Multiscale Syntheses of Knee Collateral Ligament Stresses: Aggregate Mechanics as a Function of Molecular Properties

Knee collateral ligaments play a significant role in restraining excessive frontal motion (varus/valgus rotations). In this investigation, a multiscale frame was developed based on structural hierarchies of the collateral ligaments starting from the bottom (tropocollagen molecule) to up where the fibred reinforced structure established. Experimental data of failure tensile test were considered as the principal driver of the developed model. This model was calibrated statistically using Bayesian calibration due to the high number of unknown parameters. Then the model is scaled up to fit the real structure of the collateral ligaments and simulated under realistic boundary conditions. Predications have been successful in describing the observed transient response of the collateral ligaments during tensile test under pre- and post-damage loading conditions. Collateral ligaments maximum stresses and strengths were observed near to the femoral insertions, a results that is in good agreement with experimental investigations. Also for the first time, damage initiation and propagation were documented with this model as a function of the cross-link density between tropocollagen molecules.





References:
[1] Almekinders, L. C. and A. J. Banes, Tendon and Ligaments, in Human Cell Culture. 2001, Springer. p. 17-25.
[2] Amiel, D., et al., Tendons and ligaments: a morphological and biochemical comparison. Journal of Orthopaedic Research, 1983. 1(3): p. 257-265.
[3] Gardiner, J. C. and J. A. Weiss, Subject-specific finite element analysis of the human medial collateral ligament during valgus knee loading. J Orthop Res, 2003. 21(6): p. 1098-106.
[4] Gardiner, J. C., J. A. Weiss, and T. D. Rosenberg, Strain in the human medial collateral ligament during valgus loading of the knee. Clin Orthop Relat Res, 2001. 391(391): p. 266-74.
[5] Weiss, J. A. and J. C. Gardiner, Computational modeling of ligament mechanics. Crit Rev Biomed Eng, 2001. 29(3): p. 303-71.
[6] Lorentzon, R., H. Wedrèn, and T. Pietilä, Incidence, nature, and causes of ice hockey injuries: a three-year prospective study of a Swedish elite ice hockey team. The American journal of sports medicine, 1988. 16(4): p. 392-396.
[7] Najibi, S. and J. P. Albright, The use of knee braces, part 1: prophylactic knee braces in contact sports. The American journal of sports medicine, 2005. 33(4): p. 602-611.
[8] Warme, W. J., et al., Ski injury statistics, 1982 to 1993, Jackson Hole ski resort. The American journal of sports medicine, 1995. 23(5): p. 597-600.
[9] Grood, E., et al., Ligamentous and capsular restraints preventing straight medial and lateral laxity in intact human cadaver knees. JBJS, 1981. 63(8): p. 1257-1269.
[10] Kennedy, J., et al., Tension studies of human knee ligaments. Yield point, ultimate failure, and disruption of the cruciate and tibial collateral ligaments. The Journal of bone and joint surgery. American volume, 1976. 58(3): p. 350-355.
[11] Blankevoort, L. and R. Huiskes, Ligament-bone interaction in a three-dimensional model of the knee. J Biomech Eng, 1991a. 113(3): p. 263-9.
[12] Orozco, G. A., et al., The effect of constitutive representations and structural constituents of ligaments on knee joint mechanics. Scientific reports, 2018. 8(1): p. 2323.
[13] Tang, H., M. J. Buehler, and B. Moran, A constitutive model of soft tissue: from nanoscale collagen to tissue continuum. Ann Biomed Eng, 2009. 37(6): p. 1117-30.
[14] Tang, Y., et al., Deformation micromechanisms of collagen fibrils under uniaxial tension. J R Soc Interface, 2010. 7(46): p. 839-50.
[15] Buehler, M. J. and R. Ballarini, Materiomics: multiscale mechanics of biological materials and structures. 2013: Springer.
[16] Butler, D. L., M. D. Kay, and D. C. Stouffer, Comparison of material properties in fascicle-bone units from human patellar tendon and knee ligaments. J Biomech, 1986. 19(6): p. 425-32.
[17] Erdemir, A., Open knee: open source modeling & simulation to enable scientific discovery and clinical care in knee biomechanics. The journal of knee surgery, 2016. 29(2): p. 107.
[18] Dhaher, Y. Y., T. H. Kwon, and M. Barry, The effect of connective tissue material uncertainties on knee joint mechanics under isolated loading conditions. J Biomech, 2010. 43(16): p. 3118-25.
[19] Eppell, S., et al., Nano measurements with micro-devices: mechanical properties of hydrated collagen fibrils. Journal of the Royal Society Interface, 2006. 3(6): p. 117-121.
[20] Shen, Z. L., et al., Stress-strain experiments on individual collagen fibrils. Biophysical journal, 2008. 95(8): p. 3956-3963.
[21] Shen, Z. L., et al., Viscoelastic properties of isolated collagen fibrils. Biophysical journal, 2011. 100(12): p. 3008-3015.
[22] Yamamoto, N., ensile Strength of Single Collagen Fibrils Isolated from Tendons. European Journal of Biophysics, 2017. 5(1): p. 6.
[23] Couppe, C., et al., Mechanical properties and collagen cross-linking of the patellar tendon in old and young men. Journal of applied physiology, 2009. 107(3): p. 880-886.
[24] Gautieri, A., et al., Age- and diabetes-related nonenzymatic crosslinks in collagen fibrils: candidate amino acids involved in Advanced Glycation End-products. Matrix Biol, 2014. 34: p. 89-95.
[25] Noyes, F. R., J. L. DeLucas, and P. J. Torvik, Biomechanics of Anterior Cruciate Ligament Failure: An Analysis of. J. Bone Joint Surg. Am, 1974. 56: p. 236-253.
[26] Noyes, F. R., et al., Biomechanics of ligament failure: II. An analysis of immobilization, exercise, and reconditioning effects in primates. JBJS, 1974. 56(7): p. 1406-1418.