The femur as a musculo-skeletal construct: a free boundary condition modelling approach

Previous finite element studies of the femur have made simplifications to varying extents with regard to the boundary conditions used during analysis. Fixed boundary conditions are generally applied to the distal femur when examining the proximal behaviour at the hip joint, while the same can be said for the proximal femur when examining the distal behaviour at the knee joint. While fixed boundary condition analyses have been validated against in vitro experiments it remains a matter of debate as to whether the numerical and experimental models are indicative of the in vivo situation. This study presents a finite element model in which the femur is treated as a complete musculo-skeletal construct, spanning between the hip and knee joints. Linear and non-linear implementations of a free boundary condition modelling approach are applied to the bone through the explicit inclusion of muscles and ligaments spanning both the hip joint and the knee joint. A non-linear force regulated, muscle strain based activation strategy was found to result in lower observed principal strains in the cortex of the femur, compared to a linear activation strategy. The non-linear implementation of the model in particular, was found to produce hip and knee joint reaction forces consistent with in vivo data from instrumented implants.