## Abstract

INTRODUCTION: Simultaneous prediction of body-level dynamics and detailed joint mechanics in the frame of musculoskeletal (MS) modeling represents still a highly computationally demanding task. Marra et al. (2014) recently presented and validated a MS model capable of concurrent prediction of muscle forces, knee ligament forces, tibiofemoral (TF) and patellofemoral (PF) contact forces in a MS model of Total Knee Arthroplasty (TKA) [1]. Simulation time for one complete gait cycle was in the order of 3 hours, and the iterative process that solved the equilibrium in the knee joint was thought to be the main source of overhead. Surrogate modeling techniques were suggested [2]. In this study, we develop a surrogate contact model of TKA to decrease the simulation time in the MS simulation. We hypothesize that the algorithm that allows the muscle fibers to wrap around the bones constitutes another source of overhead in the MS model. Therefore, we will also evaluate the performances of the surrogate model with and without muscle wrapping.

METHODS: The original tibial component from our TKA model [1] was split in a medial and lateral hemi-part and fixed to the ground, whereas the femoral part was left with 6 degrees of freedom (DOF). The contacting pairs exchanged three forces and three moments, which were assumed functions of the relative pose only. Translations (X, Y, Z) were defined relative to the tibial component frame and rotations of the femoral component (RotX, RotY, RotZ) were described with Cardan angles, using the z-y-x rotation sequence. Similarly to Lin et al (2010) [3] we identified two sensitive directions, Y and RotX and, therefore, we defined a sample point as composed by four pose parameters and the two loads in the sensitive directions: X, Fy, Z, Tx, RotY, RotZ.

Reference load-pose data were obtained from four simulations of gait, squat, chair-rise, and right-turn trials using the original contact model. The design space was populated using the Hammersley quasi-random sequence and adopting a multi-domain approach, as proposed by Eskinazi and Fregly (2015) [2]. One domain consisted of 20 data points per each frame of the four dynamic simulations, spanning the boundaries of ± 1 standard deviation from the time-varying reference envelopes. A second domain of 2500 points was generated in the principal component space of the reference load-pose data of each dynamic simulation, with boundaries enlarged by 50%. A third domain of 1000 data points represented one-side-contact situations, in which Tx was bounded to ± 4 Nm. In total, 36000 data points were sampled in the three different domains. Data points were evaluated using the original contact model (Fig. 1) by repeated Force-Dependent Kinematics (FDK) analyses. Data points which did not lead to equilibrium were discarded.

The remaining 27620 points were randomly subdivided into a training (70%) and testing (30%) group. Three separate Feed-Forward Artificial Neural Networks (FFANN), consisting of four inner layers of 20 hyperbolic tangent sigmoid neurons each, were configured within the Neural Network Toolbox in MATLAB 8.1 (The MathWorks Inc., Natick, MA, 2013). The first network was trained to learn the relationships between the four –two medial and two lateral– sensitive loads (output) and the six pose parameters (input). Two other networks –one medial and one lateral– were trained separately to learn the relationships between the remaining loads of each side (output) and all the pose parameters plus the two sensitive loads from each side (input). We used the popular Levenberg-Marquardt training algorithm in conjunction with Bayesian regularization to avoid over-fitting. Stopping criterion was a training time of two hours for each network. The trained networks were translated to custom C++ DLL functions for successive inclusion in our MS model. The surrogate contact model replaced the original contact model and one gait trial was simulated with 4 different combination of the following model settings: original versus surrogate contact model, wrapping enabled versus disabled.

RESULTS: The contact sampling model required 238 hours to evaluate the 36000 data points. Predicted tibiofemoral compressive forces under all simulated cases are shown in Fig. 2. A comparison with experimental measurements (eTibia line) is also shown. Surrogate model predictions showed a very good agreement with the original model counterparts. Fig. 3 summarizes the computation times: simulations took the longest when muscle wrapping was enabled and the benefits of using the surrogate model became evident only when the wrapping algorithm was switched off, leading to a 6x speed-up. Simulation time with the original contact model decreased by a factor of 8 by switching off the wrapping algorithm.

DISCUSSION: The use of FFANN-based surrogate contact model, in place of the original rigid contact model, could substantially reduce the simulation time of a full gait cycle down to 3 minutes, when the wrapping algorithm was turned off. Such improvement could not be achieved when using the wrapping algorithm. This enlightens another important source of overhead in MS modeling –the muscle wrapping algorithm– which unexpectedly was found to dominate the simulation time. At each FDK iteration, the wrapping algorithm needs to be solved as well, introducing overhead. If the wrapping algorithm is slower than the contact algorithm, then the computation time of each step will be dominated by the former, leaving only a small fraction to be gained from the latter.

SIGNIFICANCE: We showed that surrogate contact model could reduce the simulation time in a MS model of TKA down to a level which allows parametric studies and/or optimization to be feasible. We also discovered that the muscle wrapping algorithm constituted an unexpectedly large source of overhead during dynamic simulations. These represent new and important findings for the MS modeling community.

REFERENCES: [1] M. A. Marra, V. Vanheule, R. Fluit, B. H. F. J. M. Koopman, J. Rasmussen, N. J. J. Verdonschot, and M. S. Andersen, “A Subject-Specific Musculoskeletal Modeling Framework to Predict in Vivo Mechanics of Total Knee Arthroplasty.,” J. Biomech. Eng., Nov. 2014.

[2] I. Eskinazi and B. J. Fregly, “Surrogate modeling of deformable joint contact using artificial neural networks.,” Med. Eng. Phys., Jul. 2015.

[3] Y.-C. Lin, R. T. Haftka, N. V Queipo, and B. J. Fregly, “Surrogate articular contact models for computationally efficient multibody dynamic simulations.,” Med. Eng. Phys., vol. 32, no. 6, pp. 584–94, Jul. 2010.

