Efficient Computation of Cartilage Contact Pressures within Dynamic Simulations of Movement.

The objective of this study was to assess the use of an advanced collision detection algorithm to simulate cartilage contact pressure patterns within dynamic musculoskeletal simulations of movement. We created a knee model that included articular cartilage contact for the tibiofemoral and patellofemoral joints. Knee mechanics were then predicted within the context of a dynamic gait simulation. At each time step of a simulation, ray-casting was used in conjunction with hierarchical oriented bounding boxes (OBB) to rapidly identify regions of overlap between articulating cartilage surfaces. Local cartilage contact pressure was then computed using an elastic foundation model. Collision detection implemented in parallel on a GPU provided up to a 10× speed increase when using high resolution mesh densities that had >10 triangles/mm2. However, pressure magnitudes converged at considerably lower mesh densities (2.6 triangles/mm2) where CPU and GPU implementations of collision detection exhibited equivalent performance. Simulated tibiofemoral contact locations were comparable to prior experimental measurements, while pressure magnitudes were similar to those predicted by finite element models. We conclude the use of ray-casting with hierarchical OBB for collision detection is a viable method for simulating joint contact mechanics in human movement.

Articular Cartilage of the Human Knee Joint: In Vivo Multicomponent T2 Analysis at 3.0 T.

PURPOSE: To compare multicomponent T2 parameters of the articular cartilage of the knee joint measured by using multicomponent driven equilibrium single-shot observation of T1 and T2 (mcDESPOT) in asymptomatic volunteers and patients with osteoarthritis. MATERIALS AND METHODS: This prospective study was performed with institutional review board approval and with written informed consent from all subjects. The mcDESPOT sequence was performed in the knee joint of 13 asymptomatic volunteers and 14 patients with osteoarthritis of the knee. Single-component T2 (T2(Single)), T2 of the fast-relaxing water component (T2F) and of the slow-relaxing water component (T2S), and the fraction of the fast-relaxing water component (F(F)) of cartilage were measured. Wilcoxon rank-sum tests and multivariate linear regression models were used to compare mcDESPOT parameters between volunteers and patients with osteoarthritis. Receiver operating characteristic analysis was used to assess diagnostic performance with mcDESPOT parameters for distinguishing morphologically normal cartilage from morphologically degenerative cartilage identified at magnetic resonance imaging in eight cartilage subsections of the knee joint. RESULTS: Higher cartilage T2(Single) (P < .001), lower cartilage F(F) (P < .001), and similar cartilage T2F (P = .079) and T2S (P = .124) values were seen in patients with osteoarthritis compared with those in asymptomatic volunteers. Differences in T2(Single) and F(F) remained significant (P < .05) after consideration of age differences between groups of subjects. Diagnostic performance was higher with F(F) than with T2(Single) for distinguishing between normal and degenerative cartilage (P < .05), with greater areas under the curve at receiver operating characteristic analysis. CONCLUSION: Patients with osteoarthritis of the knee had significantly higher cartilage T2(Single) and significantly lower cartilage F(F) than did asymptomatic volunteers, and receiver operating characteristic analysis results suggested that F(F) may allow greater diagnostic performance than that with T2(Single) for distinguishing between normal and degenerative cartilage.

Finite element analysis of resurfacing depth and obliquity on patella stress and stability in TKA.

Patella resurfacing in total knee arthroplasty (TKA) reduces postoperative complications and revisions; however, the optimal cutting depth and angle that minimize patellar strain and fracture remain unclear. We performed three-dimensional finite element analysis (FEA) of resurfacing cutting depth and obliquity to assess the stresses in each component of the knee joint, and fatigue testing to determine cyclic loading conditions over the expected life span of the implant. Maximum stress on the patella increased as cutting depth increased up to 8mm; peak stresses on the idealized button further increased at 10-mm depth. Medial superior obliquities below 3° showed the lowest stress on the patella and button and the highest fatigue life. An oblique cut of 3° with respect to the inferior end increased patellar stress and reduced fatigue life, making this the least successful approach. Taken together, our FEA supports the use of minimal cutting depths at -3° with respect to the superior end for patellar resurfacing in TKA in order to minimize stresses in the structure and improve TKA durability. Future studies will assess the effect of patella button placement to account for real-world practice variations.