scholarly journals Knee joint contact mechanics during downhill gait and its relationship with varus/valgus motion and muscle strength in patients with knee osteoarthritis

The Knee ◽  
2016 ◽  
Vol 23 (1) ◽  
pp. 49-56 ◽  
Author(s):  
Shawn Farrokhi ◽  
Carrie A. Voycheck ◽  
Jonathan A. Gustafson ◽  
G. Kelley Fitzgerald ◽  
Scott Tashman
Keyword(s):  
Muscle Strength ◽  
Knee Joint ◽  
Knee Osteoarthritis ◽  
Contact Mechanics ◽  
Joint Contact

Prediction of Knee Joint Contact Forces From External Measures Using Principal Component Prediction and Reconstruction

2018 ◽  
Vol 34 (5) ◽  
pp. 419-423 ◽  
Author(s):  
Christopher M. Saliba ◽  
Allison L. Clouthier ◽  
Scott C.E. Brandon ◽  
Michael J. Rainbow ◽  
Kevin J. Deluzio
Keyword(s):  
Knee Joint ◽  
Knee Osteoarthritis ◽  
Real Time ◽  
Contact Force ◽  
Haptic Feedback ◽  
Principal Component ◽  
Contact Forces ◽  
Statistical Regression ◽  
Joint Contact Force ◽  
Joint Contact

Abnormal loading of the knee joint contributes to the pathogenesis of knee osteoarthritis. Gait retraining is a noninvasive intervention that aims to reduce knee loads by providing audible, visual, or haptic feedback of gait parameters. The computational expense of joint contact force prediction has limited real-time feedback to surrogate measures of the contact force, such as the knee adduction moment. We developed a method to predict knee joint contact forces using motion analysis and a statistical regression model that can be implemented in near real-time. Gait waveform variables were deconstructed using principal component analysis, and a linear regression was used to predict the principal component scores of the contact force waveforms. Knee joint contact force waveforms were reconstructed using the predicted scores. We tested our method using a heterogenous population of asymptomatic controls and subjects with knee osteoarthritis. The reconstructed contact force waveforms had mean (SD) root mean square differences of 0.17 (0.05) bodyweight compared with the contact forces predicted by a musculoskeletal model. Our method successfully predicted subject-specific shape features of contact force waveforms and is a potentially powerful tool in biofeedback and clinical gait analysis.

scholarly journals Application of Computational Lower Extremity Model to Investigate Different Muscle Activities and Joint Force Patterns in Knee Osteoarthritis Patients during Walking

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Kyung Wook Nha ◽  
Ariunzaya Dorj ◽  
Jun Feng ◽  
Jun Ho Shin ◽  
Jong In Kim ◽  
...  
Keyword(s):  
Knee Joint ◽  
Lower Extremity ◽  
Knee Osteoarthritis ◽  
Normal Subjects ◽  
Contact Forces ◽  
Flexor Muscle ◽  
Inverse Dynamic ◽  
Joint Force ◽  
Joint Contact ◽  
Muscle Activations

Many experimental and computational studies have reported that osteoarthritis in the knee joint affects knee biomechanics, including joint kinematics, joint contact forces, and muscle activities, due to functional restriction and disability. In this study, differences in muscle activities and joint force patterns between knee osteoarthritis (OA) patients and normal subjects during walking were investigated using the inverse dynamic analysis with a lower extremity musculoskeletal model. Extensor/flexor muscle activations and torque ratios and the joint contact forces were compared between the OA and normal groups. The OA patients had higher extensor muscle forces and lateral component of the knee joint force than normal subjects as well as force and torque ratios of extensor and flexor muscles, while the other parameters had little differences. The results explained that OA patients increased the level of antagonistic cocontraction and the adduction moment on the knee joint. The presented findings and technologies provide insight into biomechanical changes in OA patients and can also be used to evaluate the postoperative functional outcomes of the OA treatments.

Synthetic PVA Osteochondral Implants for the Knee Joint: Mechanical Characteristics During Simulated Gait

2021 ◽  
pp. 036354652110285
Author(s):  
Tony Chen ◽  
Caroline Brial ◽  
Moira McCarthy ◽  
Russell F. Warren ◽  
Suzanne A. Maher
Keyword(s):  
Knee Joint ◽  
Contact Mechanics ◽  
Contact Stress ◽  
Tibial Plateau ◽  
Porous Metal ◽  
Test System ◽  
Osteochondral Defects ◽  
Polymer Content ◽  
Metal Base ◽  
Joint Contact

Background: Although polyvinyl alcohol (PVA) implants have been developed and used for the treatment of femoral osteochondral defects, their effect on joint contact mechanics during gait has not been assessed. Purpose/Hypothesis: The purpose was to quantify the contact mechanics during simulated gait of focal osteochondral femoral defects and synthetic PVA implants (10% and 20% by volume of PVA), with and without porous titanium (pTi) bases. It was hypothesized that PVA implants with a higher polymer content (and thus a higher modulus) combined with a pTi base would significantly improve defect-related knee joint contact mechanics. Study Design: Controlled laboratory study. Methods: Four cylindrical implants were manufactured: 10% PVA, 20% PVA, and 10% and 20% PVA disks mounted on a pTi base. Devices were implanted into 8 mm–diameter osteochondral defects created on the medial femoral condyles of 7 human cadaveric knees. Knees underwent simulated gait and contact stresses across the tibial plateau were recorded. Contact area, peak contact stress, the sum of stress in 3 regions of interest across the tibial plateau, and the distribution of stresses, as quantified by tracking the weighted center of contact stress throughout gait, were computed for all conditions. Results: An osteochondral defect caused a redistribution of contact stress across the plateau during simulated gait. Solid PVA implants did not improve contact mechanics, while the addition of a porous metal base led to significantly improved joint contact mechanics. Implants consisting of a 20% PVA disk mounted on a pTi base significantly improved the majority of contact mechanics parameters relative to the empty defect condition. Conclusion: The information obtained using our cadaveric test system demonstrated the mechanical consequences of femoral focal osteochondral defects and provides biomechanical support to further pursue the efficacy of high-polymer-content PVA disks attached to a pTi base to improve contact mechanics. Clinical Relevance: As a range of solutions are explored for the treatment of osteochondral defects, our preclinical cadaveric testing model provides unique biomechanical evidence for the continued investigation of novel solutions for osteochondral defects.

Tibiofemoral Joint Contact During the Loading Response Phase of Gait in Individuals With Concurrent Knee Osteoarthritis and Complaints of Joint Instability

2012 ◽  
Author(s):  
Carrie A. Rainis ◽  
Shawn Farrokhi ◽  
Scott Tashman ◽  
G. Kelley Fitzgerald
Keyword(s):  
Knee Joint ◽  
Knee Osteoarthritis ◽  
Path Length ◽  
Joint Instability ◽  
Joint Space ◽  
Joint Motion ◽  
Tibiofemoral Joint ◽  
Knee Oa ◽  
Joint Contact ◽  
Response Phase

Knee osteoarthritis (OA) is one of the most prevalent chronic conditions affecting older adults and commonly leads to pain and functional limitations. Many individuals with knee OA also report episodes of knee instability, which has been shown to adversely affect their ability to perform weight-bearing functional tasks. [1] Recently it was reported that individuals with knee OA and reports of joint instability demonstrate significant reductions in their sagittal and transverse plane rotational knee joint motion. [2] It is conceivable that the decreased rotational joint motion may represent a compensatory attempt to avoid pain and/or to stabilize an unstable knee joint. However, this movement strategy may be problematic in the long term as it could lead to increased compressive loading and a reduction of shock absorption capabilities. Since abnormal rotation is associated with altered joint contact position [3], and the internal/external rotation axis in the normal knee is located on the medial side [4,5], this patient population may exhibit a decreased contact path length in the lateral compartment during the loading response phase of gait. The combination of a reduced contact path length and cartilage loss could in turn lead to a decreased dynamic joint space [6] and concentration of joint stresses responsible for disease progression. Therefore, the objectives of this work were to 1) compare the tibiofemoral joint contact path length and dynamic joint space in the medial and lateral compartments during the loading response phase of gait in individuals with knee OA and complaints of joint instability to a healthy control group and 2) investigate the relationship between these parameters.

scholarly journals Direct Validation of Human Knee-Joint Contact Mechanics Derived From Subject-Specific Finite-Element Models of the Tibiofemoral and Patellofemoral Joints

2020 ◽  
Vol 142 (7) ◽  
Author(s):  
Wei Gu ◽  
Marcus G. Pandy
Keyword(s):  
Finite Element ◽  
Knee Joint ◽  
Contact Mechanics ◽  
Contact Pressure ◽  
Weight Bearing ◽  
Human Knee ◽  
Human Knee Joint ◽  
Joint Contact ◽  
Joint Contact Pressure

Abstract The primary aim of this study was to validate predictions of human knee-joint contact mechanics (specifically, contact pressure, contact area, and contact force) derived from finite-element models of the tibiofemoral and patellofemoral joints against corresponding measurements obtained in vitro during simulated weight-bearing activity. A secondary aim was to perform sensitivity analyses of the model calculations to identify those parameters that most significantly affect model predictions of joint contact pressure, area, and force. Joint pressures in the medial and lateral compartments of the tibiofemoral and patellofemoral joints were measured in vitro during two simulated weight-bearing activities: stair descent and squatting. Model-predicted joint contact pressure distribution maps were consistent with those obtained from experiment. Normalized root-mean-square errors between the measured and calculated contact variables were on the order of 15%. Pearson correlations between the time histories of model-predicted and measured contact variables were generally above 0.8. Mean errors in the calculated center-of-pressure locations were 3.1 mm for the tibiofemoral joint and 2.1 mm for the patellofemoral joint. Model predictions of joint contact mechanics were most sensitive to changes in the material properties and geometry of the meniscus and cartilage, particularly estimates of peak contact pressure. The validated finite element modeling framework offers a useful tool for noninvasive determination of knee-joint contact mechanics during dynamic activity under physiological loading conditions.

