A study on the role of articular cartilage soft tissue constitutive form in models of whole knee biomechanics

The mechanical behaviors of biological soft tissues are challenging to describe abstractly, with each individual tissue potentially characterized by its own unique nonlinear, anisotropic, and viscoelastic properties. These complexities are exacerbated by patient to patient variability, both mechanically and anatomically, and by inherent constitutive heterogeneity. Despite these challenges, computational models of whole knee biomechanics can be instrumental in describing the onset and progression of injury and disease. In this work, a three-dimensional whole knee computational model was developed using patient-specific anatomy, containing tissues with constitutive relationships built from relevant experimental investigations. In an effort to address the common assumption of linear elastic descriptions of articular cartilage in whole knee models, this work investigates the implications, with respect to macroscopic kinematics and local deformation, of incorporating physiologically motivated and mechanically accurate constitutive heterogeneity in articular cartilage, highlighting the sensitivities of each corresponding level of constitutive complexity. We show how the inclusion of representative cartilage material models affects deformation distributions within the joint, as well as relative joint motion. In particular, the assumption of linear elasticity in articular cartilage results in an overprediction of joint motion and significantly affects predicted local cartilage strains, while full-field, mechanically heterogeneous cartilage descriptions have a less drastic effect at both the tissue and joint levels. Nonetheless, joints containing complete descriptions of articular cartilage heterogeneity may be an integral component in building comprehensive computational tools to advance our understanding of injury and disease mechanisms.