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research article

Evaluation of anterior cruciate ligament surgical reconstruction through finite element analysis

Risvas, Konstantinos
•
Stanev, Dimitar  
•
Benos, Lefteris
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May 16, 2022
Scientific Reports

Anterior cruciate ligament (ACL) tear is one of the most common knee injuries. The ACL reconstruction surgery aims to restore healthy knee function by replacing the injured ligament with a graft. Proper selection of the optimal surgery parameters is a complex task. To this end, we developed an automated modeling framework that accepts subject-specific geometries and produces finite element knee models incorporating different surgical techniques. Initially, we developed a reference model of the intact knee, validated with data provided by the Open Knee(s) project. This helped us evaluate the effectiveness of estimating ligament stiffness directly from MRI. Next, we performed a plethora of "what-if" simulations, comparing responses with the reference model. We found that (a) increasing graft pretension and radius reduces relative knee displacement, (b) the correlation of graft radius and tension should not be neglected, (c) graft fixation angle of 20 degrees can reduce knee laxity, and (d) single-versus double-bundle techniques demonstrate comparable performance in restraining knee translation. In most cases, these findings confirm reported values from comparative clinical studies. The numerical models are made publicly available, allowing for experimental reuse and lowering the barriers for meta-studies. The modeling approach proposed here can complement orthopedic surgeons in their decision-making.

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Type
research article
DOI
10.1038/s41598-022-11601-1
Web of Science ID

WOS:000796701700056

Author(s)
Risvas, Konstantinos
Stanev, Dimitar  
Benos, Lefteris
Filip, Konstantinos
Tsaopoulos, Dimitrios
Moustakas, Konstantinos
Date Issued

2022-05-16

Publisher

Nature Portfolio

Published in
Scientific Reports
Volume

12

Issue

1

Article Number

8044

Subjects

Multidisciplinary Sciences

•

Science & Technology - Other Topics

•

fibular collateral ligament

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cross-sectional area

•

soft-tissue grafts

•

double-bundle

•

single-bundle

•

popliteofibular ligament

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biomechanical evaluation

•

3-dimensional model

•

popliteus tendon

•

outside-in

Editorial or Peer reviewed

REVIEWED

Written at

EPFL

EPFL units
BIOROB  
Available on Infoscience
June 20, 2022
Use this identifier to reference this record
https://infoscience.epfl.ch/handle/20.500.14299/188610
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