. V.
, and
Vidyasagar
,
J. V. S.
, “
Biomechanical Analysis of Anterior Cruciate Ligament Graft Substitutes
,” Proceedings of the First Regional Conference, IEEE Engineering in Medicine and Biology Society and 14th Conference of the Biomedical Engineering Society of India, An International Meet
, New Delhi, India, Feb. 15–18, pp. SPC3
–SPC4
.10.1109/RCEMBS.1995.53306120.
Ravary
,
B.
,
Pourcelot
,
P.
,
Bortolussi
,
C.
,
Konieczka
,
S.
, and
Crevier-Denoix
,
N.
, 2004
, “
Strain and Force Transducers Used in Human and Veterinary Tendon and Ligament Biomechanical Studies
,” Clin. Biomech.
,
19
(5
), pp. 433
–447
.10.1016/j.clinbiomech.2004.01.00821.
Moeinzadeh
,
M. H.
,
Engin
,
A. E.
, and
Akkas
,
N.
, 1983
, “
Two-Dimensional Dynamic Modelling of Human Knee Joint
,” J. Biomech.
,
16
(4
), pp. 253
–264
.10.1016/0021-9290(83)90133-122.
Limbert
,
G.
,
Taylor
,
M.
, and
Middleton
,
J.
, 2004
, “
Three-Dimensional Finite Element Modelling of the Human ACL: Simulation of Passive Knee Flexion With a Stressed and Stress-Free ACL
,” J. Biomech.
,
37
(11
), pp. 1723
–1731
.10.1016/j.jbiomech.2004.01.03023.
Guess
,
T. M.
, and
Maletsky
,
L. P.
, 2005
, “
Computational Modelling of a Total Knee Prosthetic Loaded in a Dynamic Knee Simulator
,” Med. Eng. Phys.
,
27
(5
), pp. 357
–367
.10.1016/j.medengphy.2004.11.00324.
Xu
,
H.
,
Bloswick
,
D.
, and
Merryweather
,
A.
, 2015
, “
An Improved Opensim Gait Model With Multiple Degrees of Freedom Knee Joint and Knee Ligaments
,” Comput. Methods Biomech. Biomed. Eng.
,
18
(11
), pp. 1217
–1224
.10.1080/10255842.2014.88968925.
Sikidar
,
A.
, and
Kalyanasundaram
,
D.
, 2019
, “
An Open-Source Plugin for Opensim® to Model the Non-Linear Behaviour of Dense Connective Tissues of the Human Knee at Variable Strain Rates
,” Comput. Biol. Med.
,
110
, pp. 186
–195
.10.1016/j.compbiomed.2019.05.02126.
Akalan
,
N. E.
,
Özkan
,
M.
, and
Temelli
,
Y.
, 2008
, “
Three-Dimensional Knee Model: Constrained by Isometric Ligament Bundles and Experimentally Obtained Tibio-Femoral Contacts
,” J. Biomech.
,
41
(4
), pp. 890
–896
.10.1016/j.jbiomech.2007.10.02127.
Kang
,
K. T.
,
Koh
,
Y. G.
,
Jung
,
M.
,
Nam
,
J. H.
,
Son
,
J.
,
Lee
,
Y. H.
,
Kim
,
S. J.
, and
Kim
,
S. H.
, 2017
, “
The Effects of Posterior Cruciate Ligament Deficiency on Posterolateral Corner Structures Under Gait- and Squat-Loading Conditions: A Computational Knee Model
,” Bone Jt. Res.
,
6
(1
), pp. 31
–42
.10.1302/2046-3758.61.BJR-2016-0184.R128.
Shen
,
Z.
,
Sam
,
S.
,
Allison
,
G.
, and
Cui
,
L.
, 2017
, “
A Simulation-Based Study on a Clutch-Spring Mechanism Reducing Human Walking Metabolic Cost
,” Int. J. Mech. Eng. Rob. Res.
,
6
(6
), pp. 55
–60
.29.
He
,
J.
,
Li
,
D.
,
Lu
,
B.
,
Wang
,
Z.
, and
Zhang
,
T.
, 2006
, “
Custom Fabrication of a Composite Hemi-Knee Joint Based on Rapid Prototyping
,” Rapid Prototyping J.
,
12
(4
), pp. 198
–205
.10.1108/1355254061068270530.
Szojka
,
A.
,
Lalh
,
K.
,
Andrews
,
S. H. J.
,
Jomha
,
N. M.
,
Osswald
,
M.
, and
Adesida
,
A. B.
, 2017
, “
Biomimetic 3D Printed Scaffolds for Meniscus Tissue Engineering
,” Bioprinting
,
8
, pp. 1
–7
.10.1016/j.bprint.2017.08.00131.
Beckmann
,
J.
,
Steinert
,
A.
,
Zilkens
,
C.
,
Zeh
,
A.
,
Schnurr
,
C.
,
Schmitt-Sody
,
M.
, and
Gebauer
,
M.
, 2016
, “
Partial Replacement of the Knee Joint With Patient-Specific Instruments and Implants (ConforMIS iUni, iDuo)
,” Orthopade
,
45
(4
), pp. 322
–330
.10.1007/s00132-016-3237-x32.
Park
,
J. H.
,
Lee
,
Y.
,
Shon
,
O.-J.
