07.11.2024

The Fraunhofer Institute for Digital Medicine MEVIS, the University Medical Center Freiburg and Stryker Leibinger GmbH have received an award for their work on a finite element simulation for individual therapy planning for knee injuries. This innovative method enables personalized planning of cruciate ligament operations and could prevent long-term follow-up problems such as osteoarthritis.

Knee injuries are among the most common conditions in orthopaedics.

Image: Simulation model of the knee joint; Copyright: Fraunhofer MEVIS

A finite element simulation model of the knee joint (left) enables the dynamic prediction and analysis of various joint positions, such as hyperextension, resting position, and 20° flexion, from left to right (MRI data University Medical Center Freiburg).

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Simulation of optimal cruciate ligament fixation

The knee joint is stabilized by ligaments, including the anterior cruciate ligament. The reconstruction of this ligament after injury is complex, as the position and tension of the replacement ligament have a major influence on the mobility of the knee. In the PLANK project, a simulation enables doctors to determine the optimal fixation of the cruciate ligament on the computer. "With our decision support system, knee surgeries can become more patient-specific," explains Dr. Elin Theilen from Fraunhofer MEVIS. The aim is to avoid secondary problems such as cartilage damage in the long term and to optimize the therapy for each patient individually.

3D model and dynamic pressure distribution

The simulation is based on a 3D model of the knee joint. Using the finite element method (FEM), the structure of the knee is divided into small elements that simulate a detailed pressure and stress distribution. The static MR routine images of the knee joints were used to segment the anatomical structures, which were then used for the simulation. The FEM simulation allows doctors to focus in detail on the affected structures and analyze movement, tension and pressure distribution.

Validation and clinical application

The FEM model was validated at the University Medical Center Freiburg with eleven healthy volunteers who performed knee scans under various loads. The simulation achieved an accuracy of 2 mm in translation and 1 degree in angle compared to the reference position of the knee. The FEM model is a useful tool for individually deciding how best to restore the stability and functionality of the knee joint after injury.

Wide range of applications

The FEM model is not only suitable for cruciate ligament injuries, but can also be used for other knee problems such as implants or fractures. The PLANK project was developed by Fraunhofer MEVIS, the University Medical Center Freiburg and Stryker Leibinger GmbH & Co. KG and funded with 1.5 million euros by the Federal Ministry of Education and Research.

MEDICA-tradefair.com; Source: Fraunhofer Institute for Digital Medicine MEVIS

More about the Fraunhofer MEVIS at: www.mevis.fraunhofer.en