A noninvasive MRI based approach to estimate the mechanical properties of human knee ligaments

Hamid Naghibi; Valentina Mazzoli; Kaj Gijsbertse; Gerjon Hannink; Andre Sprengers; Dennis Janssen; Ton Van den Boogaard; Nico Verdonschot

doi:10.1016/j.jmbbm.2019.01.022

A noninvasive MRI based approach to estimate the mechanical properties of human knee ligaments

J Mech Behav Biomed Mater. 2019 May:93:43-51. doi: 10.1016/j.jmbbm.2019.01.022. Epub 2019 Feb 7.

Authors

Hamid Naghibi¹, Valentina Mazzoli², Kaj Gijsbertse³, Gerjon Hannink³, Andre Sprengers³, Dennis Janssen³, Ton Van den Boogaard⁴, Nico Verdonschot⁵

Affiliations

¹ Orthopaedic Research Lab, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands; Robotics and Mechatronics Group, The Faculty of Electrical Engineering Mathematics and Computer Science, Technical Medical Centre, University of Twente, Enschede, the Netherlands. Electronic address: h.naghibibeidokhti@utwente.nl.
² Orthopaedic Research Lab, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Radiology, Stanford University, Stanford, CA, USA.
³ Orthopaedic Research Lab, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands.
⁴ Nonlinear Solid Mechanics, Faculty of Engineering Technology, University of Twente, Enschede, the Netherlands.
⁵ Orthopaedic Research Lab, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands; Laboratory of Biomechanical Engineering, University of Twente, Enschede, the Netherlands.

PMID: 30769233
DOI: 10.1016/j.jmbbm.2019.01.022

Abstract

Characterization of the main tibiofemoral ligaments is an essential step in developing patient-specific computational models of the knee joint for personalized surgery pre-planning. Tensile tests are commonly performed in-vitro to characterize the mechanical stiffness and rupture force of the knee ligaments which makes the technique unsuitable for in-vivo application. The time required for the limited noninvasive approaches for properties estimation based on knee laxity remained the main obstacle in clinical implementation. Magnetic resonance imaging (MRI) technique can be a platform to noninvasively assess the knee ligaments. In this study the aim was to explore the potential role of quantitative MRI and dimensional properties, in characterizing the mechanical properties of the main tibiofemoral ligaments. After MR scanning of six cadaveric legs, all 24 main tibiofemoral bone-ligaments-bone specimens were tested in vitro. During the tensile test cross sectional area of the specimens was captured using ultrasound and force-displacement curve was extracted. Digital image correlation technique was implemented to check the strain behavior of the specimen and rupture region and to assure the fixation of ligament bony block during the test. The volume of the specimen was measured using manual segmentation data, and quantitative MR parameters as T₂^*, T_1ρ, and T₂ were calculated. Linear mixed statistical models for repeated measures were used to examine the association of MRI parameters and dimensional measurements with the mechanical properties (stiffness and rupture force). The results shows that while the mechanical properties were mostly correlated to the volume, inclusion of the MR parameters increased the correlation strength for stiffness (R² ≈ 0.48) and partial rupture force (R² = 0.53). Inclusion of ligament type in the statistical analysis enhanced the correlation of mechanical properties with MR parameters and volume as for stiffness (R² = 0.60) and partial rupture (R² = 0.57). In conclusion, this study revealed the potentials in using quantitative MR parameters, T_1ρ, T₂ and T₂^*, combined with specimen volume to estimate the essential mechanical properties of all main tibiofemoral ligaments required for subject-specific computational modeling of human knee joint.

Keywords: Computational model; Knee ligaments; Mechanical properties; Non-invasive characterization; Quantitative MRI.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Biomechanical Phenomena
Humans
Image Processing, Computer-Assisted
Knee*
Ligaments, Articular / diagnostic imaging*
Magnetic Resonance Imaging*
Materials Testing
Mechanical Phenomena*
Tensile Strength