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Biomedical Engineering / Biomedizinische Technik

Joint Journal of the German Society for Biomedical Engineering in VDE and the Austrian and Swiss Societies for Biomedical Engineering and the German Society of Biomaterials

Editor-in-Chief: Dössel, Olaf

Editorial Board: Augat, Peter / Habibović, Pamela / Haueisen, Jens / Jahnen-Dechent, Wilhelm / Jockenhoevel, Stefan / Knaup-Gregori, Petra / Lenarz, Thomas / Leonhardt, Steffen / Plank, Gernot / Radermacher, Klaus M. / Schkommodau, Erik / Stieglitz, Thomas / Boenick, Ulrich / Jaramaz, Branislav / Kraft, Marc / Lenthe, Harry / Lo, Benny / Mainardi, Luca / Micera, Silvestro / Penzel, Thomas / Robitzki, Andrea A. / Schaeffter, Tobias / Snedeker, Jess G. / Sörnmo, Leif / Sugano, Nobuhiko / Werner, Jürgen /

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Volume 63, Issue 6

Issues

Volume 57 (2012)

Validation of a novel biomechanical test bench for the knee joint with six degrees of freedom

Christian H. Heinrichs / Dominik Knierzinger / Hannes Stofferin
  • Division of Clinical and Functional Anatomy, Medical University of Innsbruck, 6020 Innsbruck, Austria
  • Other articles by this author:
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/ Werner Schmoelz
Published Online: 2017-10-17 | DOI: https://doi.org/10.1515/bmt-2016-0255

Abstract

A novel biomechanical test bench has been developed for in-vitro evaluation of the knee joint. The test bench allows the kinematics of the knee joint to be studied in all six degrees of freedom. Flexion-extension knee movements are induced by quadriceps and hamstring muscle forces simulated by five pneumatic cylinders. The kinematics of the knee and the actively applied muscle forces are measured simultaneously. The aim of this study was to validate the sensitivity and reproducibility of this novel test bench. Four fresh frozen human knees were tested three times, each with seven flexion-extension cycles between 5° and 60°. After the native knees had been tested, the posterior cruciate ligament and then the lateral collateral ligament were dissected. The injured knees were tested in identical conditions [3×(7×5°–60°)] in order to evaluate whether the test bench is capable of detecting differences in knee kinematics between a native state and an injured one. With regard to reproducibility, the novel test bench showed almost perfect agreement for each specimen and for all states and flexion angles. In comparison with the native knees, the injured knees showed significant differences in knee kinematics. This validated novel test bench will make it possible to investigate various knee pathologies, as well as current and newly developed treatment options.

Keywords: active muscle loading; in vitro study; knee biomechanics; knee kinematics; knee simulator; LCL deficiency; PCL deficiency; validation

References

  • [1]

    Aalbersberg S, Kingma I, Ronsky JL, Frayne R, van Dieen JH. Orientation of tendons in vivo with active and passive knee muscles. J Biomech 2005; 38: 1780–1788.Google Scholar

  • [2]

    Amis AA, Bull AMJ, Gupte CM, et al. Biomechanics of the PCL and related structures: posterolateral, posteromedial and meniscofemoral ligaments. Knee Surg Sports Traumatol Arthrosc 2003; 11: 271–281.Google Scholar

  • [3]

    Besier TF, Fredericson M, Gold GE, Beaupré GS, Delp SL. Knee muscle forces during walking and running in patellofemoral pain patients and pain-free controls. J Biomech 2009; 42: 898–905.Google Scholar

  • [4]

    Cassidy K, Hangalur G, Sabharwal P, Chandrashekar N. Combined in vivo/in vitro method to study anteriomedial bundle strain in the anterior cruciate ligament using a dynamic knee simulator. J Biomech Eng 2013; 135: 35001.Google Scholar

  • [5]

    Coobs BR, LaPrade RF, Griffith CJ, Nelson BJ. Biomechanical analysis of an isolated fibular (lateral) collateral ligament reconstruction using an autogenous semitendinosus graft. Am J Sports Med 2007; 35: 1521–1527.Google Scholar

  • [6]

    D’Lima DD, Trice M, Urquhart AG, Colwell CW. Comparison between the kinematics of fixed and rotating bearing knee prostheses. Clin Orthop Relat Res 2000; 380: 151–157.Google Scholar

  • [7]

    Dürselen L, Claes LE, Kiefer H. The influence of muscle forces and external loads on cruciate ligament strain. Am J Sports Med 1995; 23: 129–136.Google Scholar

