Optimized therapy for cruciate ligament injuries through digital simulation

Until now, treatment decisions have been based on static radiological images, although many complaints occur during movement. As part of the PLANK project (planning and navigation platform for the individualized treatment of cruciate ligament injuries), the researchers have developed a method that enables more precise treatment planning with the help of dynamic modelling. 

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. 

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. 

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