Knee Kinematics Estimation Using Multi-Body Optimisation Embedding a Knee Joint Stiffness Matrix: A Feasibility Study

• Published in: PloS one Vol. 11; no. 6; p. e0157010
• Main Authors: Richard, Vincent, Lamberto, Giuliano, Lu, Tung-Wu, Cappozzo, Aurelio, Dumas, Raphaël
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 01.06.2016; Public Library of Science (PLoS)
• Subjects: Accuracy; Adult; Bernard, Claude (1813-1878); Bioengineering; Biology and Life Sciences; Biomechanical Phenomena; Biomechanics; Constraint modelling; Data processing; Deformation; Deformation mechanisms; Embedding; Feasibility studies; Female; Femur; Femur - pathology; Femur - physiology; Fluoroscopy; Health sciences; Humans; Joint Diseases - physiopathology; Kinematics; Knee; Knee - anatomy & histology; Knee - physiology; Knee Joint - anatomy & histology; Knee Joint - physiology; Life Sciences; Male; Mechanics; Medicine and Health Sciences; Methods; Models, Theoretical; Movement - physiology; Optimization; Parameter identification; Physical Sciences; Physics; Range of Motion, Articular - physiology; Rigid structures; Rigid-body dynamics; Sensitivity analysis; Skin; Stiffness matrix; Tibia; Tibia - pathology; Tibia - physiology; France; Italy; Taiwan; KNEE; BIOMECHANICS; BIOMECANIQUE; GENOU; ARTICULATION HUMAINE
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0157010

The use of multi-body optimisation (MBO) to estimate joint kinematics from stereophotogrammetric data while compensating for soft tissue artefact is still open to debate. Presently used joint models embedded in MBO, such as mechanical linkages, constitute a considerable simplification of joint function, preventing a detailed understanding of it. The present study proposes a knee joint model where femur and tibia are represented as rigid bodies connected through an elastic element the behaviour of which is described by a single stiffness matrix. The deformation energy, computed from the stiffness matrix and joint angles and displacements, is minimised within the MBO. Implemented as a "soft" constraint using a penalty-based method, this elastic joint description challenges the strictness of "hard" constraints. In this study, estimates of knee kinematics obtained using MBO embedding four different knee joint models (i.e., no constraints, spherical joint, parallel mechanism, and elastic joint) were compared against reference kinematics measured using bi-planar fluoroscopy on two healthy subjects ascending stairs. Bland-Altman analysis and sensitivity analysis investigating the influence of variations in the stiffness matrix terms on the estimated kinematics substantiate the conclusions. The difference between the reference knee joint angles and displacements and the corresponding estimates obtained using MBO embedding the stiffness matrix showed an average bias and standard deviation for kinematics of 0.9±3.2° and 1.6±2.3 mm. These values were lower than when no joint constraints (1.1±3.8°, 2.4±4.1 mm) or a parallel mechanism (7.7±3.6°, 1.6±1.7 mm) were used and were comparable to the values obtained with a spherical joint (1.0±3.2°, 1.3±1.9 mm). The study demonstrated the feasibility of substituting an elastic joint for more classic joint constraints in MBO.