The usefulness of forward dynamic simulations to studies of human motion is well known. Although the musculoskeletal models used in these studies are generic, the modeling of specific components, such as the knee joint, may vary. Our two objectives were (1) to investigate the effects of three commonly used knee models on forward dynamic simulation results, and (2) to study the sensitivity of simulation results to variations in kinematics for the most commonly used knee model. To satisfy the first objective, three different tibiofemoral models were incorporated into an existing forward dynamic simulation of recumbent pedaling, and the resulting kinematics, pedal forces, muscle forces, and joint reaction forces were compared. Two of these models replicated the rolling and sliding motion of the tibia on the femur, while the third was a simple pin joint. To satisfy the second objective, variations in the most widely used of the three knee models were created by adjusting the experimental data used in the development of this model. These variations were incorporated into the pedaling simulation, and the resulting data were compared with the unaltered model. Differences between the two rolling-sliding models were smaller than differences between the pin-joint model and the rolling-sliding models. Joint reactions forces, particularly at the knee, were highly sensitive to changes in knee joint model kinematics, as high as 61% root mean squared difference, normalized by the corresponding peak force of the unaltered reference model. Muscle forces were also sensitive, as high as 30% root mean squared difference. Muscle excitations were less sensitive. The observed changes in muscle force and joint reaction forces were caused primarily by changes in the moment arms and musculotendon lengths of the quadriceps. Although some level of inaccuracy in the knee model may be acceptable for calculations of muscle excitation timing, a representative model of knee kinematics is necessary for accurate calculation of muscle and joint reaction forces.
A Pilot Study of Musculoskeletal Abnormalities in Patients in Recovery from a Unilateral Rupture-Repaired Achilles Tendon