J Knee Surg 2016; 29(02): 149-158
DOI: 10.1055/s-0035-1570114
Special Focus Section
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The Use of Finite Element Analysis to Enhance Research and Clinical Practice in Orthopedics

Ferris M. Pfeiffer
1   Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri
2   Department of Bioengineering, University of Missouri, Columbia, Missouri
› Author Affiliations
Further Information

Publication History

30 April 2015

01 November 2015

Publication Date:
08 January 2016 (online)

Abstract

Finite element analysis (FEA) is a very powerful tool for the evaluation of biomechanics in orthopedics. Finite element (FE) simulations can effectively and efficiently evaluate thousands of variables (such as implant variation, surgical techniques, and various pathologies) to optimize design, screening, prediction, and treatment in orthopedics. Additionally, FEA can be used to retrospectively evaluate and troubleshoot complications or failures to prevent similar future occurrences. Finally, FE simulations are used to evaluate implants, procedures, and techniques in a time- and cost-effective manner. In this work, an overview of the development of FE models is provided and an example application is presented to simulate knee biomechanics for a specimen with medial meniscus insufficiency. FE models require the development of the geometry of interest, determination of the material properties of the tissues simulated, and an accurate application of a numerical solver to produce an accurate solution and representation of the field variables. The objectives of this work are to introduce the reader to the application of FEA in orthopedic analysis of the knee joint. A brief description of the model development process as well as a specific application to the investigation of knee joint stability in geometries with normal or compromised medial meniscal attachment is included. Significant increases in stretch of the anterior cruciate ligament were predicted in specimens with medial meniscus insufficiency (such behavior was confirmed in corresponding biomechanical testing). It can be concluded from this work that FE analysis of the knee can provide significant new information with which more effective clinical decisions can be made.

