multimodal and multiscale modeling of the human knee...
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MultiScaleHuman
Marie Curie Research training network
Andra Chincisan
MIRALab, University of Geneva
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
MultiScaleHuman
Marie Curie Research training network
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
IMI Research Seminar17 June 2014
2MIRALab, University of Genevawww.miralab.ch
www.fotolibra.com
Molecular Cellular Tissue Organ Behavior
MultiScaleHuman
Marie Curie Research training network
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%)
IMI Research Seminar17 June 2014
3MIRALab, University of Genevawww.miralab.ch
[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
Marie Curie Research training network
State of the Art
IMI Research Seminar17 June 2014
4MIRALab, University of Genevawww.miralab.ch
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
Marie Curie Research training network
Method
• Overview
IMI Research Seminar17 June 2014
5MIRALab, University of Genevawww.miralab.ch
Medical images Computational model
Finite Element simulation
In vitro data / Model validation
Kinetics and Kinematics
MultiScaleHuman
Marie Curie Research training network
Computational model
Anatomical knee joint model
• Model reconstruction from magnetic resonance images (MRIs)
IMI Research Seminar17 June 2014
6MIRALab, University of Genevawww.miralab.ch
3D anatomical model
Bones
Soft tissue
MRI data
3T scanner
High resolution
knee
Segmentation
Automatic, manual
Medical expert validation
MultiScaleHuman
Marie Curie Research training network
Computational model
Mesh
– Volumetric
– Tetrahedral
IMI Research Seminar17 June 2014
7MIRALab, University of Genevawww.miralab.ch
Fiber orientation
– Laplace equation
– Attachments position
Reconstruc
ted modelMeshing
Volumetric
mesh
Fiber
Orientation
http://improvesmylife.com/
MultiScaleHuman
Marie Curie Research training network
Computational model
Biomechanical model
– mechanical behavior
• Material properties
– boundary conditions
– center of rotation - kinematics
IMI Research Seminar17 June 2014
8MIRALab, University of Genevawww.miralab.ch
[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
Marie Curie Research training network
Motion data
• Kinematics and Kinetics
– Forces
– Rotation angles
– neuromuscular simulation
– 3D kinematics
IMI Research Seminar17 June 2014
9MIRALab, University of Genevawww.miralab.ch
Rx Ry Rz
Forces, rotation degrees
MultiScaleHuman
Marie Curie Research training network
Motion data
• 3D kinematics
– XYZ directions data vs flexion angle
• xyz: rotations and translations
• multiple center of rotations
– Specimen experiments
– Accuracy
IMI Research Seminar17 June 2014
10MIRALab, University of Genevawww.miralab.ch
http://secondsightdigital.com
MultiScaleHuman
Marie Curie Research training network
Finite element analysis
• FE software packages:
– Abaqus, Ansys, FEBio, …
IMI Research Seminar17 June 2014
11MIRALab, University of Genevawww.miralab.ch
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
Marie Curie Research training network
Finite element
• Physically based simulation– FEBio package [1]
– Non linear finite element analysis - large deformation
IMI Research Seminar17 June 2014
12MIRALab, University of Genevawww.miralab.ch
[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
Marie Curie Research training network
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
IMI Research Seminar17 June 2014
13MIRALab, University of Genevawww.miralab.ch
LBB, Hannover, Germany
MultiScaleHuman
Marie Curie Research training network
Case study – Knee ligaments assessment
• Ligament injuries
– most common causes of
• musculoskeletal joint pain
• disability
IMI Research Seminar17 June 2014
14MIRALab, University of Genevawww.miralab.ch
NFL statistics (USA)
Increasing injuries by year and play type
http://bigcomputing.blogspot.ch/
MultiScaleHuman
Marie Curie Research training network
Aim
IMI Research Seminar17 June 2014
15MIRALab, University of Genevawww.miralab.ch
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
Marie Curie Research training network
Case study - Results
• Scenarios
– Flexion 45°
– Internal rotation 15°
– External rotation 15°
• Fiber strain [1]
IMI Research Seminar17 June 2014
16MIRALab, University of Genevawww.miralab.ch
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
Marie Curie Research training network
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
IMI Research Seminar17 June 2014
17MIRALab, University of Genevawww.miralab.ch
MultiScaleHuman
Marie Curie Research training network
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
IMI Research Seminar17 June 2014
18MIRALab, University of Genevawww.miralab.ch
MultiScaleHuman
Marie Curie Research training network
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
IMI Research Seminar17 June 2014
19MIRALab, University of Geneva www.miralab.ch
Tissue Organ BehaviorMolecular Cellular
UMINHO, Braga, Portugal
MultiScaleHuman
Marie Curie Research training network
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