Mannisi, Marco

ESR1 Marco Mannisi

Glasgow Caledonian University
I joined the KneeMo ITN in February 2015 as an early stage researcher (PhD student) after working as a research fellow in the Laboratory of Medical Technology at the Rizzoli Orthopaedic Institute in Bologna, Italy.

I undertook my Bachelor and Master of Science in Medical Engineering at University of Rome “Tor Vergata”, Italy. My dissertation topic was “Subject-specific finite element models of the bone-implant interaction for analysis of the risk of biomechanical failure in total hip arthroplasty with uncemented technique: application to a retrospective clinical study.”

Development and application of subject-specific musculoskeletal models in patients with knee osteoarthritis (KOA).


Knee Osteoarthritis (KOA) represents an irreversible chronic musculoskeletal disorder characterized by pain that contributes joint instability and reduced functional capacity. This is a very common disease, affecting over 9.5 million patients within Europe.
KOA is treated with a wide-range of pharmacological, non-pharmacological and surgical treatments with limited and variable effectiveness. Most non-surgical treatments are generic and primarily aimed at symptom relief without effectively maintaining or resorting joint function.
Recently, computational (Finite Element) and musculoskeletal (MS) models have been developed to reproduce the real movement of human body to study internal parameters (e.g. joint reaction force) avoiding use of direct measurement with invasive techniques.
With the use of MS and Finite Element (FE) models it is possible to estimate a variety of different parameters that may help in the understanding of KOA. Principal parameters include internal loading condition, muscle force and stress strain occurring in bones, cartilage and meniscus. Current models however, are mostly based on idealized simplification and for this reason, these do not replicate the real structural and biomechanical complexity of the knee joint.

The principal research objective of this study is to develop a multiscale subject-specific musculoskeletal model of the knee joint and to apply the model to normal subjects and KOA patients during simulated activities of daily living and biomechanical treatment conditions.

The secondary research objectives of this study are:
• To apply the model in KOA patients to investigate the relationship between biomechanical factors and structural changes in the joint.
• To apply the model in KOA patients to investigate what effect simulated biomechanical treatments (insoles and gait modifications) have on the stress-strain characteristics in knee joint structures in different groups of KOA patients.

A cross-sectional study will be conducted in the Glasgow Caledonian University human performance laboratory to collect data necessary for description of kinematic and kinetic and for the musculoskeletal modelling phase.
The innovative, multiscale and subject-specific model developed by the research team in Aalborg University using the AnyBody software (University of Aalborg, Denmark) will be tested in KOA and healthy control subject.
In particular, this approach allows to estimate important parameters relevant to the development of KOA such as joint reaction force that are not permissible with conventional gait lab measurements.
Further, the models permit integration of Finite Element Analysis (FEA) to compute stresses and strain that occur in anatomical structures as tendons, ligaments, cartilage, and meniscus.

Impact and Dissemination

The use of multiscale musculoskeletal modelling represents a non-invasive and innovative technique to evaluate the internal and external parameters of the knee joint to understand the role of biomechanics in the development of KOA. Further, it can be used to develop, test and validate subject-specific treatments that aim to prevent, maintain or restore normal joint function.