A model of articular cruciate ligament reconstructive surgery: A validation construct and computational insights

Shahab Salehghaffari, Yasin Y. Dhaher

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

This study sought to develop a computational framework that emulates the articular cruciate ligament reconstruction surgery using transtibial portal technique. The proposed model included the tibia-femoral and patella-femoral joints, articular cartilage and menisci. Key surgical parameters were incorporated including bone-patellar-tendon-bone graft excision and pre-tensioning, tunnel morphology, bone plugs, and bone plug fixation. Several simulation steps were parameterized to reflect the clinically reported surgical procedure. Our focus was to explore the intra-operative effects of variations in tunnel directions on the selected metrics of joint mechanics during Lachman and Anterior Drawer tests. A mathematical construct capable of transforming the limited and heterogeneous experimental and surgical data to evidence-based validation was adopted to ensure the viability of the finite element models. We found that the proposed models, subject to a variation in tunnel directions, resulted in simulation outputs that favor the reported experimental data of Lachman and Anterior Drawer tests under uncertainty. Simulation results for a population of three-dimensional tunnel orientations provided insights into the graft-tunnel contact mechanics and the spatial stress distribution in the graft, insights that have been anecdotally observed in prior experimental studies. The intraarticular graft tension was found to be higher than the estimated in tunnel graft force, and larger differences were found for the least inclined tunnels exhibiting higher contact pressures, transverse bending and twisting of the graft and Von-Mises stress at the graft-femoral tunnel interface. Conversely, tunnels with high inclination angles exhibited higher intraarticular graft tension and Von-Mises stress at the graft-tibial bone plug interface.

Original languageEnglish (US)
Pages (from-to)1609-1617
Number of pages9
JournalJournal of Biomechanics
Volume47
Issue number7
DOIs
StatePublished - May 7 2014
Externally publishedYes

Fingerprint

Reconstructive Surgical Procedures
Articular Ligaments
Ligaments
Grafts
Surgery
Tunnels
Transplants
Bone
Thigh
Mechanics
Bone-Patellar Tendon-Bone Grafts
Joints
Bone and Bones
Patella
Articular Cartilage
Tibia
Tendons
Cartilage
Uncertainty
Stress concentration

Keywords

  • Articular cartilage osteoarthritis
  • Experimental errors
  • Finite element model
  • Surgical variability
  • Tunnel direction
  • Validation under epistemic uncertainty

ASJC Scopus subject areas

  • Biophysics
  • Orthopedics and Sports Medicine
  • Biomedical Engineering
  • Rehabilitation

Cite this

A model of articular cruciate ligament reconstructive surgery : A validation construct and computational insights. / Salehghaffari, Shahab; Dhaher, Yasin Y.

In: Journal of Biomechanics, Vol. 47, No. 7, 07.05.2014, p. 1609-1617.

Research output: Contribution to journalArticle

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