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Bioengineering
Special Issues
Joint Biomechanics and Implant Design
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Joint Biomechanics and Implant Design

A special issue of Bioengineering (ISSN 2306-5354). This special issue belongs to the section "Biomechanics and Sports Medicine".

Deadline for manuscript submissions: 31 May 2025 | Viewed by 7078

Special Issue Editor

Dr. Ryan Willing

E-Mail Website
Guest Editor
Department of Mechanical and Materials Engineering, Western University, London, ON, Canada
Interests: orthopaedic biomechanics; joint motion simulation; prosthesis design

Special Issue Information

Dear Colleagues,

The outcomes of surgical interventions that address joint injury and degradation continue to improve, in no small part aided by novel surgical technologies, refined surgical techniques, and enhanced prosthesis designs. We also cannot overlook advancements in tools that enable us to evaluate joint biomechanics and new implant designs, as these provide important pre-clinical evidence and closed-loop feedback to guide further developments. This Special Issue showcases recent advances in the tools and techniques utilized for evaluating joint biomechanics and implants, and the novel findings that have been obtained using such techniques.

Potential topics include, but are not limited to, the following:

  • Novel experimental, computational and imaging tools for assessing joint biomechanics and/or implant design;
  • New paradigms in the pre-clinical evaluation of surgical techniques and/or implant designs;
  • New insights on surgical interventions and/or implant designs related to joint biomechanics;
  • Musculoskeletal models for understanding joint biomechanics and factors influencing their accuracy;
  • Design/optimization/failure analysis of implants/grafts.

Dr. Ryan Willing
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Bioengineering is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • orthopedics
  • sports medicine
  • arthroplasty
  • prosthesis design
  • finite element analysis
  • joint motion simulators
  • imaging
  • contact mechanics
  • instability
  • loosening

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (8 papers)