scholarly journals Lateral Meniscal Graft Transplantation: Effect of Fixation Method on Joint Contact Mechanics During Simulated Gait

2019 ◽  
Vol 47 (10) ◽  
pp. 2437-2443 ◽  
Author(s):  
Caroline Brial ◽  
Moira McCarthy ◽  
Olufunmilayo Adebayo ◽  
Hongsheng Wang ◽  
Tony Chen ◽  
...  
Keyword(s):  
Knee Joint ◽  
Contact Mechanics ◽  
Contact Stress ◽  
Contact Area ◽  
Gait Cycle ◽  
Fixation Techniques ◽  
Joint Contact ◽  
Bone Plug ◽  
Bony Fixation ◽  
Intact Knee

Background: Controversy exists regarding the optimal bony fixation technique for lateral meniscal allografts. Purpose/Hypothesis: The objective was to quantify knee joint contact mechanics across the lateral plateau for keyhole and bone plug meniscal allograft transplant fixation techniques throughout simulated gait. It was hypothesized that both methods of fixation would improve contact mechanics relative to the meniscectomized condition, while keyhole fixation would restore the distribution of contact stress closer to that of the intact knee. Study Design: Controlled laboratory study. Methods: Six human cadaveric knees were mounted on a multidirectional dynamic simulator and subjected to the following conditions: (1) native intact meniscus, (2) keyhole fixation of the native meniscus, (3) bone plug fixation of the native meniscus, and (4) meniscectomy. Contact area, peak contact stress, and the distribution of stress across the tibial plateau were computed at 14% and 45% of the gait cycle, at which axial forces are at their highest. Translation of the weighted center of contact stress throughout simulated gait was computed. Results: Both bony fixation techniques improved contact mechanics relative to the meniscectomized condition. The keyhole technique was not significantly different from the intact condition for the following metrics: contact area, peak contact stress, distribution of force between the meniscal footprint and cartilage-to-cartilage contact, and the position of the weighted center of contact. In contrast, bone plug fixation resulted in a significant decrease of 21% to 28% in contact area at 14% and 45% of the simulated gait cycle, a significant increase in peak contact stresses of 34% at 45% of the gait cycle, and a shift in the weighted center of contact, which increased forces in the cartilage-to-cartilage contact area at 45% of the gait cycle. Conclusion: While both keyhole and bone plug fixation methods improved lateral compartment contact mechanics relative to the meniscectomized knee, keyhole fixation restored contact mechanics closer to that of the intact knee. Clinical Relevance: Method of meniscal fixation is under the direct control of the surgeon. From a biomechanics perspective, keyhole fixation is advocated for its ability to mimic intact knee joint contact mechanics.

scholarly journals Falls Associated with Muscle Strength in Patients with Knee Osteoarthritis and Self-reported Knee Instability

2015 ◽  
Vol 42 (7) ◽  
pp. 1218-1223 ◽  
Author(s):  
Arjan H. de Zwart ◽  
Martin van der Esch ◽  
Mirjam A.G.M. Pijnappels ◽  
Marco J.M. Hoozemans ◽  
Marike van der Leeden ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Knee Joint ◽  
Knee Osteoarthritis ◽  
Statistical Power ◽  
Multivariate Logistic Regression Analysis ◽  
Knee Extension ◽  
Knee Instability ◽  
Valgus Knee ◽  
Knee Oa ◽  
Risk Of Falls

Objective.We aimed to evaluate the associations between knee muscle strength (MS) and falls, controlling for knee joint proprioception, varus-valgus knee joint laxity, and knee pain, among patients with knee osteoarthritis (OA) reporting knee instability.Methods.A sample of 301 subjects (203 women, 98 men, 35–82 yrs) with established knee OA and self-reported knee instability was studied. The occurrence of at least 1 fall in the previous 3 months was assessed by questionnaire. Maximum knee extension and flexion strength were measured isokinetically. Additionally, proprioception, varus-valgus laxity, and pain were assessed. Student t tests were used to assess differences between subgroups. The association of muscle strength and falls was calculated using univariate and multivariate logistic regression analysis.Results.Over 10% of the subjects (31 out of 301) reported a fall in the previous 3 months. High knee extension muscle strength (crude OR 0.3, 95% CI 0.1–0.8, p = 0.022) and high knee flexion muscle strength (crude OR 0.2, 95% CI 0.0–1.0, p = 0.048) were associated with a lower risk of falls. Proprioception and laxity did not confound this relationship. After adjusting for pain, extensor strength had an adjusted OR of 0.5 (95% CI 0.2–1.4, p = 0.212) for falls and flexor strength had an adjusted OR of 0.4 (95% CI 0.1–2.3, p = 0.312).Conclusion.High knee extension and flexion muscle strength decreased the risk of falls in patients with knee OA and self-reported knee instability. After considering the effect of pain, there was insufficient statistical power to detect an association between muscle strength and falls, which might be because of the low number of subjects who fell (n = 31).

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