 
  • References

  • 1 Cook RD, Malkus DS, Plesha ME, Witt RJ. Concepts and Applications of Finite Element Analysis. 4th ed. New York: John Wiley & Sons, Inc; 2002
  • 2 Fagan MJ, Julian S, Mohsen AM. Finite element analysis in spine research. Proc Inst Mech Eng H 2002; 216 (5) 281-298
  • 3 Goel VK, Gilbertson LG. Applications of the finite element method to thoracolumbar spinal research—past, present, and future. Spine 1995; 20 (15) 1719-1727
  • 4 Goel VK, Kong W, Han JS, Weinstein JN, Gilbertson LG. A combined finite element and optimization investigation of lumbar spine mechanics with and without muscles. Spine 1993; 18 (11) 1531-1541
  • 5 Huebner KH, Dewhirst DL, Smith DE, Byrom TG. The Finite Element Method for Engineers. 4th ed. New York: John Wiley & Sons, Inc; 2001
  • 6 Kong WZ, Goel VK. Ability of the finite element models to predict response of the human spine to sinusoidal vertical vibration. Spine 2003; 28 (17) 1961-1967
  • 7 Liebschner MAK, Kopperdahl DL, Rosenberg WS, Keaveny TM. Finite element modeling of the human thoracolumbar spine. Spine 2003; 28 (6) 559-565
  • 8 Mattei L, Campioni E, Accardi MA, Dini D. Finite element analysis of the meniscectomised tibio-femoral joint: implementation of advanced articular cartilage models. Comput Methods Biomech Biomed Engin 2014; 17 (14) 1553-1571
  • 9 Noor AK. Bibliography of books and monographs on finite element technology. Appl Mech Rev 1991; 44 (6) 307-317
  • 10 Pfeiffer FM, Smith DE, Ward CV, Alander DA. Patient Specific Finite Element Modeling of Lumbar Vertebrae. Palo Alto, CA: American Society of Biomechanics; 2007
  • 11 Reddy JN. An Introduction to the Finite Element Method. 2nd ed. New York: McGraw-Hill Book Co.; 1993
  • 12 Williamson Jr F. An historical note on the finite element method. Int J Numer Methods Eng 1980; 15 (6) 930-934
  • 13 Belytschko T, Kulak RF, Schultz AB, Galante JO. Finite element stress analysis of an intervertebral disc. J Biomech 1974; 7 (3) 277-285
  • 14 Crawford RP, Rosenberg WS, Keaveny TM. Quantitative computed tomography-based finite element models of the human lumbar vertebral body: effect of element size on stiffness, damage, and fracture strength predictions. J Biomech Eng 2003; 125 (4) 434-438
  • 15 Faulkner KG, Cann CE, Hasegawa BH. Effect of bone distribution on vertebral strength: assessment with patient-specific nonlinear finite element analysis. Radiology 1991; 179 (3) 669-674
  • 16 Hirata Y, Inaba Y, Kobayashi N , et al. Correlation between mechanical stress by finite element analysis and 18F-fluoride PET uptake in hip osteoarthritis patients. J Orthop Res 2015; 33 (1) 78-83
  • 17 Hopkins AR, New AM, Rodriguez-y-Baena F, Taylor M. Finite element analysis of unicompartmental knee arthroplasty. Med Eng Phys 2010; 32 (1) 14-21
  • 18 Imai K, Ohnishi I, Bessho M, Nakamura K. Nonlinear finite element model predicts vertebral bone strength and fracture site. Spine 2006; 31 (16) 1789-1794
  • 19 Jacobs CR, Levenston ME, Beaupré GS, Simo JC, Carter DR. Numerical instabilities in bone remodeling simulations: the advantages of a node-based finite element approach. J Biomech 1995; 28 (4) 449-459
  • 20 Jog CS, Haber RB. Stability of finite element models for distributed-parameter optimization and topology design. Comput Methods Appl Mech Eng 1996; 130 (3–4) 203-226
  • 21 Kong WZ, Goel VK, Gilbertson LG, Weinstein JN. Effects of muscle dysfunction on lumbar spine mechanics. A finite element study based on a two motion segments model. Spine 1996; 21 (19) 2197-2206 , discussion 2206–2207
  • 22 Kumaresan S, Yoganandan N, Pintar FA, Maiman DJ, Kuppa S. Biomechanical study of pediatric human cervical spine: a finite element approach. J Biomech Eng 2000; 122 (1) 60-71
  • 23 Lee CK, Kim YE, Lee CS, Hong YM, Jung JM, Goel VK. Impact response of the intervertebral disc in a finite-element model. Spine 2000; 25 (19) 2431-2439
  • 24 Miller JAA, Haderspeck KA, Schultz AB. Posterior element loads in lumbar motion segments. Spine 1983; 8 (3) 331-337
  • 25 Natarajan RN, Garretson III RB, Biyani A, Lim TH, Andersson GBJ, An HS. Effects of slip severity and loading directions on the stability of isthmic spondylolisthesis: a finite element model study. Spine 2003; 28 (11) 1103-1112
  • 26 Rohlmann A, Zander T, Schmidt H, Wilke HJ, Bergmann G. Analysis of the influence of disc degeneration on the mechanical behaviour of a lumbar motion segment using the finite element method. J Biomech 2006; 39 (13) 2484-2490
  • 27 Schmidt H, Kettler A, Rohlmann A, Claes L, Wilke HJ. The risk of disc prolapses with complex loading in different degrees of disc degeneration - a finite element analysis. Clin Biomech (Bristol, Avon) 2007; 22 (9) 988-998
  • 28 Shuib S, Ridzwan M, Mohamad Ibrahim M, Tan C. Analysis of orthopedic screws for bone fracture fixations with finite element method. J Appl Sci 2007; 7 (13) 1748-1754
  • 29 Silva MJ, Keaveny TM, Hayes WC. Computed tomography-based finite element analysis predicts failure loads and fracture patterns for vertebral sections. J Orthop Res 1998; 16 (3) 300-308
  • 30 Totoribe K, Tajima N, Chosa E. A biomechanical study of posterolateral lumbar fusion using a three-dimensional nonlinear finite element method. J Orthop Sci 1999; 4 (2) 115-126
  • 31 Tsouknidas A, Sarigiannidis SO, Anagnostidis K, Michailidis N, Ahuja S. Assessment of stress patterns on a spinal motion segment in healthy versus osteoporotic bony models with or without disc degeneration: a finite element analysis. Spine J 2015; 15 (3, Suppl): S17-S22
  • 32 Beaubien BP, Derincek A, Lew WD, Wood KB. In vitro, biomechanical comparison of an anterior lumbar interbody fusion with an anteriorly placed, low-profile lumbar plate and posteriorly placed pedicle screws or translaminar screws. Spine 2005; 30 (16) 1846-1851
  • 33 Beaupré GS, Orr TE, Carter DR. An approach for time-dependent bone modeling and remodeling—theoretical development. J Orthop Res 1990; 8 (5) 651-661
  • 34 Beaupré GS, Orr TE, Carter DR. An approach for time-dependent bone modeling and remodeling-application: a preliminary remodeling simulation. J Orthop Res 1990; 8 (5) 662-670
  • 35 Blenman PR, Carter DR, Beaupré GS. Role of mechanical loading in the progressive ossification of a fracture callus. J Orthop Res 1989; 7 (3) 398-407
  • 36 Carter DR. Mechanical loading histories and cortical bone remodeling. Calcif Tissue Int 1984; 36 (Suppl. 01) S19-S24
  • 37 Carter DR, Beaupré GS. Skeletal Function and Form. Cambridge: Cambridge University Press; 2001
  • 38 Carter DR, Beaupré GS, Giori NJ, Helms JA. Mechanobiology of skeletal regeneration. Clin Orthop Relat Res 1998; (355, Suppl): S41-S55
  • 39 Carter DR, Blenman PR, Beaupré GS. Correlations between mechanical stress history and tissue differentiation in initial fracture healing. J Orthop Res 1988; 6 (5) 736-748
  • 40 Cowin SC, Hegedus DH. Bone remodeling I: theory of adaptive elasticity. J Elast 1976; 6 (3) 313-326
  • 41 Frost HM. The Laws of Bone Structure. Springfield, IL: Charles C. Thomas; 1964
  • 42 Frost HM. Bone “mass” and the “mechanostat”: a proposal. Anat Rec 1987; 219 (1) 1-9
  • 43 Goldring SR. Role of bone in osteoarthritis pathogenesis. Med Clin North Am 2009; 93 (1) 25-35 , xv
  • 44 Halvorson TL, Kelley LA, Thomas KA, Whitecloud III TS, Cook SD. Effects of bone mineral density on pedicle screw fixation. Spine 1994; 19 (21) 2415-2420
  • 45 Kummer BK. Biomechanics of Bone. Englewood Cliffs, CA: Prentice Hall; 1972
  • 46 Erdemir A. Open knee: a pathway to community driven modeling and simulation in joint biomechanics. J Med Device 2013; 7 (4) 0409101-409101