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One of the reasons leading to joint laxity and instability is ligamentous insufficiency. This study, therefore, aims to investigate the effects of insufficient ligaments-related knee laxity on both nonlinear dynamics and wear of TKA. The study hypothesizes (a) ligamentous insufficiency can increase TKA damage; (b) stiffness reduction of each of the posterior cruciate ligament (PCL) and medial\u2013lateral collateral ligaments (MCL-LCL) can differently contribute to TKA damage. A forward dynamics methodology is developed and the ligament behavior is simulated employing an asymmetric nonlinear elastic model. External loads and moment, due to the presence of all soft tissues, e.g., muscles and hip joint reaction forces, applied to the femoral bone are determined using a musculoskeletal approach linked to the developed model. A mesh density analysis is performed and comparing outcomes with that available in the literature allows for the assessment of our approach. From the results acquired, reduced PCL stiffness leads to an increase in linear wear rates and results in the maximum damage in TKAs. However, the maximum linear wear rates on both condyles occur once the stiffness of all ligaments is reduced. Moreover, the worn area of the tibia surface increases with the reduction in MCL-LCL stiffness on the medial condyle. The joint with insufficient PCL also shows a considerable increase in ligament forces right after toe-off.<\/jats:p>","DOI":"10.1115\/1.4048707","type":"journal-article","created":{"date-parts":[[2020,10,8]],"date-time":"2020-10-08T10:25:43Z","timestamp":1602152743000},"update-policy":"https:\/\/doi.org\/10.1115\/crossmarkpolicy-asme","source":"Crossref","is-referenced-by-count":11,"title":["Effect of Ligament Properties on Nonlinear Dynamics and Wear Prediction of Knee Prostheses"],"prefix":"10.1115","volume":"143","author":[{"given":"Ehsan","family":"Askari","sequence":"first","affiliation":[{"name":"Department of Electromechanical, Systems and Metal Engineering, Ghent University, Zwijnaarde B-9052, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael S.","family":"Andersen","sequence":"additional","affiliation":[{"name":"Department of Materials and Production, Aalborg University, Aalborg 9220, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"33","published-online":{"date-parts":[[2020,12,1]]},"reference":[{"issue":"12","key":"2020120105484030800_bib1","doi-asserted-by":"crossref","first-page":"1227","DOI":"10.1001\/2012.jama.11153","article-title":"Total Knee Arthroplasty Volume, Utilization, and Outcomes Among Medicare Beneficiaries 1991-2010","volume":"308","year":"2012","journal-title":"JAMA"},{"issue":"22","key":"2020120105484030800_bib2","doi-asserted-by":"crossref","first-page":"2072","DOI":"10.2106\/JBJS.J.01143","article-title":"Increased Long-Term Survival of Posterior Cruciate-Retaining Versus Posterior Cruciate-Stabilizing Total Knee Replacements","volume":"93","year":"2011","journal-title":"J. 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