Currently available knee joint kinematic tracking systems fail to nondestructively capture the subtle variation in joint and soft tissue kinematics that occur in native, injured, and reconstructed joint states. Microcomputed tomography (CT) imaging has the potential as a noninvasive, high-resolution kinematic tracking system, but no dynamic simulators exist to take advantage of this. The purpose of this work was to develop and assess a novel micro-CT compatible knee joint simulator to quantify the knee joint's kinematic and kinetic response to clinically (e.g., pivot shift test) and functionally (e.g., gait) relevant loading. The simulator applies closed-loop, load control over four degrees-of-freedom (DOF) (internal/external rotation, varus/valgus rotation, anterior/posterior translation, and compression/distraction), and static control over a fifth degree-of-freedom (flexion/extension). Simulator accuracy (e.g., load error) and repeatability (e.g., coefficient of variation) were assessed with a cylindrical rubber tubing structure and a human cadaveric knee joint by applying clinically and functionally relevant loads along all active axes. Micro-CT images acquired of the joint at a loaded state were then used to calculate joint kinematics. The simulator loaded both the rubber tubing and the cadaveric specimen to within 0.1% of the load target, with an intertrial coefficient of variation below 0.1% for all clinically relevant loading protocols. The resultant kinematics calculated from the acquired images agreed with previously published values, and produced errors of 1.66 mm, 0.90 mm, 4.41 deg, and 1.60 deg with respect to anterior translation, compression, internal rotation, and valgus rotation, respectively. All images were free of artifacts and showed knee joint displacements in response to clinically and functionally loading with isotropic CT image voxel spacing of 0.15 mm. The results of this study demonstrate that the joint-motion simulator is capable of applying accurate, clinically and functionally relevant loads to cadaveric knee joints, concurrent with micro-CT imaging. Nondestructive tracking of bony landmarks allows for the precise calculation of joint kinematics with less error than traditional optical tracking systems.
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October 2019
Research-Article
Development and Assessment of a Microcomputed Tomography Compatible Five Degrees-of-Freedom Knee Joint Motion Simulator
Alexandra M. Blokker,
Alexandra M. Blokker
Department of Biomedical Engineering,
Robarts Research Institute,
Western University,
London, ON N6A 5B9, Canada
Robarts Research Institute,
Western University,
London, ON N6A 5B9, Canada
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Alan M. Getgood,
Alan M. Getgood
Department of Surgery,
Fowler Kennedy Sports Medicine Clinic,
Western University,
London, ON N6A 3K7, Canada
Fowler Kennedy Sports Medicine Clinic,
Western University,
London, ON N6A 3K7, Canada
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Nathan J. Curiale,
Nathan J. Curiale
Department of Mechanical Engineering,
Western University,
London, ON N6A 5B9, Canada
Western University,
London, ON N6A 5B9, Canada
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Hristo N. Nikolov,
Hristo N. Nikolov
Robarts Research Institute,
Western University,
London, ON N6A 5B7, Canada
Western University,
London, ON N6A 5B7, Canada
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Justin G. Laing,
Justin G. Laing
Department of Biomedical Engineering,
Western University,
London, ON N6A 5B9, Canada
Western University,
London, ON N6A 5B9, Canada
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David W. Holdsworth,
David W. Holdsworth
Professor
Department of Medical Biophysics,
Western University,
London, ON N6A 5C1, Canada
Department of Medical Biophysics,
Western University,
London, ON N6A 5C1, Canada
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Timothy A. Burkhart
Timothy A. Burkhart
Department Mechanical Engineering,
Lawson Health Research Institute,
Western University,
London, ON N6A 5B9, Canada
Lawson Health Research Institute,
Western University,
1151 Richmond Road
,London, ON N6A 5B9, Canada
1Corresponding author.
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Alexandra M. Blokker
Department of Biomedical Engineering,
Robarts Research Institute,
Western University,
London, ON N6A 5B9, Canada
Robarts Research Institute,
Western University,
London, ON N6A 5B9, Canada
Alan M. Getgood
Department of Surgery,
Fowler Kennedy Sports Medicine Clinic,
Western University,
London, ON N6A 3K7, Canada
Fowler Kennedy Sports Medicine Clinic,
Western University,
London, ON N6A 3K7, Canada
Nathan J. Curiale
Department of Mechanical Engineering,
Western University,
London, ON N6A 5B9, Canada
Western University,
London, ON N6A 5B9, Canada
Hristo N. Nikolov
Robarts Research Institute,
Western University,
London, ON N6A 5B7, Canada
Western University,
London, ON N6A 5B7, Canada
Justin G. Laing
Department of Biomedical Engineering,
Western University,
London, ON N6A 5B9, Canada
Western University,
London, ON N6A 5B9, Canada
David W. Holdsworth
Professor
Department of Medical Biophysics,
Western University,
London, ON N6A 5C1, Canada
Department of Medical Biophysics,
Western University,
London, ON N6A 5C1, Canada
Timothy A. Burkhart
Department Mechanical Engineering,
Lawson Health Research Institute,
Western University,
London, ON N6A 5B9, Canada
Lawson Health Research Institute,
Western University,
1151 Richmond Road
,London, ON N6A 5B9, Canada
1Corresponding author.
Manuscript received December 18, 2017; final manuscript received May 1, 2019; published online July 15, 2019. Editor: Beth A. Winkelstein.
J Biomech Eng. Oct 2019, 141(10): 101006 (10 pages)
Published Online: July 15, 2019
Article history
Received:
December 18, 2017
Revised:
May 1, 2019
Citation
Blokker, A. M., Getgood, A. M., Curiale, N. J., Nikolov, H. N., Laing, J. G., Holdsworth, D. W., and Burkhart, T. A. (July 15, 2019). "Development and Assessment of a Microcomputed Tomography Compatible Five Degrees-of-Freedom Knee Joint Motion Simulator." ASME. J Biomech Eng. October 2019; 141(10): 101006. https://doi.org/10.1115/1.4043755
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