Correlation Between In Vivo Knee Contact Forces and External Measures During Gait

Author(s):  
Andrew J. Meyer ◽  
Darryl D. D’Lima ◽  
Scott A. Banks ◽  
David G. Lloyd ◽  
Thor F. Besier ◽  
...  

Researchers have sought to explain the development and progression of knee osteoarthritis using in vivo estimates of knee contact forces. Unfortunately, it is not possible to measure knee contact forces in a clinical environment. Thus, studies often estimate knee contact forces using a variety of external measures. For example, inverse dynamics knee loads such as the adduction moment and superior force are frequently used as surrogate measures of medial and total knee contact force, respectively. Contraction of muscles spanning the knee is believed to increase knee contact force, and hence muscle electromyographic (EMG) signals are another external measure that may be indicative of internal contact force. The recent development of instrumented knee implants, such as the eTibia design [1], has provided access to in vivo knee contact force data during gait and other activities. However, few studies have correlated inverse dynamics loads, and none have correlated EMG signals, with total, medial, and lateral in vivo knee contact forces.

2016 ◽  
Vol 138 (2) ◽  
Author(s):  
Yihwan Jung ◽  
Cong-Bo Phan ◽  
Seungbum Koo

Joint contact forces measured with instrumented knee implants have not only revealed general patterns of joint loading but also showed individual variations that could be due to differences in anatomy and joint kinematics. Musculoskeletal human models for dynamic simulation have been utilized to understand body kinetics including joint moments, muscle tension, and knee contact forces. The objectives of this study were to develop a knee contact model which can predict knee contact forces using an inverse dynamics-based optimization solver and to investigate the effect of joint constraints on knee contact force prediction. A knee contact model was developed to include 32 reaction force elements on the surface of a tibial insert of a total knee replacement (TKR), which was embedded in a full-body musculoskeletal model. Various external measurements including motion data and external force data during walking trials of a subject with an instrumented knee implant were provided from the Sixth Grand Challenge Competition to Predict in vivo Knee Loads. Knee contact forces in the medial and lateral portions of the instrumented knee implant were also provided for the same walking trials. A knee contact model with a hinge joint and normal alignment could predict knee contact forces with root mean square errors (RMSEs) of 165 N and 288 N for the medial and lateral portions of the knee, respectively, and coefficients of determination (R2) of 0.70 and −0.63. When the degrees-of-freedom (DOF) of the knee and locations of leg markers were adjusted to account for the valgus lower-limb alignment of the subject, RMSE values improved to 144 N and 179 N, and R2 values improved to 0.77 and 0.37, respectively. The proposed knee contact model with subject-specific joint model could predict in vivo knee contact forces with reasonable accuracy. This model may contribute to the development and improvement of knee arthroplasty.


2013 ◽  
Vol 135 (2) ◽  
Author(s):  
Hannah J. Lundberg ◽  
Christopher Knowlton ◽  
Markus A. Wimmer

The purpose of this study was to perform a blinded comparison of model predictions of total knee replacement contact forces to in vivo forces from an instrumented prosthesis during normal walking and medial thrust gait by participating in the “Third Grand Challenge Competition to Predict in vivo Knee Loads.” We also evaluated model assumptions that were critical for accurate force predictions. Medial, lateral, and total axial forces through the knee were calculated using a previously developed and validated parametric numerical model. The model uses equilibrium equations between internal and external moments and forces to obtain knee joint contact forces and calculates a range of forces at instances during the gait cycle through parametric variation of muscle activity levels. For 100 instances during a normal over-ground gait cycle, model root mean square differences from eTibia data were 292, 248, and 281 for medial, lateral, and total contact forces, respectively. For 100 instances during a medial thrust gait cycle, model root mean square differences from eTibia data were 332, 234, and 470 for medial, lateral, and total contact forces, respectively. The percent difference between measured and predicted peak total axial force was 2.89% at the first peak and 9.36% at the second peak contact force for normal walking and 3.94% at the first peak and 14.86% at the second peak contact force for medial thrust gait. After unblinding, changes to model assumptions improved medial and lateral force predictions for both gait styles but did not improve total force predictions. Axial forces computed with the model compared well to the eTibia data under blinded and unblinded conditions. Knowledge of detailed knee kinematics, namely anterior-posterior translation, appears to be critical in obtaining accurate force predictions.


