A Weighted Objective Function Reduces Estimates of Medial and Lateral Knee Joint Contact Loads During Gait

Author(s):  
S. C. E. Brandon ◽  
D. G. Thelen ◽  
K. J. Deluzio

Accurate prediction of knee joint contact loading during gait is important for understanding knee pathology and development of suitable clinical interventions. While many researchers have modeled the knee contact loads during level walking, these predictions have ranged from 3.4 [1] to 7 [2] times body weight. Validation of contact loads is difficult; the joint contact load depends not only on readily obtainable external kinematics and reaction forces, but also on the forces generated by muscle and other soft tissues. Recently, an instrumented tibial implant, capable of telemetrically reporting the six degree-of-freedom loading environment of the tibial plateau, was used to tune and validate an EMG-driven model of the lower extremity [3]. Recognizing the value of these in vivo data, and the limitations of existing knee models, these researchers devised the Grand Challenge Competitions to Predict In Vivo Knee Loads.

Author(s):  
Hannah J. Lundberg ◽  
Markus A. Wimmer

Detailed knowledge of in vivo knee contact forces and the contribution from muscles, ligaments, and other soft-tissues to knee joint function are essential for evaluating total knee replacement (TKR) designs. We have recently developed a mathematical model for calculating knee joint contact forces using parametric methodology (Lundberg et al., 2009). The numerical model calculates a “solution space” of three-dimensional contact forces for both the medial and lateral compartments of the tibial plateau. The solution spaces are physiologically meaningful, and represent the result of balancing the external moments and forces by different strategies.


Author(s):  
Koichi Kobayashi ◽  
Guoan Li

The load transfer mechanics across the patellofemoral (PF) joint during weight-bearing conditions is important for treatment of the knee pathology, such as knee OA, ACL deficiency as well as TKA. Many studies have characterized the PF joint reaction forces using equilibriums of the quadriceps and ground reaction forces at the knee joint [1,2,3]. However, this simplification does not consider other muscle function as well as 3D knee joint contact location when calculate moment arms of the involved forces.


2013 ◽  
Vol 135 (2) ◽  
Author(s):  
Kurt Manal ◽  
Thomas S. Buchanan

Computational models that predict internal joint forces have the potential to enhance our understanding of normal and pathological movement. Validation studies of modeling results are necessary if such models are to be adopted by clinicians to complement patient treatment and rehabilitation. The purposes of this paper are: (1) to describe an electromyogram (EMG)-driven modeling approach to predict knee joint contact forces, and (2) to evaluate the accuracy of model predictions for two distinctly different gait patterns (normal walking and medial thrust gait) against known values for a patient with a force recording knee prosthesis. Blinded model predictions and revised model estimates for knee joint contact forces are reported for our entry in the 2012 Grand Challenge to predict in vivo knee loads. The EMG-driven model correctly predicted that medial compartment contact force for the medial thrust gait increased despite the decrease in knee adduction moment. Model accuracy was high: the difference in peak loading was less than 0.01 bodyweight (BW) with an R2 = 0.92. The model also predicted lateral loading for the normal walking trial with good accuracy exhibiting a peak loading difference of 0.04 BW and an R2 = 0.44. Overall, the EMG-driven model captured the general shape and timing of the contact force profiles and with accurate input data the model estimated joint contact forces with sufficient accuracy to enhance the interpretation of joint loading beyond what is possible from data obtained from standard motion capture studies.


Author(s):  
Christopher B. Knowlton ◽  
Markus A. Wimmer ◽  
Hannah J. Lundberg

Numerical models are necessary to estimate forces through the knee joint during activities of daily living. However, the numerous muscles and soft tissues crossing the knee joint result in a computationally indeterminate problem. The recent availability of measured contact force data from telemeterized total knee replacements (TKRs) has given researchers the chance to validate models, but telemeterized TKRs represent only a few patients with a specific implant type. Computational models remain necessary to bridge the gap between the small instrumented patient population with a particular implant and larger patient populations executing various activities. Abstracted gait data from another lab tests the versatility of any model to accurately predict forces of TKR patients performing a variety of gaits with disparate implant types. In this study, we calculate and examine the differences between medial and lateral contact forces in level walking and medial thrust gait trials from a freely provided dataset1.


Author(s):  
Massoud Akbarshahi ◽  
Justin W. Fernandez ◽  
Anthony Schache ◽  
Richard Baker ◽  
Marcus G. Pandy

The ability to accurately measure joint kinematics in vivo is of critical importance to researchers in the field of biomechanics [1]. Applications range from the quantitative evaluation of different surgical techniques, treatment methods and/or implant designs, to the development of computer-based models capable of simulating normal and pathological musculoskeletal conditions [1,2]. Currently, non-invasive marker-based three dimensional (3D) motion analysis is the most commonly used method for quantitative assessment of normal and pathological locomotion. The accuracy of this technique is influenced by movement of the soft tissues relative to the underlying bones, which causes inaccuracies in the determination of segmental anatomical coordinate systems and tracking of segmental motion. The purpose of this study was to quantify the errors in the measurement of knee-joint kinematics due solely to soft-tissue artifact (STA) in healthy subjects. To facilitate valid inter-subject comparisons of the kinematic data, relevant anatomical coordinate systems were defined using 3D bone models generated from magnetic resonance imaging (MRI).