,
Shon
,
H. C.
, and
Kim
,
J. W.
, 2016
, “
Surgical Tips of Intramedullary Nailing in Severely Bowed Femurs in Atypical Femur Fractures: Simulation With 3D Printed Model
,” Injury
,
47
(6
), pp. 1318
–1324
.10.1016/j.injury.2016.02.02633.
Woo
,
S. L. Y.
,
Abramowitch
,
S. D.
,
Kilger
,
R.
, and
Liang
,
R.
, 2006
, “
Biomechanics of Knee Ligaments: Injury, Healing, and Repair
,” J. Biomech.
,
39
(1
), pp. 1
–20
.10.1016/j.jbiomech.2004.10.02534.
Petersen
,
W.
, and
Zantop
,
T.
, 2007
, “
Anatomy of the Anterior Cruciate Ligament With Regard to Its Two Bundles
,” Clin. Orthop. Relat. Res.
,
454
, pp. 35
–47
.10.1097/BLO.0b013e31802b4a5935.
Race
,
A.
, and
Amis
,
A. A.
, 1994
, “
The Mechanical Properties of the Two Bundles of the Human Posterior Cruciate Ligament
,” J. Biomech.
,
27
(1
), pp. 13
–24
.10.1016/0021-9290(94)90028-036.
Liu
,
F.
,
Gadikota
,
H. R.
,
Kozánek
,
M.
,
Hosseini
,
A.
,
Yue
,
B.
,
Gill
,
T. J.
,
Rubash
,
H. E.
, and
Li
,
G.
, 2011
, “
In Vivo Length Patterns of the Medial Collateral Ligament During the Stance Phase of Gait
,” Knee Surg., Sports Traumatol., Arthroscopy
,
19
(5
), pp. 719
–727
.10.1007/s00167-010-1336-537.
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)00040-238.
Fu
,
F. H.
,
Harner
,
C. D.
,
Johnson
,
D. L.
,
Miller
,
M. D.
, and
Woo
,
S. L.-Y.
, 1993
, “
Biomechanics of Knee Ligaments: Basic Concepts and Clinical Application
,” J. Bone Jt. Surg.
,
75
(11
), pp. 1716
–1727
.10.2106/00004623-199311000-0001839.
Mesfar
,
W.
, and
Shirazi-Adl
,
A.
, 2005
, “
Biomechanics of the Knee Joint in Flexion Under Various Quadriceps Forces
,” Knee
,
12
(6
), pp. 424
–434
.10.1016/j.knee.2005.03.00440.
Edwards
,
R. G.
,
Lafferty
,
J. F.
, and
Lange
,
K. O.
, 1970
, “
Ligament Strain in the Human Knee Joint
,” J. Basic Eng.
,
92
(1
), pp. 131
–136
.10.1115/1.342492041.
Kim
,
S.
, 1998
, “
Three-Dimensional Dynamic Model of the Knee
,” KSME Int. J.
,
12
(6
), p. 1041
.10.1007/BF0294257842.
Park
,
S. E.
,
DeFrate
,
L. E.
,
Suggs
,
J. F.
,
Gill
,
T. J.
,
Rubash
,
H. E.
, and
Li
,
G.
, 2005
, “
The Change in Length of the Medial and Lateral Collateral Ligaments During In Vivo Knee Flexion
,” Knee
,
12
(5
), pp. 377
–382
.10.1016/j.knee.2004.12.01143.
Lee
,
Y. S.
,
Lee
,
S.-W.
,
Nam
,
S. W.
,
Oh
,
W. S.
,
Sim
,
J. A.
,
Kwak
,
J. H.
, and
Lee
,
B. K.
, 2012
, “
Analysis of Tunnel Widening After Double-Bundle ACL Reconstruction
,” Knee Surg., Sports Traumatol., Arthroscopy
,
20
(11
), pp. 2243
–2250
.10.1007/s00167-011-1874-544.
Harner
,
C. D.
,
Xerogeanes
,
J. W.
,
Livesay
,
G. A.
,
Carlin
,
G. J.
,
Smith
,
B. A.
,
Kusayama
,
T.
,
Kashiwaguchi
,
S.
, and
Woo
,
S. L.
, 1995
, “
The Human Posterior Cruciate Ligament Complex: An Interdisciplinary Study. Ligament Morphology and Biomechanical Evaluation
,” Am. J. Sports Med.
,
23
(6
), pp. 736
–745
.10.1177/03635465950230061745.
LaPrade
,
R. F.
,
Engebretsen
,
A. H.
,
Ly
,
T. V.
,
Johansen
,
S.
,
Wentorf
,
F. A.
, and
Engebretsen
,
L.
, 2007
, “
The Anatomy of the Medial Part of the Knee
,” J. Bone Jt. Surg.
,
89
(9
), pp. 2000
–2010
.10.2106/JBJS.F.0117646.
LaPrade
,
R. F.
,
Ly
,
T. V.
,
Wentorf
,
F. A.
, and
Engebretsen
,
L.
, 2003
, “
The Posterolateral Attachments of the Knee: A Qualitative and Quantitative Morphologic Analysis of the Fibular Collateral Ligament, Popliteus Tendon, Popliteofibular Ligament, and Lateral Gastrocnemius Tendon
,” Am. J. Sports Med.
,
31
(6
), pp. 854
–860
.10.1177/03635465030310062101Copyright © 2021 by ASME
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