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Research

14 pages, 3740 KiB  
Article
A Biomechanical Evaluation of a Novel Interspinous Process Device: In Vitro Flexibility Assessment and Finite Element Analysis
by Hangkai Shen, Chuanguang Ju, Tao Gao, Jia Zhu and Weiqiang Liu
Bioengineering 2025, 12(4), 384; https://doi.org/10.3390/bioengineering12040384 - 3 Apr 2025
Viewed by 166
Abstract
The interspinous process device (IPD) has emerged as a viable alternative for managing lumbar degenerative pathologies. Nevertheless, limited research exists regarding mechanical failure modes including device failure and spinous process fracture. This study developed a novel IPD (IPD-NEW) and systematically evaluated its biomechanical [...] Read more.
The interspinous process device (IPD) has emerged as a viable alternative for managing lumbar degenerative pathologies. Nevertheless, limited research exists regarding mechanical failure modes including device failure and spinous process fracture. This study developed a novel IPD (IPD-NEW) and systematically evaluated its biomechanical characteristics through finite element (FE) analysis and in vitro cadaveric biomechanical testing. Six human L1–L5 lumbar specimens were subjected to mechanical testing under four experimental conditions: (1) Intact spine (control); (2) L3–L4 implanted with IPD-NEW; (3) L3–L4 implanted with Wallis device; (4) L3–L4 implanted with Coflex device. Segmental range of motion (ROM) was quantified across all test conditions. A validated L1–L5 finite element model was subsequently employed to assess biomechanical responses under both static and vertical vibration loading regimes. Comparative analysis revealed that IPD-NEW demonstrated comparable segmental ROM to the Wallis device while exhibiting lower rigidity than the Coflex implant. The novel design effectively preserved physiological spinal mobility while enhancing load distribution capacity. IPD-NEW demonstrated notable reductions in facet joint forces, device stress concentrations, and spinous process loading compared to conventional implants, particularly under vibrational loading conditions. These findings suggest that IPD-NEW may mitigate risks associated with facetogenic pain, device failure, and spinous process fracture through optimized load redistribution. Full article
(This article belongs to the Special Issue Joint Biomechanics and Implant Design)
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16 pages, 2915 KiB  
Article
Optimization of Tibial Stem Geometry in Total Knee Arthroplasty Using Design of Experiments: A Finite Element Analysis
by Hyun Hee Lee, Hyoung-Taek Hong, Jong-Keun Kim, Yong-Gon Koh, Kwan Kyu Park and Kyoung-Tak Kang
Bioengineering 2025, 12(2), 172; https://doi.org/10.3390/bioengineering12020172 - 11 Feb 2025
Viewed by 778
Abstract
The stability of the tibial component in Total Knee Arthroplasty (TKA) is critical to preventing aseptic loosening, a major cause of implant failure. However, existing tibial stem designs often lead to stress shielding and bone resorption, highlighting the need for further optimization. This [...] Read more.
The stability of the tibial component in Total Knee Arthroplasty (TKA) is critical to preventing aseptic loosening, a major cause of implant failure. However, existing tibial stem designs often lead to stress shielding and bone resorption, highlighting the need for further optimization. This study addresses these challenges by employing the Design of Experiments (DOE) methodology, specifically utilizing a full factorial design approach combined with finite element analysis (FEA), to optimize the geometry of the tibial stem. The material properties of the cortical and cancellous bone, as well as the tibial tray, were assigned based on values from the literature, representing their elastic moduli and Poisson’s ratios. For boundary conditions, the distal end of the tibia was fully constrained to simulate realistic load transfer, while compressive loads representative of walking and daily activities were applied to the tibial base. Key design parameters, including stem diameter, length, mediolateral ratio (M/L ratio), and wing angle, were systematically analyzed. The results identified stem diameter and length as the most influential factors in improving biomechanical performance, while the wing angle showed minimal impact. The optimized design, featuring a stem diameter of 12 mm, length of 40 mm, M/L ratio of 0.61, and a wing angle of 60°, demonstrated significant reductions in stress shielding and aseptic loosening compared to conventional models. These findings provide valuable insights into enhancing the long-term success of TKA implants by balancing implant stability and minimizing bone resection. Full article
(This article belongs to the Special Issue Joint Biomechanics and Implant Design)
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13 pages, 2882 KiB  
Article
Comparative Study on Three Different Designs of Locking Mechanisms in Total Knee Arthroplasty
by Byung Woo Cho, Hyoung-Taek Hong, Yong-Gon Koh, Kwan Kyu Park and Kyoung-Tak Kang
Bioengineering 2025, 12(2), 169; https://doi.org/10.3390/bioengineering12020169 - 10 Feb 2025
Viewed by 637
Abstract
The locking mechanism of the fixed-bearing tibial insert is a crucial factor in total knee arthroplasty. Previous studies have predominantly been retrieval-based, with no research examining the forces required for disassembly and assembly based on the design of the tibial insert’s locking mechanism. [...] Read more.
The locking mechanism of the fixed-bearing tibial insert is a crucial factor in total knee arthroplasty. Previous studies have predominantly been retrieval-based, with no research examining the forces required for disassembly and assembly based on the design of the tibial insert’s locking mechanism. This study aimed to measure the disassembly and assembly forces of three different locking mechanism designs. Group 1 featured a dovetail design, Group 2 had a peripheral rim design, and Group 3 combined a snap-fit mechanism with a dovetail design. Among the groups, Group 1 exhibited the highest disassembly force (379 ± 42 N), followed by Group 3 (342 ± 58) and then Group 2 (269 ± 18). Similarly, Group 1 also demonstrated the highest assembly force (71 ± 3); however, Group 3 showed a lower assembly force (48.7 ± 2.1) compared to Group 2 (49.7 ± 1.5). These results suggest that design modifications can produce mechanisms requiring minimal assembly force while maintaining strong resistance to disassembly. Due to its snap-pit structure, Group 3 exhibited the lowest assembly force while utilizing the dovetail mechanism to demonstrate a strong disassembly force. The rigorous analysis and robust methodology employed in this study ensure the reliability of the findings, which can serve as a reference for future research and development in this field. Full article
(This article belongs to the Special Issue Joint Biomechanics and Implant Design)
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18 pages, 3962 KiB  
Article
Muscle-Driven Total Knee Replacement Stability with Virtual Ligaments
by Alexandre Galley, Emma Donnelly, Ilya Borukhov, Brent Lanting and Ryan Willing
Bioengineering 2025, 12(2), 112; https://doi.org/10.3390/bioengineering12020112 - 25 Jan 2025
Viewed by 631
Abstract
Knee joint stability comprises passive (ligaments), active (muscles), and static (articular congruency) contributors. The stability of total knee replacement (TKR) implants can be assessed pre-clinically using joint motion simulators. However, contemporary testing methods with these platforms do not accurately reproduce the biomechanical contributions [...] Read more.
Knee joint stability comprises passive (ligaments), active (muscles), and static (articular congruency) contributors. The stability of total knee replacement (TKR) implants can be assessed pre-clinically using joint motion simulators. However, contemporary testing methods with these platforms do not accurately reproduce the biomechanical contributions of passive stabilizers, active stabilizers, or both. A key component of joint stability is therefore missing from laxity tests. A recently developed muscle actuator system (MAS) pairs the quadriceps-driven motion capabilities of an Oxford knee simulator with the prescribed displacements and laxity testing methods of a VIVO robotic knee testing system, which also includes virtual ligament capabilities. Using a TKR-embedded non-cadaveric joint analogue, TKR with two different virtual ligament models were compared to TKR with no active ligaments. Laxity limits were then obtained for both developed models using the conventional style of laxity testing (the VIVO’s force/displacement control) and compared with results obtained under similar conditions with the MAS (gravity-dependent muscle control). Differences in joint control methods identified the need for muscle forces providing active joint stability, while differences in the effects of the virtual ligament models identified the importance of physiological representations of collateral ligaments during testing. Full article
(This article belongs to the Special Issue Joint Biomechanics and Implant Design)
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17 pages, 3709 KiB  
Article
Constraint of Different Knee Implant Designs Under Anterior–Posterior Shear Forces and Internal–External Rotation Moments in Human Cadaveric Knees
by Saskia A. Brendle, Sven Krueger, Joachim Grifka, Peter E. Müller, William M. Mihalko, Berna Richter and Thomas M. Grupp
Bioengineering 2025, 12(1), 87; https://doi.org/10.3390/bioengineering12010087 - 19 Jan 2025
Viewed by 695
Abstract
Instability remains one of the most common indications for revision after total knee arthroplasty. To gain a better understanding of how an implant will perform in vivo and support surgeons in selecting the most appropriate implant design for an individual patient, it is [...] Read more.
Instability remains one of the most common indications for revision after total knee arthroplasty. To gain a better understanding of how an implant will perform in vivo and support surgeons in selecting the most appropriate implant design for an individual patient, it is crucial to evaluate the implant constraint within clinically relevant ligament and boundary conditions. Therefore, this study investigated the constraint of three different implant designs (symmetrical implants with and without a post-cam mechanism and an asymmetrical medial-stabilized implant) under anterior–posterior shear forces and internal–external rotation moments at different flexion angles in human cadaveric knees using a six-degrees-of-freedom joint motion simulator. Both symmetrical designs showed no significant differences between the anterior–posterior range of motion of the medial and lateral condyles. In contrast, the medial-stabilized implant exhibited less anterior–posterior translation medially than laterally, without constraining the medial condyle to a fixed position. Furthermore, the post-cam implant design showed a significantly more posterior position of the femoral condyles in flexion compared to the other designs. The results show that despite the differences in ligament situations and individual implant positioning, specific characteristics of each implant design can be identified, reflecting the different geometries of the implant components. Full article
(This article belongs to the Special Issue Joint Biomechanics and Implant Design)
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15 pages, 3329 KiB  
Article
The Effect of Thigh Muscle Forces on Knee Contact Force in Female Patients with Severe Knee Osteoarthritis
by Tingting Liu, Hao Xie, Songhua Yan, Jizhou Zeng and Kuan Zhang
Bioengineering 2024, 11(12), 1299; https://doi.org/10.3390/bioengineering11121299 - 20 Dec 2024
Viewed by 896
Abstract
Thigh muscles greatly influence knee joint loading, and abnormal loading significantly contributes to the progression of knee osteoarthritis (KOA). Muscle weakness in KOA patients is common, but the specific contribution of each thigh muscle to joint loading is unclear. The gait data from [...] Read more.
Thigh muscles greatly influence knee joint loading, and abnormal loading significantly contributes to the progression of knee osteoarthritis (KOA). Muscle weakness in KOA patients is common, but the specific contribution of each thigh muscle to joint loading is unclear. The gait data from 10 severe female KOA patients and 10 controls were collected, and the maximum isometric forces of the biceps femoris long head (BFL), semitendinosus (ST), rectus femoris (RF), vastus lateralis (VL), and vastus medialis (VM) were calibrated via ultrasound. Four musculoskeletal (MSK) models were developed based on EMG-assisted optimization, static optimization, and ultrasound data. The ultrasound-calibrated EMG-assisted MSK model achieved higher accuracy (R2 > 0.97, RMSE < 0.045 Nm/kg). Patients exhibited increased VL and VM forces (p < 0.004) and decreased RF force (p < 0.006), along with elevated medial and total joint contact forces (p < 0.001) and reduced lateral forces (p < 0.001) compared to controls. The affected side relied on VL and BFL the most (p < 0.042), while RF was key for the unaffected side (p < 0.003). Ultrasound calibration and EMG-assisted optimization significantly enhanced MSK model accuracy. Patients exerted greater quadriceps and hamstring forces bilaterally, shifting knee loading medially, and depended more on the lateral thigh muscles on the affected side. Hamstrings contributed more to joint contact forces, while quadriceps’ contributions decreased. Full article
(This article belongs to the Special Issue Joint Biomechanics and Implant Design)
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33 pages, 4176 KiB  
Article
In Vitro Verification of Simulated Daily Activities Using Implant-Specific Kinematics from In Vivo Measurements
by Yashar A. Behnam, Ahilan Anantha Krishnan, Renate List and Chadd W. Clary
Bioengineering 2024, 11(11), 1108; https://doi.org/10.3390/bioengineering11111108 - 2 Nov 2024
Viewed by 1229
Abstract
The mechanism and boundary conditions used to drive experimental joint simulators have historically adopted standardized profiles developed from healthy, non-total knee arthroplasty (TKA) patients. The purpose of this study was to use implant-specific in vivo knee kinematics to generate physiologically relevant boundary conditions [...] Read more.
The mechanism and boundary conditions used to drive experimental joint simulators have historically adopted standardized profiles developed from healthy, non-total knee arthroplasty (TKA) patients. The purpose of this study was to use implant-specific in vivo knee kinematics to generate physiologically relevant boundary conditions used in the evaluation of cadaveric knees post-TKA. Implant-specific boundary conditions were generated by combining in vivo fluoroscopic kinematics, musculoskeletal modeling-generated quadriceps loading, and telemetric knee compressive loading during activities of daily living (ADL) to dynamically drive a servo-hydraulic knee joint simulator. Ten cadaveric knees were implanted with the same TKA components and mounted in the knee simulator to verify the resulting load profiles against reported fluoroscopic kinematics and loading captured by an ultra-congruent telemetric knee implant. The cadaveric simulations resulted in implant-specific boundary conditions, which accurately recreate the in vivo performance of the like-implanted knee, with Root Mean Square Error (RMSE) in femoral low point kinematics below 2.0 mm across multiple activities of daily living. This study demonstrates the viability of in vivo fluoroscopy as the source of relevant boundary conditions for a novel knee loading apparatus, enabling dynamic cadaveric knee loading that aligns with clinical observations to improve the preclinical development of TKA component design. Full article
(This article belongs to the Special Issue Joint Biomechanics and Implant Design)
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18 pages, 4215 KiB  
Article
Kinematic Patterns of Different Loading Profiles Before and After Total Knee Arthroplasty: A Cadaveric Study
by Saskia A. Brendle, Sven Krueger, Janno Fehrenbacher, Joachim Grifka, Peter E. Müller, William M. Mihalko, Berna Richter and Thomas M. Grupp
Bioengineering 2024, 11(11), 1064; https://doi.org/10.3390/bioengineering11111064 - 24 Oct 2024
Cited by 1 | Viewed by 1175
Abstract
One of the major goals of total knee arthroplasty (TKA) is to restore the physiological function of the knee. In order to select the appropriate TKA design for a specific patient, it would be helpful to understand whether there is an association between [...] Read more.
One of the major goals of total knee arthroplasty (TKA) is to restore the physiological function of the knee. In order to select the appropriate TKA design for a specific patient, it would be helpful to understand whether there is an association between passive knee kinematics intraoperatively and during complex activities, such as ascending stairs. Therefore, the primary objective of this study was to compare the anterior–posterior (AP) range of motion during simulated passive flexion and stair ascent at different conditions in the same knees using a six-degrees-of-freedom joint motion simulator, and secondary, to identify whether differences between TKA designs with and without a post-cam mechanism can be detected during both activities, and if one design is superior in recreating the AP translation of the native knee. It was shown that neither TKA design was superior in restoring the mean native AP translation, but that both CR/CS and PS TKA designs may be suitable to restore the individual native kinematic pattern. Moreover, it was shown that passive and complex loading scenarios do not result in exactly the same kinematic pattern, but lead to the same choice of implant design to restore the general kinematic behavior of the native individual knee. Full article
(This article belongs to the Special Issue Joint Biomechanics and Implant Design)
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