2016 ◽  
Vol 138 (2) ◽  
Author(s):  
Florent Moissenet ◽  
Laurence Chèze ◽  
Raphaël Dumas

While recent literature has clearly demonstrated that an extensive personalization of the musculoskeletal models was necessary to reach high accuracy, several components of the generic models may be further investigated before defining subject-specific parameters. Among others, the choice in muscular geometry and thus the level of muscular redundancy in the model may have a noticeable influence on the predicted musculotendon and joint contact forces. In this context, the aim of this study was to investigate if the level of muscular redundancy can contribute or not to reduce inaccuracies in tibiofemoral contact forces predictions. For that, the dataset disseminated through the Sixth Grand Challenge Competition to Predict In Vivo Knee Loads was applied to a versatile 3D lower limb musculoskeletal model in which two muscular geometries (i.e., two different levels of muscular redundancy) were implemented. This dataset provides tibiofemoral implant measurements for both medial and lateral compartments and thus allows evaluation of the validity of the model predictions. The results suggest that an increase of the level of muscular redundancy corresponds to a better accuracy of total tibiofemoral contact force whatever the gait pattern investigated. However, the medial and lateral contact forces ratio and accuracy were not necessarily improved when increasing the level of muscular redundancy and may thus be attributed to other parameters such as the location of contact points. To conclude, the muscular geometry, among other components of the generic model, has a noticeable impact on joint contact forces predictions and may thus be correctly chosen even before trying to personalize the model.


2015 ◽  
Vol 137 (2) ◽  
Author(s):  
Marco A. Marra ◽  
Valentine Vanheule ◽  
René Fluit ◽  
Bart H. F. J. M. Koopman ◽  
John Rasmussen ◽  
...  

Musculoskeletal (MS) models should be able to integrate patient-specific MS architecture and undergo thorough validation prior to their introduction into clinical practice. We present a methodology to develop subject-specific models able to simultaneously predict muscle, ligament, and knee joint contact forces along with secondary knee kinematics. The MS architecture of a generic cadaver-based model was scaled using an advanced morphing technique to the subject-specific morphology of a patient implanted with an instrumented total knee arthroplasty (TKA) available in the fifth “grand challenge competition to predict in vivo knee loads” dataset. We implemented two separate knee models, one employing traditional hinge constraints, which was solved using an inverse dynamics technique, and another one using an 11-degree-of-freedom (DOF) representation of the tibiofemoral (TF) and patellofemoral (PF) joints, which was solved using a combined inverse dynamic and quasi-static analysis, called force-dependent kinematics (FDK). TF joint forces for one gait and one right-turn trial and secondary knee kinematics for one unloaded leg-swing trial were predicted and evaluated using experimental data available in the grand challenge dataset. Total compressive TF contact forces were predicted by both hinge and FDK knee models with a root-mean-square error (RMSE) and a coefficient of determination (R2) smaller than 0.3 body weight (BW) and equal to 0.9 in the gait trial simulation and smaller than 0.4 BW and larger than 0.8 in the right-turn trial simulation, respectively. Total, medial, and lateral TF joint contact force predictions were highly similar, regardless of the type of knee model used. Medial (respectively lateral) TF forces were over- (respectively, under-) predicted with a magnitude error of M < 0.2 (respectively > −0.4) in the gait trial, and under- (respectively, over-) predicted with a magnitude error of M > −0.4 (respectively < 0.3) in the right-turn trial. Secondary knee kinematics from the unloaded leg-swing trial were overall better approximated using the FDK model (average Sprague and Geers' combined error C = 0.06) than when using a hinged knee model (C = 0.34). The proposed modeling approach allows detailed subject-specific scaling and personalization and does not contain any nonphysiological parameters. This modeling framework has potential applications in aiding the clinical decision-making in orthopedics procedures and as a tool for virtual implant design.


2021 ◽  
pp. 036354652110204
Author(s):  
Dong Wang ◽  
Lukas Willinger ◽  
Kiron K. Athwal ◽  
Andy Williams ◽  
Andrew A. Amis

Background: Little scientific evidence is available regarding the effect of knee joint line obliquity (JLO) before and after coronal realignment osteotomy. Hypotheses: Higher JLO would lead to abnormal relative position of the femur on the tibia, a shift of the joint contact areas, and elevated joint contact pressures. Study Design: Descriptive laboratory study. Methods: 10 fresh-frozen human cadaveric knees (age, 59 ± 5 years) were axially loaded to 1500 N in a materials testing machine with the joint line tilted 0°, 4°, 8°, and 12° varus (“downhill” medially) and valgus, at 0° and 20° of knee flexion. The mechanical compression axis was aligned to the center of the tibial plateau. Contact pressure and contact area were recorded by pressure sensors inserted between the tibia and femur below the menisci. Changes in relative femoral and tibial position in the coronal plane were obtained by an optical tracking system. Results: Both medial and lateral JLO caused significant tibiofemoral subluxation and pressure distribution changes. Medial (varus) JLO caused the femur to subluxate medially down the coronal slope of the tibial plateau, and vice versa for lateral (valgus) downslopes ( P < .01), giving a 6-mm range of subluxation. The areas of peak pressure moved 12 mm and 8 mm across the medial and lateral condyles, onto the downhill meniscus and the “uphill” tibial spine. Changes in JLO had only small effects on maximum contact pressures. Conclusion: A 4° change of JLO during load bearing caused significant mediolateral tibiofemoral subluxation. The femur slid down the slope of the tibial plateau to abut the tibial eminence and also to rest on the downhill meniscus. This caused large movements of the tibiofemoral contact pressures across each compartment. Clinical Relevance: These results provide important information for understanding the consequences of creating coronal JLO and for clinical practice in terms of osteotomy planning regarding the effect on JLO. This information provides guidance regarding the choice of single- or double-level osteotomy. Excessive JLO alteration may cause abnormal tibiofemoral joint articulation and chondral or meniscal loading.


2021 ◽  
Author(s):  
Luca Modenese ◽  
Martina Barzan ◽  
Christopher P Carty

AbstractBackgroundMusculoskeletal (MSK) models based on literature data are meant to represent a generic anatomy and are a popular tool employed by biomechanists to estimate the internal loads occurring in the lower limb joints, such as joint reaction forces (JRFs). However, since these models are normally just linearly scaled to an individual’s anthropometry, it is unclear how their estimations would be affected by the personalization of key features of the MSK anatomy, one of which is the femoral anteversion angle.Research QuestionHow are the lower limb JRF magnitudes computed through a generic MSK model affected by changes in the femoral anteversion?MethodsWe developed a bone-deformation tool in MATLAB (https://simtk.org/projects/bone_deformity) and used it to create a set of seven OpenSim models spanning from 2° femoral retroversion to 40° anteversion. We used these models to simulate the gait of an elderly individual with an instrumented prosthesis implanted at their knee joint (5th Grand Challenge dataset) and quantified both the changes in JRFs magnitude due to varying the skeletal anatomy and their accuracy against the correspondent in vivo measurements at the knee joint.ResultsHip and knee JRF magnitudes were affected by the femoral anteversion with variations from the unmodified generic model up to 11.7±5.5% at the hip and 42.6±31.0% at the knee joint. The ankle joint was unaffected by the femoral geometry. The MSK models providing the most accurate knee JRFs (root mean squared error: 0.370±0.069 body weight, coefficient of determination: 0.764±0.104, largest peak error: 0.36±0.16 body weight) were those with the femoral anteversion angle closer to that measured on the segmented bone of the individual.SignificanceFemoral anteversion substantially affects hip and knee JRFs estimated with generic MSK models, suggesting that personalizing key MSK anatomical features might be necessary for accurate estimation of JRFs with these models.


2013 ◽  
Vol 103 (2) ◽  
pp. 126-135 ◽  
Author(s):  
Wangdo Kim ◽  
Antonio P. Veloso ◽  
Veronica E. Vleck ◽  
Carlos Andrade ◽  
Sean S. Kohles

Background: Ligaments and cartilage contact contribute to the mechanical constraints in the knee joints. However, the precise influence of these structural components on joint movement, especially when the joint constraints are computed using inverse dynamics solutions, is not clear. Methods: We present a mechanical characterization of the connections between the infinitesimal twist of the tibia and the femur due to restraining forces in the specific tissue components that are engaged and responsible for such motion. These components include the anterior cruciate, posterior cruciate, medial collateral, and lateral collateral ligaments and cartilage contact surfaces in the medial and lateral compartments. Their influence on the bony rotation about the instantaneous screw axis is governed by restraining forces along the constraints explored using the principle of reciprocity. Results: Published kinetic and kinematic joint data (American Society of Mechanical Engineers Grand Challenge Competition to Predict In Vivo Knee Loads) are applied to define knee joint function for verification using an available instrumented knee data set. We found that the line of the ground reaction force (GRF) vector is very close to the axis of the knee joint. It aligns the knee joint with the GRF such that the reaction torques are eliminated. The reaction to the GRF will then be carried by the structural components of the knee instead. Conclusions: The use of this reciprocal system introduces a new dimension of foot loading to the knee axis alignment. This insight shows that locating knee functional axes is equivalent to the static alignment measurement. This method can be used for the optimal design of braces and orthoses for conservative treatment of knee osteoarthritis. (J Am Podiatr Med Assoc 103(2): 126–135, 2013)


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