Development and Analysis of a Software Package to Quantify In Vivo Polyethylene Wear after Total Hip Arthroplasty

Since the first total hip arthroplasty (THA) in 1938, THA evolved and developed into one of the major concentrations of orthopaedic research. The typical hip implant device used today incorporates a femoral and an acetabular component that serve to replicate the anatomical and mechanical functions of the natural hip joint. However, several problems exist that can effect the function of the implant device. Wear in the polyethylene liner of the acetabular component of the total hip replacement device is known as one of the major factors that affects the longevity of total hip replacement devices. Both manual and computer-aided techniques have been developed to measure linear and volumetric polyethylene wear in two and three-dimensional directions. This study aims to develop a software package that will accurately measure in vivo polyethylene wear after total hip arthroplasty and can be applied to determine the factors that lead to polyethylene wear

Development of a Muscle Model Parameter Calibration Method via Passive Muscle Force Minimization

Computational predictions of subject-specific muscle and knee joint contact forces during walking may improve individual rehabilitation treatment design. Such predictions depend directly on specified model parameter values. However, model parameters are difficult to measure non-invasively. Methods for muscle model parameter calibration have been developed previously. However, it is currently unknown how the musculoskeletal system chooses muscle model parameter values. Previous studies have hypothesized that muscles avoid injury during walking by generating little passive force and operating in the ascending region of the force-length curve. This hypothesis suggests that muscle model parameter values may be selected by the body to minimize passive force. The purpose of this study was to develop a method for calibrating muscle model parameter values and muscle moment arms during walking via minimization of passive force

Influence of musculoskeletal model parameter values on prediction of accurate knee contact forces during walking

Treatment design for musculoskeletal disorders using in silico patient-specific dynamic simulations is becoming a clinical possibility. However, these simulations are sensitive to model parameter values that are difficult to measure experimentally, and the influence of uncertainties in these parameter values on the accuracy of estimated knee contact forces remains unknown. This study evaluates which musculoskeletal model parameters have the greatest influence on estimating accurate knee contact forces during walking. We performed the evaluation using a two-level optimization algorithm where musculoskeletal model parameter values were adjusted in the outer level and muscle activations were estimated in the inner level. We tested the algorithm with different sets of design variables (combinations of optimal muscle fiber lengths, tendon slack lengths, and muscle moment arm offsets) resulting in nine different optimization problems. The most accurate lateral knee contact force predictions were obtained when tendon slack lengths and moment arm offsets were adjusted simultaneously, and the most accurate medial knee contact force estimations were obtained when all three types of parameters were adjusted together. Inclusion of moment arm offsets as design variables was more important than including either tendon slack lengths or optimal muscle fiber lengths alone to obtain accurate medial and lateral knee contact force predictions. These results provide guidance on which musculoskeletal model parameter values should be calibrated when seeking to predict in vivo knee contact forces accurately.Postprint (updated version

Muscle Contributions to Frontal and Transverse Plane Whole-Body Angular Momentum

The purpose of this study was to build upon previous work by analyzing how gravity and individual muscles contribute to frontal and traverse plane whole-body angular momentum. Identifying which muscles are responsible for generating angular momentum has important implications for the diagnosis and treatment of movement disorders

Evaluation of Different Optimal Control Problem Formulations for Solving the Muscle Redundancy Problem

This study evaluates several possible optimal control problem formulations for solving the muscle redundancy problem with the goal of identifying the most efficient and robust formulation. One novel formulation involves the introduction of additional controls that equal the time derivative of the states, resulting in very simple dynamic equations. The nonlinear equations describing muscle dynamics are then imposed as algebraic constraints in their implicit form, simplifying their evaluation. By comparing different problem formulations for computing muscle controls that can reproduce inverse dynamic joint torques during gait, we demonstrate the efficiency and robustness of the proposed novel formulation

The Influence of Neuromusculoskeletal Model Calibration Method on Predicted Knee Contact Forces during Walking

This study explored the influence of three model calibration methods on predicted knee contact and leg muscle forces during walking. Static optimization was used to calculate muscle activations for all three methods. Approach A used muscle-tendon model parameter values (i.e., optimal muscle fiber lengths and tendon slack lengths) taken directly from literature. Approach B used a simple algorithm to calibrate muscle-tendon model parameter values such that each muscle operated within the ascending region of its normalized force-length curve. Approach C used a novel two-level optimization procedure to calibrate muscle-tendon, moment arm, and neural control model parameter values while simultaneously predicting muscle activations