ACKNOWLEDGEMENTS: This study was conducted within the ERC ‘BioMechTools’ project, funded by the European Research Council.

METHODS: The original tibial component from our TKA model [1] was split in a medial and lateral hemi-part and fixed to the ground, whereas the femoral part was left with 6 degrees of freedom (DOF). The contacting pairs exchanged three forces and three moments, which were assumed functions of the relative pose only. Translations (X, Y, Z) were defined relative to the tibial component frame and rotations of the femoral component (RotX, RotY, RotZ) were described with Cardan angles, using the z-y-x rotation sequence. Similarly to Lin et al (2010) [3] we identified two sensitive directions, Y and RotX and, therefore, we defined a sample point as composed by four pose parameters and the two loads in the sensitive directions: X, Fy, Z, Tx, RotY, RotZ.

Reference load-pose data were obtained from four simulations of gait, squat, chair-rise, and right-turn trials using the original contact model. The design space was populated using the Hammersley quasi-random sequence and adopting a multi-domain approach, as proposed by Eskinazi and Fregly (2015) [2]. One domain consisted of 20 data points per each frame of the four dynamic simulations, spanning the boundaries of ± 1 standard deviation from the time-varying reference envelopes. A second domain of 2500 points was generated in the principal component space of the reference load-pose data of each dynamic simulation, with boundaries enlarged by 50%. A third domain of 1000 data points represented one-side-contact situations, in which Tx was bounded to ± 4 Nm. In total, 36000 data points were sampled in the three different domains. Data points were evaluated using the original contact model (Fig. 1) by repeated Force-Dependent Kinematics (FDK) analyses. Data points which did not lead to equilibrium were discarded.

The remaining 27620 points were randomly subdivided into a training (70%) and testing (30%) group. Three separate Feed-Forward Artificial Neural Networks (FFANN), consisting of four inner layers of 20 hyperbolic tangent sigmoid neurons each, were configured within the Neural Network Toolbox in MATLAB 8.1 (The MathWorks Inc., Natick, MA, 2013). The first network was trained to learn the relationships between the four –two medial and two lateral– sensitive loads (output) and the six pose parameters (input). Two other networks –one medial and one lateral– were trained separately to learn the relationships between the remaining loads of each side (output) and all the pose parameters plus the two sensitive loads from each side (input). We used the popular Levenberg-Marquardt training algorithm in conjunction with Bayesian regularization to avoid over-fitting. Stopping criterion was a training time of two hours for each network. The trained networks were translated to custom C++ DLL functions for successive inclusion in our MS model. The surrogate contact model replaced the original contact model and one gait trial was simulated with 4 different combination of the following model settings: original versus surrogate contact model, wrapping enabled versus disabled.

RESULTS: The contact sampling model required 238 hours to evaluate the 36000 data points. Predicted tibiofemoral compressive forces under all simulated cases are shown in Fig. 2. A comparison with experimental measurements (eTibia line) is also shown. Surrogate model predictions showed a very good agreement with the original model counterparts. Fig. 3 summarizes the computation times: simulations took the longest when muscle wrapping was enabled and the benefits of using the surrogate model became evident only when the wrapping algorithm was switched off, leading to a 6x speed-up. Simulation time with the original contact model decreased by a factor of 8 by switching off the wrapping algorithm.

DISCUSSION: The use of FFANN-based surrogate contact model, in place of the original rigid contact model, could substantially reduce the simulation time of a full gait cycle down to 3 minutes, when the wrapping algorithm was turned off. Such improvement could not be achieved when using the wrapping algorithm. This enlightens another important source of overhead in MS modeling –the muscle wrapping algorithm– which unexpectedly was found to dominate the simulation time. At each FDK iteration, the wrapping algorithm needs to be solved as well, introducing overhead. If the wrapping algorithm is slower than the contact algorithm, then the computation time of each step will be dominated by the former, leaving only a small fraction to be gained from the latter.

SIGNIFICANCE: We showed that surrogate contact model could reduce the simulation time in a MS model of TKA down to a level which allows parametric studies and/or optimization to be feasible. We also discovered that the muscle wrapping algorithm constituted an unexpectedly large source of overhead during dynamic simulations. These represent new and important findings for the MS modeling community.

REFERENCES: [1] M. A. Marra, V. Vanheule, R. Fluit, B. H. F. J. M. Koopman, J. Rasmussen, N. J. J. Verdonschot, and M. S. Andersen, “A Subject-Specific Musculoskeletal Modeling Framework to Predict in Vivo Mechanics of Total Knee Arthroplasty.,” J. Biomech. Eng., Nov. 2014.

[2] I. Eskinazi and B. J. Fregly, “Surrogate modeling of deformable joint contact using artificial neural networks.,” Med. Eng. Phys., Jul. 2015.

[3] Y.-C. Lin, R. T. Haftka, N. V Queipo, and B. J. Fregly, “Surrogate articular contact models for computationally efficient multibody dynamic simulations.,” Med. Eng. Phys., vol. 32, no. 6, pp. 584–94, Jul. 2010.

ACKNOWLEDGEMENTS: This study was conducted within the ERC ‘BioMechTools’ project, funded by the European Research Council.

Original language | English |
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Publication status | Published - 4 Mar 2016 |

Event | Orthopaedic Research Society Annual Meeting 2016 - Orlando, United States Duration: 4 Mar 2016 → 8 Mar 2016 https://www.ors.org/2016-annual-meeting/ |

### Conference

Conference | Orthopaedic Research Society Annual Meeting 2016 |
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Abbreviated title | ORS 2016 |

Country/Territory | United States |

City | Orlando |

Period | 4/03/16 → 8/03/16 |

Internet address |

## Keywords

- METIS-317859