A Robotic Clamped-Kinematic System to Study Knee Ligament Injury.

Journal: Annals of biomedical engineering
PMID: 39356378

Abstract

Knee ligament injury is among the most common sports injuries and is associated with long recovery periods and low return-to-sport rates. Unfortunately, the mechanics of ligament injury are difficult to study in vivo, and computational studies provide limited insight. The objective of this study was to implement and validate a robotic system capable of reproducing natural six degree-of-freedom clamped-kinematic trajectories on human cadaver knees (meaning that positions and orientations are rigidly controlled and resultant loads are measured). To accomplish this, we leveraged the field's recent access to high-fidelity bone kinematics from dynamic biplanar radiography (DBR), and implemented these kinematics in a coordinate frame built around the knee's natural flexion-extension axis. We assessed our system's capabilities in the context of ACL injury, by moving seven cadaveric knee specimens through kinematics derived from walking, running, drop jump, and ACL injury. We then used robotically simulated clinical stability tests to evaluate the hypothesis that knee stability would be only reduced by the motions intended to injure the knee. Our results show that the structural integrity of the knee was not compromised by non-injurious motions, while the injury motion produced a clinically relevant ACL injury with characteristic anterior and valgus instability. We also demonstrated that our robotic system can provide direct measurements of reaction loads during a variety of motions, and facilitate gross evaluation of ligament failure mechanisms. Clamped-kinematic robotic evaluation of cadaver knees has the potential to deepen understanding of the mechanics of knee ligament injury.

Authors

  • Ophelie M Herve
    Department of Mechanical and Aerospace Engineering, University of California, Los Angeles, CA, 90095, USA.
  • Will Flanagan
    Department of Mechanical and Aerospace Engineering, University of California, Los Angeles, CA, 90095, USA.
  • Jake Kanetis
    Department of Mechanical and Aerospace Engineering, University of California, Los Angeles, CA, 90095, USA.
  • Bailey Mooney
    Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90095, USA.
  • Thomas J Kremen
    Division of Sports Medicine and Shoulder Surgery, Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California.
  • David R McAllister
    Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
  • Tyler R Clites
    MIT Center for Extreme Bionics, Massachusetts Institute of Technology, Cambridge, MA.

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