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Next Generation In-Vivo Forward Solution Physiological Model of The University of Tennessee, Knoxville Trace: Tennessee Research and Creative Exchange Doctoral Dissertations Graduate School 8-2016 Next Generation In-Vivo Forward Solution Physiological Model of the Human Lower Limb to Predict Implanted Knee Mechanics Bradley Allen Meccia University of Tennessee, Knoxville, [email protected] Recommended Citation Meccia, Bradley Allen, "Next Generation In-Vivo Forward Solution Physiological Model of the Human Lower Limb to Predict Implanted Knee Mechanics. " PhD diss., University of Tennessee, 2016. https://trace.tennessee.edu/utk_graddiss/3948 This Dissertation is brought to you for free and open access by the Graduate School at Trace: Tennessee Research and Creative Exchange. It has been accepted for inclusion in Doctoral Dissertations by an authorized administrator of Trace: Tennessee Research and Creative Exchange. For more information, please contact [email protected]. To the Graduate Council: I am submitting herewith a dissertation written by Bradley Allen Meccia entitled "Next Generation In- Vivo Forward Solution Physiological Model of the Human Lower Limb to Predict Implanted Knee Mechanics." I have examined the final electronic copy of this dissertation for form and content and recommend that it be accepted in partial fulfillment of the requirements for the degree of Doctor of Philosophy, with a major in Engineering Science. Richard D. Komistek, Major Professor We have read this dissertation and recommend its acceptance: Mohamed R. Mahfouz, Aly Fathy, Adrija Sharma Accepted for the Council: Dixie L. Thompson Vice Provost and Dean of the Graduate School (Original signatures are on file with official student records.) Next Generation In-Vivo Forward Solution Physiological Model of the Human Lower Limb to Predict Implanted Knee Mechanics A Dissertation Presented for the Doctor of Philosophy Degree The University of Tennessee, Knoxville Bradley Allen Meccia August 2016 Copyright © 2016 by Bradley Meccia All rights reserved ii Dedication This dissertation is dedicated to my father, Robert Meccia, who possessed ac MS in environmental engineering in addition to being a two sport varsity athlete at West Point a member of the U.S. Army Rangers. It is from him that I learned to love academics which has drove me to gain the knowledge necessary to complete this dissertation. His coaching in athletics also taught me the determination necessary to complete this PhD. In both his life, sickness, and death, he always placed his family first and for that I am forever grateful. Thank you, Dad. iii Acknowledgements First, I would like to thank Dr. John Mueller for developing this model which I have had the privilege of refining for the last several years. I would also like to thank Dr. Sharma for countless hours of help in the lab over the years. Most importantly, I would like to thank Dr. Komistek for his guidance in this project. His education on the theory and practice of modeling has been invaluable. iv Abstract Current total knee arthroplasty (TKA) evaluation methods are both time consuming and expensive. They require fabrication of the TKA and then utilize a wear or cadaveric simulator which does not necessarily replicate in-vivo conditions. Other analysis methods involve following the long-term success of TKA in subjects for five or more years. Mathematical modeling of TKA provide an efficient method at a greatly reduced cost for evaluating TKA. Obviously, the accuracy of a mathematical model is extremely important to the validity of the results. Mathematical modeling of the knee faces many difficulties. The number of muscles actuating the knee is much larger than the number of equations of motion, producing an indeterminate system. Furthermore, the complex shapes of both the tibial plateaus and femoral condyles result in interactions which must be modeled using non-holonomic constrains. A forward solution mathematical model has been developed which overcomes these difficulties to serve as a theoretical simulator. In this model, the articulating geometry of the TKA is defined mathematically. The trochlear groove, medial and lateral polyethylene plateaus, and post (in posterior stabilized designs) are defined using mathematical surfaces. Then, the femoral condyles, the patella surface, and the cam (in posterior stabilized designs) are defined using point clouds. Contact forces are computed by searching for contact between the defined surfaces and point clouds. The muscle forces are computed using control systems to generate the desired motion of the knee. In addition the model, a graphical user interface (GUI) was developed which allows users to efficiently set up simulations for the model. This program guides the users step-by-step through mathematically defining the surfaces, selecting the orientation of the implants on the bones, and setting up initial v conditions. It also gives users the option to adjust patient specific parameters such as ligament origins, insertions, and stiffness. Using this model, many simulations have been performed to explore the effect of varying implant designs. With the knowledge gained from these designs, a new TKA was developed. A desired kinematic profile was selected, and the TKA was modified based on the results of successive simulations until the desired results were obtained. vi Table of Contents Chapter 1: Background ................................................................................................................................. 1 Chapter 2: Literature Review ........................................................................................................................ 5 Methods of Rigid Body Knee Modeling .................................................................................................... 6 OpenSim ................................................................................................................................................ 6 LifeMod ................................................................................................................................................. 7 AnyBody Modeling System ................................................................................................................... 8 Autolev® ................................................................................................................................................ 9 Chapter 3: Methods .................................................................................................................................... 11 Overview ................................................................................................................................................. 11 Description of Original Model and General Updates .............................................................................. 12 Overview and General Updates .......................................................................................................... 12 General Changes to the Original Model.............................................................................................. 15 Original Tibiofemoral and Patellofemoral Joint Definition ................................................................. 15 Inclusion of Mobile Bearing Polyethylene .............................................................................................. 17 Improvements at Tibiofemoral Joint ...................................................................................................... 20 Improvements at Patellofemoral Joint ................................................................................................... 26 Improvements at Cam/Post .................................................................................................................... 31 Ability to Model New Contact Surfaces .................................................................................................. 34 Modifications to Muscle Controller ........................................................................................................ 37 vii Contact Force Algorithm ......................................................................................................................... 39 Chapter 4: Development of Graphical User Interface ................................................................................ 44 Objectives ............................................................................................................................................... 44 Initial Simulation Set Up .......................................................................................................................... 45 Save and Load Simulations ..................................................................................................................... 67 Modify Simulation ................................................................................................................................... 67 Change Default Simulation Parameters .................................................................................................. 70 Run a Simulation from the GUI ............................................................................................................... 75 Automatically Plot Results ...................................................................................................................... 75 Chapter 5: Results ....................................................................................................................................... 82 Changing
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