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An anatomically based patient-specific finite element model of patella articulation: towards a diagnostic tool

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Abstract

A 3D anatomically based patient-specific finite element (FE) model of patello-femoral (PF) articulation is presented to analyse the main features of patella biomechanics, namely, patella tracking (kinematics), quadriceps extensor forces, surface contact and internal patella stresses. The generic geometries are a subset from the model database of the International Union of Physiological Sciences (IUPS) (http://www.physiome.org.nz) Physiome Project with soft tissue derived from the widely used visible human dataset, and the bones digitised from an anatomically accurate physical model with muscle attachment information. The models are customised to patient magnetic resonance images using a variant of free-form deformation, called ‘host-mesh’ fitting. The continuum was solved using the governing equation of finite elasticity, with the multibody problem coupled through contact mechanics. Additional constraints such as tissue incompressibility are also imposed. Passive material properties are taken from the literature and implemented for deformable tissue with a non-linear micro-structurally based constitutive law. Bone and cartilage are implemented using a ‘St-Venant Kirchoff’ model suitable for rigid body rotations. The surface fibre directions have been estimated from anatomy images of cadaver muscle dissections and active muscle contraction was based on a steady-state calcium-tension relation. The 3D continuum model of muscle, tendon and bone is compared with experimental results from the literature, and surgical simulations performed to illustrate its clinical assessment capabilities (a Maquet procedure for reducing patella stresses and a vastus lateralis release for a bipartite patella). Finally, the model limitations, issues and future improvements are discussed.

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Notes

  1. An interactive computer program developed by the Bioengineering Institute for Continuum Mechanics, Image analysis, Signal processing and System identification.

  2. Non-uniform rational basis functions.

  3. CMISS graphics user interface

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Acknowledgements

The authors would like to acknowledge the important input to this project from the members of the Bioengineering Institute, in particular, Dr Phil Blyth for providing the MR images and Dr Sharon Walt for the motion capture data. Financial assistance was received from the Foundation for Research, Science and Technology New Zealand under NERF contract UOAX0232 (PJH) and a Bright Future scholarship (JWF).

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  1. Bioengineering Institute, The University of Auckland, Auckland, New Zealand

    J. W. Fernandez & P. J. Hunter

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  1. J. W. Fernandez
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  2. P. J. Hunter
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Correspondence to J. W. Fernandez.

Appendix

Appendix

Table 1 Patella model degrees of freedom
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Table 2 Pole-zero material parameters for skeletal muscle, patella and quadriceps tendon
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Table 3 Patella bone and cartilage material properties
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Table 4 Peak fibrous tissue strain for VL release at various angles
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Fernandez, J.W., Hunter, P.J. An anatomically based patient-specific finite element model of patella articulation: towards a diagnostic tool. Biomech Model Mechanobiol 4, 20–38 (2005). https://doi.org/10.1007/s10237-005-0072-0

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