  • [8]

    Farahmand F, Senavongse W, Amis AA. Quantitative study of the quadriceps muscles and trochlear groove geometry related to instability of the patellofemoral joint. J Orthop Res 1998; 16: 136–143.Google Scholar

  • [9]

    Farahmand F, Tahmasbi MN, Amis AA. Lateral force-displacement behaviour of the human patella and its variation with knee flexion – a biomechanical study in vitro. J Biomech 1998; 31: 1147–1152.Google Scholar

  • [10]

    Fujie H, Sekito T, Orita A. A novel robotic system for joint biomechanical tests: application to the human knee joint. J Biomech Eng 2004; 126: 54–61.Google Scholar

  • [11]

    Gill TJ, DeFrate LE, Wang C, et al. The biomechanical effect of posterior cruciate ligament reconstruction on knee joint function. Kinematic response to simulated muscle loads. Am J Sports Med 2003; 31: 530–536.Google Scholar

  • [12]

    Gill TJ, Van de Velde SK, Wing DW, et al. Tibiofemoral and patellofemoral kinematics after reconstruction of an isolated posterior cruciate ligament injury: in vivo analysis during lunge. Am J Sports Med 2009; 37: 2377–2385.Google Scholar

  • [13]

    Goldsmith MT, Jansson KS, Smith SD, et al. Biomechanical comparison of anatomic single- and double-bundle anterior cruciate ligament reconstructions: an in vitro study. Am J Sports Med 2013; 41: 1595–1604.Google Scholar

  • [14]

    Guess TM, Maletsky LP. Computational modeling of a dynamic knee simulator for reproduction of knee loading. J Biomech Eng 2005; 127: 1216–1221.Google Scholar

  • [15]

    Hacker SP, Ignatius A, Durselen L. The influence of the test setup on knee joint kinematics – a meta-analysis of tibial rotation. J Biomech 2016; 49: 2982–2988.Google Scholar

  • [16]

    Hashemi J, Chandrashekar N, Jang T, et al. An alternative mechanism of non-contact anterior cruciate ligament injury during jump-landing: in-vitro simulation. Exp Mech 2007; 47: 347–354.Google Scholar

  • [17]

    Heller MO, Matziolis G, König C, et al. Muskuloskelettale Biomechanik des Kniegelenks: Grundlagen für die präoperative Planung von Umstellung und Gelenkersatz. Orthopade 2007; 36: 628–634.Google Scholar

  • [18]

    Kadaba MP, Ramakrishnan HK, Wootten ME, et al. Repeatability of kinematic, kinetic, and electromyographic data in normal adult gait. J Orthop Res 1989; 7: 849–860.Google Scholar

  • [19]

    Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977; 33: 159–174.Google Scholar

  • [20]

    Li G, Gill TJ, DeFrate LE, et al. Biomechanical consequences of PCL deficiency in the knee under simulated muscle loads – an in vitro experimental study. J Orthop Res 2002; 20: 887–892.Google Scholar

  • [21]

    Li G, Papannagari R, Li M, et al. Effect of posterior cruciate ligament deficiency on in vivo translation and rotation of the knee during weightbearing flexion. Am J Sports Med 2008; 36: 474–479.Google Scholar

  • [22]

    Li G, Rudy TW, Sakane M, et al. The importance of quadriceps and hamstring muscle loading on knee kinematics and in-situ forces in the ACL. J Biomech 1999; 32: 395–400.Google Scholar

  • [23]

    Lorenz A, Bobrowitsch E, Wunschel M, et al. Robot-aided in vitro measurement of patellar stability with consideration to the influence of muscle loading. Biomed Eng Online 2015; 14: 70.Google Scholar

  • [24]

    Lorenz A, Rothstock S, Bobrowitsch E, et al. Cartilage surface characterization by frictional dissipated energy during axially loaded knee flexion – an in vitro sheep model. J Biomech 2013; 46: 1427–1432.Google Scholar

  • [25]

    Luyckx T, Didden K, Vandenneucker H, et al. Is there a biomechanical explanation for anterior knee pain in patients with patella alta?: Influence of patellar height on patellofemoral contact force, contact area and contact pressure. J Bone Joint Surg Br 2009; 91: 344–350.Google Scholar

  • [26]

    Maletsky LP, Hillberry BM. Simulating dynamic activities using a five-axis knee simulator. J Biomech Eng 2005; 127: 123–133.Google Scholar