Relationships between Muscle Contributions to Walking Subtasks and Functional Walking Status in Persons with Post-Stroke Hemiparesis

Walking speed is commonly used to predict stroke severity and assess functional walking status (i.e., household, limited community and community walking status) post-stroke. The underlying mechanisms that limit walking speed (and functional walking status by extension) need to be understood to improve post-stroke rehabilitation. Previous experimental studies have shown correlations between paretic plantarflexor output during the pre-swing phase and walking speed and suggest that the paretic hip flexors can compensate in some hemiparetic subjects. Modeling and simulation studies of healthy walking have shown that the ankle plantarflexors, soleus (SOL) and gastrocnemius (GAS), and uniarticular hip flexors (IL) are essential contributors to the walking subtasks of forward propulsion, swing initiation and/or power generation during pre-swing. However, the relationships between functional walking status and individual muscle contributions to these walking subtasks in hemiparetic walking are unknown. The goal of this study was to use 3D forward dynamics simulations to investigate the relationships between functional walking status in post-stroke hemiparetic walking and muscle contributions to forward propulsion, swing initiation and power generation

Synergy-Based Two-Level Optimization for Predicting Knee Contact Forces during Walking

Musculoskeletal models and optimization methods are combined to calculate muscle forces. Some model parameters cannot be experimentally measured due to the invasiveness, such as the muscle moment arms or the muscle and tendon lengths. Moreover, other parameters used in the optimization, such as the muscle synergy components, can be also unknown. The estimation of all these parameters needs to be validated to obtain physiologically consistent results. In this study, a two-step optimization problem was formulated to predict both muscle and knee contact forces of a subject wearing an instrumented knee prosthesis. In the outer level, muscle parameters were calibrated, whereas in the inner level, muscle activations were predicted. Two approaches are presented. In Approach A, contact forces were used when calibrating the parameters, whereas in Approach B, no contact force information was used as input. The optimization formulation is validated comparing the model and the experimental knee contact forces. The goal was to evaluate whether we can predict the contact forces when in-vivo contact forces are not available

A Novel Approach to Estimation of Patient-Specific Muscle Strength

Current modeling techniques have been used to model the Reverse Total Shoulder Arthroplasty (RTSA) to account for the geometric changes implemented after RTSA. Though these models have provided insight into the effects of geometric changes from RTSA these is still a limitation of understanding muscle function after RTSA on a patient-specific basis. The goal of this study sought to overcome this limitation by developing an approach to calibrate patient-specific muscle strength for an RTSA subject

Pre-Swing Deficits in Forward Propulsion, Swing Initiation and Power Generation by Individual Muscles in Hemiparetic Walking

Clinical studies of hemiparetic walking have shown pre-swing abnormalities in the paretic leg suggesting that paretic muscle contributions to important biomechanical walking subtasks are different than those of non-disabled individuals. Three-dimensional forward dynamics simulations of two representative hemiparetic subjects with different levels of walking function classified by self-selected walking speed (i.e., limited community=0.4–0.8 m/s and community walkers=\u3e0.8 m/s) and a speed-matched control were generated to quantify individual muscle contributions to forward propulsion, swing initiation and power generation during the pre-swing phase (i.e., double support phase proceeding toe-off). Simulation analyses identified decreased paretic soleus and gastrocnemius contributions to forward propulsion and power generation as the primary impairment in the limited community walker compared to the control subject. The non-paretic leg did not compensate for decreased forward propulsion by paretic muscles during pre-swing in the limited community walker. Paretic muscles had the net effect to absorb energy from the paretic leg during pre-swing in the community walker suggesting that deficits in swing initiation are a primary impairment. Specifically, the paretic gastrocnemius and hip flexors (i.e., iliacus, psoas and sartorius) contributed less to swing initiation and the paretic soleus and gluteus medius absorbed more power from the paretic leg in the community walker compared to the control subject. Rehabilitation strategies aimed at diminishing these deficits have much potential to improve walking function in these hemiparetic subjects and those with similar deficits