University of Oulu

Jahangir, S., Mohammadi, A., Mononen, M.E. et al. Rapid X-Ray-Based 3-D Finite Element Modeling of Medial Knee Joint Cartilage Biomechanics During Walking. Ann Biomed Eng 50, 666–679 (2022).

Rapid X-ray-based 3-D finite element modeling of medial knee joint cartilage biomechanics during walking

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Author: Jahangir, Sana1; Mohammadi, Ali1; Mononen, Mika E.1;
Organizations: 1Department of Applied Physics, University of Eastern Finland, POB 1627, 70211, Kuopio, Finland
2Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
3Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
4Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
5Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 2.9 MB)
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Language: English
Published: Springer Nature, 2022
Publish Date: 2022-08-30


Finite element (FE) modeling is becoming an increasingly popular method for analyzing knee joint mechanics and biomechanical mechanisms leading to osteoarthritis (OA). The most common and widely available imaging method for knee OA diagnostics is planar X-ray imaging, while more sophisticated imaging methods, e.g., magnetic resonance imaging (MRI) and computed tomography (CT), are seldom used. Hence, the capability to produce accurate biomechanical knee joint models directly from X-ray imaging would bring FE modeling closer to clinical use. Here, we extend our atlas-based framework by generating FE knee models from X-ray images (N = 28). Based on measured anatomical landmarks from X-ray and MRI, knee joint templates were selected from the atlas library. The cartilage stresses and strains of the X-ray-based model were then compared with the MRI-based model during the stance phase of the gait. The biomechanical responses were statistically not different between MRI- vs. X-ray-based models when the template obtained from X-ray imaging was the same as the MRI template. However, if this was not the case, the peak values of biomechanical responses were statistically different between X-ray and MRI models. The developed X-ray-based framework may pave the way for a clinically feasible approach for knee joint FE modeling.

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Series: Annals of biomedical engineering
ISSN: 0090-6964
ISSN-E: 1573-9686
ISSN-L: 0090-6964
Volume: 50
Issue: 6
Pages: 666 - 679
DOI: 10.1007/s10439-022-02941-0
Type of Publication: A1 Journal article – refereed
Field of Science: 3126 Surgery, anesthesiology, intensive care, radiology
Funding: Financial support from Academy of Finland (#324529, #324994, #328920, #334773—under the Frame of ERA PerMed), Strategic Funding of University of Eastern Finland, Sigrid Juselius Foundation and Alfred Kordelin Foundation (#190317) are acknowledged.
Dataset Reference: The online version contains supplementary material available at
Copyright information: © 2022 The Author(s). This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit