{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T18:54:13Z","timestamp":1785524053965,"version":"3.56.0"},"reference-count":61,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100000288","name":"Royal Society","doi-asserted-by":"publisher","award":["RG\/R1\/251639"],"award-info":[{"award-number":["RG\/R1\/251639"]}],"id":[{"id":"10.13039\/501100000288","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000288","name":"Royal Society","doi-asserted-by":"publisher","award":["IES\/R3\/243317"],"award-info":[{"award-number":["IES\/R3\/243317"]}],"id":[{"id":"10.13039\/501100000288","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000737","name":"University of Exeter","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000737","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Ann Biomed Eng"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Cerebral palsy (CP) is typically associated with abnormal gait that may alter knee joint loading and accelerate joint degeneration. We developed an integrated musculoskeletal-finite element (MSK-FE) framework to quantify differences in knee joint biomechanics between children with CP and typically developing (TD) peers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Gait data from 13 children (TD,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20095; hemiplegia [HP],\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20094; diplegia [DP],\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20094) were analyzed using OpenSim to obtain knee kinematics and compressive knee joint reaction forces (KJRFs). These were applied to scaled 3D FE knee models, incorporating biphasic cartilage, menisci, and ligaments, at the first force peak, mid-stance, and second force peak to evaluate cartilage pressures.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Compared with TD, both CP subtypes (HP and DP) exhibited greater knee flexion throughout the gait cycle, except for the affected limb in HP (HP\n                      <jats:sub>A<\/jats:sub>\n                      ), which showed reduced flexion during the stance phase. Peak KJRFs over the gait cycle were slightly higher in DP and HP\n                      <jats:sub>A<\/jats:sub>\n                      than in TD, whereas the unaffected limb in HP (HP\n                      <jats:sub>UA<\/jats:sub>\n                      ) generated the highest peak KJRFs among all groups, indicating compensatory overloading of the unaffected limb in HP. Correspondingly, FE analysis showed that peak cartilage contact pressures in the HP cohorts were significantly higher than in DP and TD, while pressures in DP were slightly higher than in TD over the gait cycle. The HP\n                      <jats:sub>UA<\/jats:sub>\n                      showed the highest contact pressures among all groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The MSK-FE framework quantified knee loading and cartilage contact pressure patterns in children with CP. These preliminary findings highlight subtype- and limb-specific gait-loading patterns and provide a mechanistic basis for future larger-scale and longitudinal investigations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10439-026-04302-7","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T17:15:45Z","timestamp":1785258945000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Musculoskeletal-Finite Element Study of Knee Joint Loading and Cartilage Mechanics in Children with Cerebral Palsy"],"prefix":"10.1007","author":[{"given":"Dongfei","family":"Huo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Run","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junyan","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy P.","family":"Holsgrove","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominic","family":"Farris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7512-660X","authenticated-orcid":false,"given":"Xijin","family":"Hua","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,28]]},"reference":[{"key":"4302_CR1","doi-asserted-by":"publisher","first-page":"15082","DOI":"10.1038\/nrdp.2015.82","volume":"2","author":"HK Graham","year":"2016","unstructured":"Graham, H. K., et al. Cerebral palsy. Nat Rev Dis Primers. 2:15082, 2016. https:\/\/doi.org\/10.1038\/nrdp.2015.82.","journal-title":"Cerebral palsy. Nat Rev Dis Primers"},{"issue":"9","key":"4302_CR2","doi-asserted-by":"publisher","first-page":"1686","DOI":"10.1016\/j.jbiomech.2005.04.030","volume":"39","author":"E Pena","year":"2006","unstructured":"Pena, E., et al. A three-dimensional finite element analysis of the combined behavior of ligaments and menisci in the healthy human knee joint. J Biomech. 39(9):1686\u20131701, 2006. https:\/\/doi.org\/10.1016\/j.jbiomech.2005.04.030.","journal-title":"J Biomech"},{"issue":"3","key":"4302_CR3","doi-asserted-by":"publisher","first-page":"409","DOI":"10.1007\/s40846-020-00523-w","volume":"40","author":"K Thienkarochanakul","year":"2020","unstructured":"Thienkarochanakul, K., et al. Stress Distribution of the Tibiofemoral Joint in a Healthy Versus Osteoarthritis Knee Model Using Image-Based Three-Dimensional Finite Element Analysis. Journal of Medical and Biological Engineering. 40(3):409\u2013418, 2020. https:\/\/doi.org\/10.1007\/s40846-020-00523-w.","journal-title":"Journal of Medical and Biological Engineering"},{"key":"4302_CR4","doi-asserted-by":"publisher","unstructured":"Paz, A., et al., Expediting Finite Element Analyses for Subject-Specific Studies of Knee Osteoarthritis: A Literature Review. Applied Sciences, 2021. 11(23). https:\/\/doi.org\/10.3390\/app112311440","DOI":"10.3390\/app112311440"},{"issue":"2","key":"4302_CR5","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1111\/os.13980","volume":"16","author":"M Yan","year":"2024","unstructured":"Yan, M., et al. Model Properties and Clinical Application in the Finite Element Analysis of Knee Joint: A Review. Orthop Surg. 16(2):289\u2013302, 2024. https:\/\/doi.org\/10.1111\/os.13980.","journal-title":"Orthop Surg"},{"issue":"2","key":"4302_CR6","doi-asserted-by":"publisher","first-page":"93","DOI":"10.3109\/17453674.2015.1137439","volume":"87","author":"G King","year":"2016","unstructured":"King, G., et al. Good outcome of total hip replacement in patients with cerebral palsy: A comparison of 389 patients and 425,813 controls from the National Joint Registry for England and Wales. Acta Orthop. 87(2):93\u201399, 2016. https:\/\/doi.org\/10.3109\/17453674.2015.1137439.","journal-title":"Acta Orthop"},{"issue":"8","key":"4302_CR7","doi-asserted-by":"publisher","first-page":"575","DOI":"10.2340\/16501977-2582","volume":"51","author":"ZP French","year":"2019","unstructured":"French, Z. P., R. V. Torres, and D. G. Whitney. Elevated prevalence of osteoarthritis among adults with cerebral palsy. J Rehabil Med. 51(8):575\u2013581, 2019. https:\/\/doi.org\/10.2340\/16501977-2582.","journal-title":"J Rehabil Med"},{"issue":"11","key":"4302_CR8","doi-asserted-by":"publisher","first-page":"1940","DOI":"10.1109\/TBME.2007.901024","volume":"54","author":"SL Delp","year":"2007","unstructured":"Delp, S. L., et al. OpenSim: open-source software to create and analyze dynamic simulations of movement. IEEE Trans Biomed Eng. 54(11):1940\u20131950, 2007. https:\/\/doi.org\/10.1109\/TBME.2007.901024.","journal-title":"IEEE Trans Biomed Eng"},{"key":"4302_CR9","doi-asserted-by":"publisher","DOI":"10.1016\/j.compbiomed.2021.105023","volume":"141","author":"L Shu","year":"2022","unstructured":"Shu, L., et al. Multiscale finite element musculoskeletal model for intact knee dynamics. Comput Biol Med.141:105023, 2022. https:\/\/doi.org\/10.1016\/j.compbiomed.2021.105023.","journal-title":"Comput Biol Med"},{"issue":"1","key":"4302_CR10","doi-asserted-by":"publisher","first-page":"17396","DOI":"10.1038\/s41598-017-17228-x","volume":"7","author":"KS Halonen","year":"2017","unstructured":"Halonen, K. S., et al. Workflow assessing the effect of gait alterations on stresses in the medial tibial cartilage - combined musculoskeletal modelling and finite element analysis. Sci Rep. 7(1):17396, 2017. https:\/\/doi.org\/10.1038\/s41598-017-17228-x.","journal-title":"Sci Rep"},{"key":"4302_CR11","doi-asserted-by":"publisher","unstructured":"Carbone, V., et al., TLEM 2.0 - a comprehensive musculoskeletal geometry dataset for subject-specific modeling of lower extremity. J Biomech, 2015. 48(5): p. 734-41. https:\/\/doi.org\/10.1016\/j.jbiomech.2014.12.034","DOI":"10.1016\/j.jbiomech.2014.12.034"},{"key":"4302_CR12","doi-asserted-by":"publisher","unstructured":"Peitola, J.P.J., et al., Sensitivity of knee cartilage biomechanics in finite element analysis to selected Musculoskeletal models. Comput Methods Biomech Biomed Engin, 2024: p. 1-12. https:\/\/doi.org\/10.1080\/10255842.2024.2360594","DOI":"10.1080\/10255842.2024.2360594"},{"issue":"11","key":"4302_CR13","doi-asserted-by":"publisher","first-page":"1193","DOI":"10.1177\/0954411914559737","volume":"228","author":"Q Meng","year":"2014","unstructured":"Meng, Q., et al. Computational investigation of the time-dependent contact behaviour of the human tibiofemoral joint under body weight. Proc Inst Mech Eng H. 228(11):1193\u20131207, 2014. https:\/\/doi.org\/10.1177\/0954411914559737.","journal-title":"Proc Inst Mech Eng H"},{"issue":"3","key":"4302_CR14","doi-asserted-by":"publisher","first-page":"1055","DOI":"10.1007\/s10237-024-01822-w","volume":"23","author":"J Yao","year":"2024","unstructured":"Yao, J., et al. Effect of meniscus modelling assumptions in a static tibiofemoral finite element model: importance of geometry over material. Biomech Model Mechanobiol. 23(3):1055\u20131065, 2024. https:\/\/doi.org\/10.1007\/s10237-024-01822-w.","journal-title":"Biomech Model Mechanobiol"},{"key":"4302_CR15","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1016\/j.medengphy.2018.11.003","volume":"63","author":"S Park","year":"2019","unstructured":"Park, S., et al. Finite element analysis of knee and ankle joint during gait based on motion analysis. Med Eng Phys. 63:33\u201341, 2019. https:\/\/doi.org\/10.1016\/j.medengphy.2018.11.003.","journal-title":"Med Eng Phys"},{"issue":"11","key":"4302_CR16","doi-asserted-by":"publisher","first-page":"1353","DOI":"10.1080\/10255842.2022.2117548","volume":"26","author":"A Paz","year":"2023","unstructured":"Paz, A., et al. A novel knee joint model in FEBio with inhomogeneous fibril-reinforced biphasic cartilage simulating tissue mechanical responses during gait: data from the osteoarthritis initiative. Comput Methods Biomech Biomed Engin. 26(11):1353\u20131367, 2023. https:\/\/doi.org\/10.1080\/10255842.2022.2117548.","journal-title":"Comput Methods Biomech Biomed Engin"},{"issue":"9","key":"4302_CR17","doi-asserted-by":"publisher","first-page":"1679","DOI":"10.1016\/j.jbiomech.2016.03.050","volume":"49","author":"J Li","year":"2016","unstructured":"Li, J., et al. The influence of the representation of collagen fibre organisation on the cartilage contact mechanics of the hip joint. J Biomech. 49(9):1679\u20131685, 2016. https:\/\/doi.org\/10.1016\/j.jbiomech.2016.03.050.","journal-title":"J Biomech"},{"key":"4302_CR18","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmpb.2021.106606","volume":"215","author":"X Hua","year":"2022","unstructured":"Hua, X., et al. Multiscale biomechanics of the biphasic articular cartilage in the natural hip joint during routine activities. Comput Methods Programs Biomed.215:106606, 2022. https:\/\/doi.org\/10.1016\/j.cmpb.2021.106606.","journal-title":"Comput Methods Programs Biomed"},{"issue":"4","key":"4302_CR19","doi-asserted-by":"publisher","first-page":"1145","DOI":"10.1007\/s10237-022-01581-6","volume":"21","author":"X Hua","year":"2022","unstructured":"Hua, X., L. Shu, and J. Li. Multiscale modelling for investigating the long-term time-dependent biphasic behaviour of the articular cartilage in the natural hip joint. Biomech Model Mechanobiol. 21(4):1145\u20131155, 2022. https:\/\/doi.org\/10.1007\/s10237-022-01581-6.","journal-title":"Biomech Model Mechanobiol"},{"key":"4302_CR20","doi-asserted-by":"publisher","unstructured":"Adouni, M., et al., The effect of body weight on the knee joint biomechanics based on subject-specific finite element-musculoskeletal approach. Scientific Reports, 2024. 14(1). https:\/\/doi.org\/10.1038\/s41598-024-63745-x","DOI":"10.1038\/s41598-024-63745-x"},{"issue":"7","key":"4302_CR21","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0235966","volume":"15","author":"H Kainz","year":"2020","unstructured":"Kainz, H., et al. A multi-scale modelling framework combining musculoskeletal rigid-body simulations with adaptive finite element analyses, to evaluate the impact of femoral geometry on hip joint contact forces and femoral bone growth. PLoS One.15(7):e0235966, 2020. https:\/\/doi.org\/10.1371\/journal.pone.0235966.","journal-title":"PLoS One"},{"key":"4302_CR22","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmbbm.2020.104136","volume":"113","author":"J Li","year":"2021","unstructured":"Li, J. Development and validation of a finite-element musculoskeletal model incorporating a deformable contact model of the hip joint during gait. J Mech Behav Biomed Mater.113:104136, 2021. https:\/\/doi.org\/10.1016\/j.jmbbm.2020.104136.","journal-title":"J Mech Behav Biomed Mater"},{"issue":"1","key":"4302_CR23","doi-asserted-by":"publisher","first-page":"267","DOI":"10.1186\/s13018-022-03094-5","volume":"17","author":"B Xiong","year":"2022","unstructured":"Xiong, B., et al. Changes in hip joint contact stress during a gait cycle based on the individualized modeling method of \u201cgait-musculoskeletal system-finite element.\u201d J Orthop Surg Res. 17(1):267, 2022. https:\/\/doi.org\/10.1186\/s13018-022-03094-5.","journal-title":"J Orthop Surg Res"},{"issue":"1","key":"4302_CR24","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1109\/TBME.2024.3438272","volume":"72","author":"A Esrafilian","year":"2025","unstructured":"Esrafilian, A., et al. An Automated and Robust Tool for Musculoskeletal and Finite Element Modeling of the Knee Joint. IEEE Trans Biomed Eng. 72(1):56\u201369, 2025. https:\/\/doi.org\/10.1109\/TBME.2024.3438272.","journal-title":"IEEE Trans Biomed Eng"},{"issue":"1","key":"4302_CR25","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1007\/s10439-022-03074-0","volume":"51","author":"S Chokhandre","year":"2023","unstructured":"Chokhandre, S., et al. Open Knee(s): A Free and Open Source Library of Specimen-Specific Models and Related Digital Assets for Finite Element Analysis of the Knee Joint. Annals of Biomedical Engineering. 51(1):10\u201323, 2023. https:\/\/doi.org\/10.1007\/s10439-022-03074-0.","journal-title":"Annals of Biomedical Engineering"},{"key":"4302_CR26","doi-asserted-by":"publisher","DOI":"10.1016\/j.dib.2021.106824","volume":"35","author":"S Chokhandre","year":"2021","unstructured":"Chokhandre, S., et al. Specimen specific imaging and joint mechanical testing data for next generation virtual knees. Data Brief.35:106824, 2021. https:\/\/doi.org\/10.1016\/j.dib.2021.106824.","journal-title":"Data Brief"},{"issue":"1","key":"4302_CR27","doi-asserted-by":"publisher","first-page":"18328","DOI":"10.1038\/s41598-023-45408-5","volume":"13","author":"A Karimi Dastgerdi","year":"2023","unstructured":"Karimi Dastgerdi, A., et al. Validation and evaluation of subject-specific finite element models of the pediatric knee. Sci Rep. 13(1):18328, 2023. https:\/\/doi.org\/10.1038\/s41598-023-45408-5.","journal-title":"Sci Rep"},{"key":"4302_CR28","doi-asserted-by":"publisher","DOI":"10.3389\/fbioe.2021.648356","volume":"9","author":"I Loi","year":"2021","unstructured":"Loi, I., D. Stanev, and K. Moustakas. Total Knee Replacement: Subject-Specific Modeling, Finite Element Analysis, and Evaluation of Dynamic Activities. Front Bioeng Biotechnol.9:648356, 2021. https:\/\/doi.org\/10.3389\/fbioe.2021.648356.","journal-title":"Front Bioeng Biotechnol"},{"key":"4302_CR29","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1016\/j.gaitpost.2017.12.005","volume":"60","author":"SCE Brandon","year":"2018","unstructured":"Brandon, S. C. E., et al. The coupled effects of crouch gait and patella alta on tibiofemoral and patellofemoral cartilage loading in children. Gait Posture. 60:181\u2013187, 2018. https:\/\/doi.org\/10.1016\/j.gaitpost.2017.12.005.","journal-title":"Gait Posture"},{"key":"4302_CR30","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1016\/j.gaitpost.2024.06.012","volume":"113","author":"W Koller","year":"2024","unstructured":"Koller, W., et al. ESMAC Best Paper Award 2023: Increased knee flexion in participants with cerebral palsy results in altered stresses at the distal femoral growth plate compared to a typically developing cohort. Gait Posture. 113:158\u2013166, 2024. https:\/\/doi.org\/10.1016\/j.gaitpost.2024.06.012.","journal-title":"Gait Posture"},{"key":"4302_CR31","doi-asserted-by":"publisher","first-page":"1140527","DOI":"10.3389\/fbioe.2023.1140527","volume":"11","author":"W Koller","year":"2023","unstructured":"Koller, W., et al. Intra- and inter-subject variability of femoral growth plate stresses in typically developing children and children with cerebral palsy. Front Bioeng Biotechnol. 11:1140527, 2023. https:\/\/doi.org\/10.3389\/fbioe.2023.1140527.","journal-title":"Front Bioeng Biotechnol"},{"key":"4302_CR32","doi-asserted-by":"publisher","unstructured":"Surveillance of cerebral palsy in Europe: a collaboration of cerebral palsy surveys and registers. Surveillance of Cerebral Palsy in Europe (SCPE). Dev Med Child Neurol, 2000. 42(12): p. 816-24. https:\/\/doi.org\/10.1017\/s0012162200001511","DOI":"10.1017\/s0012162200001511"},{"key":"4302_CR33","doi-asserted-by":"publisher","unstructured":"Meyns, P., et al., The Differential Effect of Arm Movements during Gait on the Forward Acceleration of the Centre of Mass in Children with Cerebral Palsy and Typically Developing Children. Frontiers in Human Neuroscience, 2017. 11. https:\/\/doi.org\/10.3389\/fnhum.2017.00096","DOI":"10.3389\/fnhum.2017.00096"},{"key":"4302_CR34","doi-asserted-by":"crossref","unstructured":"DELP, S.L., An Interactive Graphics-Based Model of the Lower Extremity to Study Orthopaedic Surgical Procedures. 1990.","DOI":"10.1109\/10.102791"},{"issue":"3","key":"4302_CR35","doi-asserted-by":"publisher","first-page":"631","DOI":"10.1016\/j.jbiomech.2013.12.002","volume":"47","author":"GG Handsfield","year":"2014","unstructured":"Handsfield, G. G., et al. Relationships of 35 lower limb muscles to height and body mass quantified using MRI. J Biomech. 47(3):631\u2013638, 2014. https:\/\/doi.org\/10.1016\/j.jbiomech.2013.12.002.","journal-title":"J Biomech"},{"key":"4302_CR36","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1016\/j.gaitpost.2018.07.172","volume":"65","author":"H Kainz","year":"2018","unstructured":"Kainz, H., et al. The influence of maximum isometric muscle force scaling on estimated muscle forces from musculoskeletal models of children with cerebral palsy. Gait Posture. 65:213\u2013220, 2018. https:\/\/doi.org\/10.1016\/j.gaitpost.2018.07.172.","journal-title":"Gait Posture"},{"issue":"16","key":"4302_CR37","doi-asserted-by":"publisher","first-page":"2782","DOI":"10.1016\/j.jbiomech.2011.08.024","volume":"44","author":"TA Correa","year":"2011","unstructured":"Correa, T. A., and M. G. Pandy. A mass-length scaling law for modeling muscle strength in the lower limb. J Biomech. 44(16):2782\u20132789, 2011. https:\/\/doi.org\/10.1016\/j.jbiomech.2011.08.024.","journal-title":"J Biomech"},{"key":"4302_CR38","doi-asserted-by":"publisher","unstructured":"Hicks, J.L., et al., Is My Model Good Enough? Best Practices for Verification and Validation of Musculoskeletal Models and Simulations of Movement. Journal of Biomechanical Engineering, 2015. 137(2). https:\/\/doi.org\/10.1115\/1.4029304","DOI":"10.1115\/1.4029304"},{"issue":"4","key":"4302_CR39","first-page":"172","volume":"10","author":"RO Robinson","year":"1987","unstructured":"Robinson, R. O., W. Herzog, and B. M. Nigg. Use of force platform variables to quantify the effects of chiropractic manipulation on gait symmetry. J Manipulative Physiol Ther. 10(4):172\u2013176, 1987.","journal-title":"J Manipulative Physiol Ther"},{"key":"4302_CR40","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbiomech.2024.112387","volume":"177","author":"BA Killen","year":"2024","unstructured":"Killen, B. A., M. Willems, and I. Jonkers. An open-source framework for the generation of OpenSim models with personalised knee joint geometries for the estimation of articular contact mechanics. Journal of Biomechanics.177:112387, 2024. https:\/\/doi.org\/10.1016\/j.jbiomech.2024.112387.","journal-title":"Journal of Biomechanics"},{"key":"4302_CR41","doi-asserted-by":"publisher","unstructured":"J. Zhang, W.D., Y. Dong, et al, Parameters of Finite Element Model of the Knee Joint. Chinese Journal of Tissue Engineering Research, 2021. 25(30): p. 4781-4786. https:\/\/doi.org\/10.12307\/2021.261","DOI":"10.12307\/2021.261"},{"issue":"2","key":"4302_CR42","doi-asserted-by":"publisher","first-page":"302","DOI":"10.1016\/j.jbiomech.2015.12.020","volume":"49","author":"AA Ali","year":"2016","unstructured":"Ali, A. A., et al. Validation of predicted patellofemoral mechanics in a finite element model of the healthy and cruciate-deficient knee. J Biomech. 49(2):302\u2013309, 2016. https:\/\/doi.org\/10.1016\/j.jbiomech.2015.12.020.","journal-title":"J Biomech"},{"issue":"4","key":"4302_CR43","doi-asserted-by":"publisher","first-page":"232596711663989","DOI":"10.1177\/2325967116639895","volume":"4","author":"JW Arner","year":"2016","unstructured":"Arner, J. W., et al. The Effects of Anterior Cruciate Ligament Deficiency on the Meniscus and Articular Cartilage: A Novel Dynamic In Vitro Pilot Study. Orthop J Sports Med. 4(4):2325967116639895, 2016. https:\/\/doi.org\/10.1177\/2325967116639895.","journal-title":"Orthop J Sports Med"},{"issue":"4","key":"4302_CR44","doi-asserted-by":"publisher","first-page":"234","DOI":"10.1007\/bf01845594","volume":"2","author":"T Kusayama","year":"1994","unstructured":"Kusayama, T., et al. Anatomical and biomechanical characteristics of human meniscofemoral ligaments. Knee Surg Sports Traumatol Arthrosc. 2(4):234\u2013237, 1994. https:\/\/doi.org\/10.1007\/bf01845594.","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"12","key":"4302_CR45","doi-asserted-by":"publisher","first-page":"1623","DOI":"10.1016\/s0021-9290(02)00238-5","volume":"35","author":"CM Gupte","year":"2002","unstructured":"Gupte, C. M., et al. Meniscofemoral ligaments\u2013structural and material properties. J Biomech. 35(12):1623\u20131629, 2002. https:\/\/doi.org\/10.1016\/s0021-9290(02)00238-5.","journal-title":"J Biomech"},{"key":"4302_CR46","doi-asserted-by":"publisher","unstructured":"Jin, X., et al., The Effect of Posterior Cruciate Ligament Reconstruction Operations on Contact Mechanics of the Tibiofemoral Joint. Biosurface and Biotribology, 2025. 11(1). https:\/\/doi.org\/10.1049\/bsb2.70007","DOI":"10.1049\/bsb2.70007"},{"issue":"1","key":"4302_CR47","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1111\/dmcn.13205","volume":"59","author":"SA Rethlefsen","year":"2017","unstructured":"Rethlefsen, S. A., et al. Prevalence of specific gait abnormalities in children with cerebral palsy revisited: influence of age, prior surgery, and Gross Motor Function Classification System level. Developmental Medicine & Child Neurology. 59(1):79\u201388, 2017. https:\/\/doi.org\/10.1111\/dmcn.13205.","journal-title":"Developmental Medicine & Child Neurology"},{"issue":"6","key":"4302_CR48","doi-asserted-by":"publisher","first-page":"1340","DOI":"10.1016\/j.ridd.2010.07.007","volume":"31","author":"M Galli","year":"2010","unstructured":"Galli, M., et al. Gait patterns in hemiplegic children with Cerebral Palsy: comparison of right and left hemiplegia. Res Dev Disabil. 31(6):1340\u20131345, 2010. https:\/\/doi.org\/10.1016\/j.ridd.2010.07.007.","journal-title":"Res Dev Disabil"},{"key":"4302_CR49","doi-asserted-by":"publisher","unstructured":"Choi, T.Y., et al., Gait Adaptation Is Different between the Affected and Unaffected Legs in Children with Spastic Hemiplegic Cerebral Palsy While Walking on a Changing Slope. Children (Basel), 2022. 9(5). https:\/\/doi.org\/10.3390\/children9050593","DOI":"10.3390\/children9050593"},{"issue":"1","key":"4302_CR50","doi-asserted-by":"publisher","first-page":"7465","DOI":"10.1038\/s41598-026-40523-5","volume":"16","author":"S Tsitlakidis","year":"2026","unstructured":"Tsitlakidis, S., et al. Comparison of compensatory strategies and gait deviations in unclassified and type 1 unilateral cerebral palsy. Scientific Reports. 16(1):7465, 2026. https:\/\/doi.org\/10.1038\/s41598-026-40523-5.","journal-title":"Scientific Reports"},{"issue":"4","key":"4302_CR51","doi-asserted-by":"publisher","first-page":"556","DOI":"10.1016\/j.gaitpost.2011.11.023","volume":"35","author":"KM Steele","year":"2012","unstructured":"Steele, K. M., et al. Compressive tibiofemoral force during crouch gait. Gait & Posture. 35(4):556\u2013560, 2012. https:\/\/doi.org\/10.1016\/j.gaitpost.2011.11.023.","journal-title":"Gait & Posture"},{"issue":"12","key":"4302_CR52","doi-asserted-by":"publisher","first-page":"448","DOI":"10.1302\/2058-5241.1.000052","volume":"1","author":"S Armand","year":"2016","unstructured":"Armand, S., G. Decoulon, and A. Bonnefoy-Mazure. Gait analysis in children with cerebral palsy. EFORT Open Rev. 1(12):448\u2013460, 2016. https:\/\/doi.org\/10.1302\/2058-5241.1.000052.","journal-title":"EFORT Open Rev"},{"key":"4302_CR53","doi-asserted-by":"publisher","unstructured":"Feng, J., et al., Motion of the center of mass in children with spastic hemiplegia: balance, energy transfer, and work performed by the affected leg vs. the unaffected leg. Gait Posture, 2014. 39(1): p. 570-6. https:\/\/doi.org\/10.1016\/j.gaitpost.2013.09.009","DOI":"10.1016\/j.gaitpost.2013.09.009"},{"issue":"7","key":"4302_CR54","doi-asserted-by":"publisher","first-page":"431","DOI":"10.1093\/ptj\/70.7.431","volume":"70","author":"SJ Olney","year":"1990","unstructured":"Olney, S. J., et al. Work and Power in Hemiplegic Cerebral Palsy Gait. Physical Therapy. 70(7):431\u2013438, 1990. https:\/\/doi.org\/10.1093\/ptj\/70.7.431.","journal-title":"Physical Therapy"},{"issue":"1","key":"4302_CR55","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1017\/s0012162200000086","volume":"42","author":"JR Engsberg","year":"2000","unstructured":"Engsberg, J. R., et al. Ankle spasticity and strength in children with spastic diplegic cerebral palsy. Dev Med Child Neurol. 42(1):42\u201347, 2000. https:\/\/doi.org\/10.1017\/s0012162200000086.","journal-title":"Dev Med Child Neurol"},{"key":"4302_CR56","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2021.105402","volume":"87","author":"H Kainz","year":"2021","unstructured":"Kainz, H., M. Wesseling, and I. Jonkers. Generic scaled versus subject-specific models for the calculation of musculoskeletal loading in cerebral palsy gait: Effect of personalized musculoskeletal geometry outweighs the effect of personalized neural control. Clin Biomech (Bristol).87:105402, 2021. https:\/\/doi.org\/10.1016\/j.clinbiomech.2021.105402.","journal-title":"Clin Biomech (Bristol)"},{"issue":"6","key":"4302_CR57","doi-asserted-by":"publisher","first-page":"1873","DOI":"10.1007\/s10237-022-01626-w","volume":"21","author":"G Davico","year":"2022","unstructured":"Davico, G., et al. Multi-level personalization of neuromusculoskeletal models to estimate physiologically plausible knee joint contact forces in children. Biomech Model Mechanobiol. 21(6):1873\u20131886, 2022. https:\/\/doi.org\/10.1007\/s10237-022-01626-w.","journal-title":"Biomech Model Mechanobiol"},{"key":"4302_CR58","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1016\/j.clinbiomech.2019.12.011","volume":"72","author":"G Davico","year":"2020","unstructured":"Davico, G., et al. Increasing level of neuromusculoskeletal model personalisation to investigate joint contact forces in cerebral palsy: A twin case study. Clin Biomech (Bristol). 72:141\u2013149, 2020. https:\/\/doi.org\/10.1016\/j.clinbiomech.2019.12.011.","journal-title":"Clin Biomech (Bristol)"},{"issue":"11","key":"4302_CR59","doi-asserted-by":"publisher","first-page":"2675","DOI":"10.1007\/s10439-015-1326-3","volume":"43","author":"RL Lenhart","year":"2015","unstructured":"Lenhart, R. L., et al. Prediction and Validation of Load-Dependent Behavior of the Tibiofemoral and Patellofemoral Joints During Movement. Annals of Biomedical Engineering. 43(11):2675\u20132685, 2015. https:\/\/doi.org\/10.1007\/s10439-015-1326-3.","journal-title":"Annals of Biomedical Engineering"},{"issue":"3","key":"4302_CR60","doi-asserted-by":"publisher","first-page":"1077","DOI":"10.1007\/s10237-024-01825-7","volume":"23","author":"MF Rabbi","year":"2024","unstructured":"Rabbi, M. F., et al. Muscle synergy-informed neuromusculoskeletal modelling to estimate knee contact forces in children with cerebral palsy. Biomech Model Mechanobiol. 23(3):1077\u20131090, 2024. https:\/\/doi.org\/10.1007\/s10237-024-01825-7.","journal-title":"Biomech Model Mechanobiol"},{"key":"4302_CR61","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.medengphy.2019.08.002","volume":"74","author":"RJ Cooper","year":"2019","unstructured":"Cooper, R. J., R. K. Wilcox, and A. C. Jones. Finite element models of the tibiofemoral joint: A review of validation approaches and modelling challenges. Medical Engineering & Physics. 74:1\u201312, 2019. https:\/\/doi.org\/10.1016\/j.medengphy.2019.08.002.","journal-title":"Medical Engineering & Physics"}],"container-title":["Annals of Biomedical Engineering"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10439-026-04302-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10439-026-04302-7","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10439-026-04302-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T17:31:32Z","timestamp":1785519092000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10439-026-04302-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,28]]},"references-count":61,"alternative-id":["4302"],"URL":"https:\/\/doi.org\/10.1007\/s10439-026-04302-7","relation":{},"ISSN":["0090-6964","1573-9686"],"issn-type":[{"value":"0090-6964","type":"print"},{"value":"1573-9686","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,28]]},"assertion":[{"value":"20 March 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 July 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 July 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors have no competing interests to declare that are relevant to the content of this article.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study used a publicly accessible gait dataset from children recruited at the Clinical Movement Analysis Laboratory, UZ Pellenberg (UZ Leuven). Ethical approval was obtained from the local ethics committee (Commissie Medische Ethiek KU Leuven; approval number S51498), and written informed consent was obtained from the parents of all participants.","order":2,"name":"Ethics","label":"Ethics Approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All authors consent to the publication of this manuscript.","order":3,"name":"Ethics","label":"Consent for Publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":4,"name":"Ethics","label":"Clinical Trial Number","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The custom script used for muscle-force scaling is provided in the Supplementary Material.","order":5,"name":"Ethics","label":"Code Availability","group":{"name":"EthicsHeading","label":"Declarations"}}]}}