Dynamic simulation of tibial tuberosity realignment: model evaluation

Abstract

This study was performed to evaluate a dynamic multibody model developed to characterize the influence of tibial tuberosity realignment procedures on patellofemoral motion and loading. Computational models were created to represent four knees previously tested at 40°, 60°, and 80° of flexion with the tibial tuberosity in a lateral, medial and anteromedial positions. The experimentally loaded muscles, major ligaments of the knee, and patellar tendon were represented. A repeated measures ANOVA with post-hoc testing was performed at each flexion angle to compare data between the three positions of the tibial tuberosity. Significant experimental trends for decreased patella flexion due to tuberosity anteriorization and a decrease in the lateral contact force due to tuberosity medialization were reproduced computationally. The dynamic multibody modeling technique will allow simulation of function for symptomatic knees to identify optimal surgical treatment methods based on parameters related to knee pathology and pre-operative kinematics.

Keywords::

• patellofemoral joint
• tuberosity realignment
• dynamic model
• kinematics
• knee
• biomechanics

Additional information

Funding

This work was supported by the Industrial Strategic Technology Development Program [10041605] funded by the Ministry of Trade, Industry and Energy (MOTIE), Korea. Partial funding was also provided by Award Number [R03AR054910] from the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health.