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<<TableOfContents>>

== Synopsis ==

The overall goal of this case study is to provide the utility of Open Knee(s) - Generation 1 model for reproducing the outcome of a clinical test, the pivot shift, for evaluating mechanical function of the anterior cruciate ligament.

=== Use Case ===

The case is based on reproduction of a pivot shift loading scenario in a tibiofemoral joint model. The loading scenario was measured in a cadaver knee during pivot shift tests conducted by an orthopaedic surgeon. In follow-up robotics testing, this loading profile was adjusted for robotics testing of intact, ACL deficient, and ACL reconstructed knees. The use case aims for illustrating the capacity of the Open Knee(s) - Generation 1 model to reproduce the clinical differentiation of intact and ACL deficient knee in a virtual sense.

=== Simulation Aims ===

 * To understand the role of ACL for stabilization of the joint during pivot shift testing (primary)
 * To explore the correspondence of Open Knee(s) simulation against robotics prescribed pivot shift loading of various knees (secondary)

=== Model ===

The model is based on Open Knee(s) - Generation 1 model, which was updated for FEBio version 2.1:

 . https://simtk.org/svn/openknee/_gen1/src/tf_joint_FEBio_v2.feb

=== Inputs ===

Prescribed time histories of movement and loading of the tibiofemoral joint (six degrees of freedom) representative of pivot shift data: 

 * flexion
 * internal/external rotation torque
 * varus/valgus torque
 * anterior/posterior force
 * medial/lateral force
 * compression/distraction force

=== Outputs ===

 * Time histories of kinematics-kinetics of the tibiofemoral joint (six degrees of freedom) (primary)
  * flexion torque
  * internal/external rotation
  * varus/valgus
  * anterior/posterior translation
  * medial/lateral translation
  * compression/distraction
 * Time histories of stress-strain behavior (secondary)

=== Simulation Conditions ===

 * with intact ACL
 * without the ACL (very low stiffness for convenient modeling and simulation workflow)

== Team Members ==

 * Ahmet Erdemir - study planning, outline of publications
 * Snehal Chokhandre - execution of simulations and post-processing, lead authorship in publications
 * Craig Bennetts - assisting simulations, scripting for pre-/post-processing, support to document model in publications
 * Tara Bonner - assiting pivot shift trajectory generation, support documentation on pivot shift literature and implications of simulations for robotics testing
 * Robb Colbrunn - lead pivot shift trajectory generation, provide literature survey on pivot shift studies (clinical and cadaver testing), support to document implications of simulations for robotics testing
 * Paul Saluan - support to document clinical utility of pivot shift and implications of simulations for clinical practice

== Progress ==

=== Source Code Repository ===

https://simtk.org/svn/openknee/app/PivotShift/

=== Data ===

https://simtk.org/svn/openknee/app/PivotShift/dat/

=== Model Customization ===

https://simtk.org/svn/openknee/app/PivotShift/src/

=== Simulations ===

=== Post-Processing ===

https://simtk.org/svn/openknee/app/PivotShift/sol/

=== Publications ===

https://simtk.org/svn/openknee/app/PivotShift/doc/

== References ==