  • [27]

    McHanwell S, Brenner E, Chirculescu ARM, et al. The legal and ethical framework governing Body Donation in Europe – a review of current practice and recommendations for good practice. Eur J Anat 2008; 12: 1–24.Google Scholar

  • [28]

    Müller O, Lo J, Wünschel M, Obloh C, Wülker N. Simulation of force loaded knee movement in a newly developed in vitro knee simulator. Biomed Tech (Berl) 2009; 54: 142–149.Google Scholar

  • [29]

    Murray MP, Drought AB, Kory RC. Walking patterns of normal men. J Bone Joint Surg Am 1964; 46: 335–360.Google Scholar

  • [30]

    Powers CM, Lilley JC, Lee TQ. The effects of axial and multi-plane loading of the extensor mechanism on the patellofemoral joint. Clin Biomech 1998; 13: 616–624.Google Scholar

  • [31]

    Riederer BM, Bolt SH, Brenner E, et al. The legal and ethical framework governing Body Donation in Europe – 1st update on current practice. Eur J Anat 2012; 16: 1–21.Google Scholar

  • [32]

    Schmitt-Sody M, Kirchhoff C, Luciani E, Plitz W, Kirchhoff S. Dynamic in vitro analysis of tractile forces of the anterior cruciate ligament (ACL) transplant using patellar and semitendinosus muscle tendon: a cadaver study. Arch Orthop Trauma Surg 2015; 135: 29–39.Google Scholar

  • [33]

    Shoemaker SC, Adams D, Daniel DM, Woo SL-Y. Quadriceps/anterior cruciate graft interaction. An in vitro study of joint kinematics and anterior cruciate ligament graft tension. Clin Orthop Relat Res 1993; 294: 379–390.Google Scholar

  • [34]

    Steinbrück A, Schröder C, Woiczinski M, et al. Patellofemoral contact patterns before and after total knee arthroplasty: an in vitro measurement. Biomed Eng Online 2013; 12: 58.Google Scholar

  • [35]

    Strobel MJ, Weiler A, Schulz MS, Russe K, Eichhorn HJ. Fixed posterior subluxation in posterior cruciate ligament-deficient knees: diagnosis and treatment of a new clinical sign. Am J Sports Med 2002; 30: 32–38.Google Scholar

  • [36]

    Stukenborg-Colsman C, Ostermeier S, Wenger KH, Wirth CJ. Relative motion of a mobile bearing inlay after total knee arthroplasty-dynamic in vitro study. Clin Biomech 2002; 17: 49–55.Google Scholar

  • [37]

    Verstraete MA, Victor J. Possibilities and limitations of novel in-vitro knee simulator. J Biomech 2015; 48: 3377–3382.Google Scholar

  • [38]

    Walker PS, Arno S, Borukhoy I, Bell CP. Characterising knee motion and laxity in a testing machine for application to total knee evaluation. J Biomech 2015; 48: 3551–3558.Google Scholar

  • [39]

    Withrow TJ, Huston LJ, Wojtys EM, Ashton-Miller JA. The relationship between quadriceps muscle force, knee flexion, and anterior cruciate ligament strain in an in vitro simulated jump landing. Am J Sports Med 2006; 34: 269–274.Google Scholar

  • [40]

    Woo SL-Y, Debski RE, Withrow JD, Janaushek MA. Biomechanics of knee ligaments. Am J Sports Med 1999; 27: 533–543.Google Scholar

  • [41]

    Zavatsky AB. A kinematic-freedom analysis of a flexed-knee-stance testing rig. J Biomech 1997; 30: 277–280.Google Scholar

  • [42]

    Zens M, Niemeyer P, Ruhhammer J, et al. Length changes of the anterolateral ligament during passive knee motion: a human cadaveric study. Am J Sports Med 2015; 43: 2545–2552.Google Scholar

About the article

Corresponding author: Assoc. Prof. Dr. Werner Schmoelz, Department of Trauma Surgery, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria, Phone: +43 512 504 22413, Fax: +43 512 504 25743


Received: 2016-12-21

Accepted: 2017-09-04

Published Online: 2017-10-17

Published in Print: 2018-11-27


Citation Information: Biomedical Engineering / Biomedizinische Technik, Volume 63, Issue 6, Pages 709–717, ISSN (Online) 1862-278X, ISSN (Print) 0013-5585, DOI: https://doi.org/10.1515/bmt-2016-0255.

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