2021 ◽  
Author(s):  
Martin Huber ◽  
Matthew Eschbach ◽  
Kazem Kazerounian ◽  
Horea T. Ilies

Abstract Knee osteoarthritis (OA) is a disease that compromises the cartilage inside the knee joint, resulting in pain and impaired mobility. Bracing is a common treatment, however currently prescribed braces cannot treat bicompartmental knee OA, fail to consider the muscle weakness that typically accompanies the disease, and utilize hinges that restrict the knee's natural biomechanics. We have developed and evaluated a brace which addresses these shortcomings. This process has respected three principal design goals: reducing the load experienced across the entire knee joint, generating a supportive moment to aid the muscles in shock absorption, and interfering minimally with gait kinematics. Load reduction is achieved via the compression of medial and lateral leaf springs, and magnetorheological dampers provide the supportive moment during knee loading. A novel, personalized joint mechanism replaces a traditional hinge to reduce interference with knee kinematics. Using motion capture gait analysis, we evaluated the basic functionality of a prototype device. We calculated, via inverse dynamics analysis, the reaction forces at the knee joint and the moments generated by the leg muscles during gait. Comparing these values between braced and unbraced trials allowed us to evaluate the system's effectiveness. Kinematic measurements showed the extent to which the brace interfered with natural gait characteristics. Of the three design goals: a reduction in knee contact forces was demonstrated; increased shock absorption was observed, but not to statistical significance; and natural gait was largely preserved. The techniques presented in this paper could lead to improved OA treatment through patient-specific braces.


Author(s):  
Allison L. Kinney ◽  
Heather K. Vincent ◽  
Melinda K. Harman ◽  
James Coburn ◽  
Darryl D. D’Lima ◽  
...  

Obesity is commonly considered a risk factor for the development of knee osteoarthritis [1]. Previous studies have shown that reductions in body weight correspond to reductions in total knee joint compressive forces (as calculated by inverse dynamics) [2–4]. A recent study showed that external knee load measurements are not strong predictors of internal knee contact forces [5]. Therefore, direct measurement of knee contact force is important for understanding how body weight changes impact knee joint loading. Force-measuring knee implants can directly measure internal knee contact forces [6].


1997 ◽  
Vol 13 (1) ◽  
pp. 14-23 ◽  
Author(s):  
Franck Quaine ◽  
Luc Martin ◽  
Jean-Pierre Blanchi

This manuscript describes three-dimensional force data collected during postural shifts performed by individuals simulating rock-climbing skills. Starting from a quadrupedal vertical posture, 6 expert climbers had to release their right-hand holds and maintain the tripedal posture for a few seconds. The vertical and contact forces (lateral and anteroposterior forces) applied on the holds were analyzed in two positions: an “imposed” position (the trunk far from the supporting wall) and an “optimized” position (the trunk close to the wall and lower contact forces at the holds). The tripedal postures performed in the two positions were achieved by the same pattern of vertical and contact forces exerted by the limbs on the holds. In the optimized position, the transfer of the forces was less extensive than in the imposed position, so that the forces were exerted primarily on the ipsilateral hold. Moreover, a link between the contact force values and the couple due to body weight with respect to the feet was shown.


Author(s):  
Kartik M. Varadarajan ◽  
Angela Moynihan ◽  
Darryl D’Lima ◽  
Clifford W. Colwell ◽  
Harry E. Rubash ◽  
...  

Accurate knowledge of in vivo articular contact kinematics and contact forces is required to quantitatively understand factors limiting life of total knee arthroplasty (TKA) implants, such as polyethylene component wear and implant loosening [1]. Determination of in vivo tibiofemoral contact forces has been a challenging issue in biomechanics. Historically, instrumented tibial implants have been used to measure tibiofemoral forces in vitro [2] and computational models involving inverse dynamic optimization have been used to estimate joint forces in vivo [3]. Recently, D’Lima et al. reported the first in vivo measurement of 6DOF tibiofemoral forces via an instrumented implant in a TKA patient [4]. However this technique does not provide a direct estimation of tibiofemoral contact forces in the medial and lateral compartments. Recently, a dual fluoroscopic imaging system has been used to accurately determine tibiofemoral contact locations on the medial and lateral tibial polyethylene surfaces [5]. The objective of this study was to combine the dual fluoroscope technique and the instrumented TKAs to determine the dynamic 3D articular contact kinematics and contact forces on the medial and lateral tibial polyethylene surfaces during functional activities.


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

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.


2008 ◽  
Vol 41 (10) ◽  
pp. 2159-2168 ◽  
Author(s):  
Kartik M. Varadarajan ◽  
Angela L. Moynihan ◽  
Darryl D’Lima ◽  
Clifford W. Colwell ◽  
Guoan Li

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):  
Hannah J. Lundberg ◽  
Christopher B. Knowlton ◽  
Diego Orozco ◽  
Markus A. Wimmer

Knowledge of in vivo knee contact forces is essential for evaluating total knee replacement (TKR) designs. This is particularly true for activities other than walking, because there is still a limited understanding of its impact on wear. It has been shown that wear scars from retrieved implants have obvious differences compared with simulator tested components in both size of worn area and in damage mode. The divergence could be related to the omission of other activities than walking when testing components in the simulator. The purpose of this study was to use a parametric numerical model for predicting joint contact forces during stair ascent/descent and chair sitting/rising and compare those to measured forces from a database. We hypothesized that the contact force output of the numeric model would be similar to the measured forces.


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