Abstract
Common practice in musculoskeletal modelling is to use scaled musculoskeletal models based on a healthy adult, but this does not consider subject-specific geometry, such as tibial torsion and femoral neck-shaft and anteversion angles (NSA and AVA). The aims of this study were to (1) develop an automated tool for creating OpenSim models with subject-specific tibial torsion and femoral NSA and AVA, (2) evaluate the femoral component, and (3) release the tool open-source.The Torsion Tool (https://simtk.org/projects/torsiontool) is a MATLAB-based tool that requires an individual’s tibial torsion, NSA and AVA estimates as input and rotates corresponding bones and associated muscle points of a generic musculoskeletal model. Performance of the Torsion Tool was evaluated comparing femur bones as personalised with the Torsion Tool and scaled generic femurs with manually segmented bones as golden standard for six typically developing children and thirteen children with cerebral palsy.The tool generated femur geometries closer to the segmentations, with lower maximum (−19%) and root mean square (−18%) errors and higher Jaccard indices (+9%) compared to generic femurs. Furthermore, the tool resulted in larger improvements for participants with higher NSA and AVA deviations.The Torsion Tool allows an automatic, fast, and user-friendly way of personalising femoral and tibial geometry in an OpenSim musculoskeletal model. Personalisation is expected to be particularly relevant in pathological populations, as will be further investigated by evaluating the effects on simulation outcomes.
Highlights
Musculoskeletal modelling can be used to evaluate musculoskeletal function in both healthy and pathological populations (e.g., Davico et al, 2020; Fox et al, 2018; Kainz et al, 2019; Steele et al, 2012; van der Krogt et al, 2012; Veerkamp et al, 2019; Wesseling et al, 2016)
This does not consider subject-specific geometry, such as tibial torsion and femoral neck-shaft angle (NSA) and anteversion angle (AVA), which have been shown to be aberrant in clinical populations like cerebral palsy (CP; Bobroff et al, 1999; Hicks et al, 2007; Robin et al, 2008)
The femurs with larger deviations in NSA and AVA resulted in a larger improvement with respect to NSA and AVA when using the tool, indicated by lower slopes for the linear regression for the personalised femurs compared to generic femurs (Fig. 5A)
Summary
Musculoskeletal modelling can be used to evaluate musculoskeletal function in both healthy and pathological populations (e.g., Davico et al, 2020; Fox et al, 2018; Kainz et al, 2019; Steele et al, 2012; van der Krogt et al, 2012; Veerkamp et al, 2019; Wesseling et al, 2016). Musculoskeletal models based on a healthy adult are used and scaled to the dimensions of the subject. This does not consider subject-specific geometry, such as tibial torsion and femoral neck-shaft angle (NSA) and anteversion angle (AVA), which have been shown to be aberrant in clinical populations like cerebral palsy (CP; Bobroff et al, 1999; Hicks et al, 2007; Robin et al, 2008). We aimed to (1) develop an automated tool for creating an OpenSim model containing subjectspecific tibial torsion and femoral NSA and AVA, (2) evaluate this tool for the femur, and (3) make this Torsion Tool openly available
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