Mediolateral force distribution at the knee joint shifts across activities and is driven by tibiofemoral alignment

2017 ◽  
Vol 99-B (6) ◽  
pp. 779-787 ◽  
Author(s):  
I. Kutzner ◽  
A. Bender ◽  
J. Dymke ◽  
G. Duda ◽  
P. von Roth ◽  
...  
Keyword(s):  
Knee Joint ◽  
Force Distribution ◽  
Tibiofemoral Alignment

Distribution of the Force in the Knee Joint during Daily Activities after Open Wedge High Tibial Osteotomy: A Rationale for the Proper Postoperative Management

2019 ◽  
Vol 33 (02) ◽  
pp. 158-166
Author(s):  
Hansol Seo ◽  
Dohyung Lim ◽  
Young Woong Jang ◽  
Kwan-su Kang ◽  
Myung Chul Lee ◽  
...  
Keyword(s):  
Knee Joint ◽  
High Tibial Osteotomy ◽  
Knee Flexion ◽  
Weight Bearing ◽  
Daily Activities ◽  
Force Distribution ◽  
Tibial Osteotomy ◽  
Edge Region ◽  
Open Wedge ◽  
Wedge High Tibial Osteotomy

AbstractThe present study was conducted to evaluate the force distribution in knee joint during daily activities after open-wedge high tibial osteotomy (OWHTO). A three-dimensional proximal tibial finite element model (FEM) was created using Mimics software to evaluate computed tomography (CT) scans of the tibia after OWHTO. The anterior and posterior gaps were 7.0 and 12.1 mm, respectively, and the target opening angle was 12 degrees. The loading ratio of the medial and lateral tibial plateaus was 6:4. To evaluate force distribution in the knee joint during activities of daily living (ADLs) after OWHTO, peak von Mises stresses (PVMSs) were analyzed at the plate and posterolateral edge region of osteotomized tibia. ADLs associated with greater knee flexion (sitting 90 degrees, standing 90 degrees, bending 90 degrees, stepping up stairs 60 degrees, and stepping downstairs 30 and 60 degrees) yielded PVMSs ranging from 195.2 to 221.5 MPa at the posterolateral edge region. In particular, stepping downstairs with knee flexion to 60 degrees produced the highest PVMS (221.5 MPa), greater than the yield strength (100–200 MPa). The highest plate PVMS was greater than 300 MPa during ADLs associated with flexion angles of approximately 90 degrees. However, these values did not exceed the yield stress (760.0 MPa). Conclusively, higher force was generated during higher flexion associated with weight-bearing and stepping downstairs produced a high force (even at lower flexion) on the posterolateral area of the tibial plateau. Therefore, a caution should be exercised when engaging in knee flexion of approximately 90 degrees and stepping downstairs in the early postoperative period when patients follow a weight-bearing rehabilitation protocol. However, this study is based on modeling; further translational studies are needed prior to clinical application.

scholarly journals Dynamic Knee Joint Line Orientation Is Not Predictive of Tibio-Femoral Load Distribution During Walking

2021 ◽  
Vol 9 ◽  
Author(s):  
Adam Trepczynski ◽  
Philippe Moewis ◽  
Philipp Damm ◽  
Pascal Schütz ◽  
Jörn Dymke ◽  
...  
Keyword(s):  
Knee Joint ◽  
Strong Correlation ◽  
Load Distribution ◽  
Joint Line ◽  
Force Distribution ◽  
Ground Reaction Forces ◽  
Joint Loading ◽  
Internal Joint ◽  
Reaction Forces ◽  
Dynamic Alignment

Some approaches in total knee arthroplasty aim for an oblique joint line to achieve an even medio-lateral load distribution across the condyles during the stance phase of gait. While there is much focus on the angulation of the joint line in static frontal radiographs, precise knowledge of the associated dynamic joint line orientation and the internal joint loading is limited. The aim of this study was to analyze how static alignment in frontal radiographs relates to dynamic alignment and load distribution, based on direct measurements of the internal joint loading and kinematics. A unique and novel combination of telemetrically measured in vivo knee joint loading and simultaneous internal joint kinematics derived from mobile fluoroscopy (“CAMS-Knee dataset”) was employed to access the dynamic alignment and internal joint loading in 6 TKA patients during level walking. Static alignment was measured in standard frontal postoperative radiographs while external adduction moments were computed based on ground reaction forces. Both static and dynamic parameters were analyzed to identify correlations using linear and non-linear regression. At peak loading during gait, the joint line was tilted laterally by 4°–7° compared to the static joint line in most patients. This dynamic joint line tilt did not show a strong correlation with the medial force (R2: 0.17) or with the mediolateral force distribution (pseudo R2: 0.19). However, the external adduction moment showed a strong correlation with the medial force (R2: 0.85) and with the mediolateral force distribution (pseudo R2: 0.78). Alignment measured in static radiographs has only limited predictive power for dynamic kinematics and loading, and even the dynamic orientation of the joint line is not an important factor for the medio-lateral knee load distribution. Preventive and rehabilitative measures should focus on the external knee adduction moment based on the vertical and horizontal components of the ground reaction forces.

Frontal Plane Tibiofemoral Alignment is Strongly Related to Compartmental Knee Joint Contact Forces and Muscle Control Strategies During Stair Ascent

2018 ◽  
Vol 140 (6) ◽  
Author(s):  
Hunter J. Bennett ◽  
Joshua T. Weinhandl ◽  
Kristina Fleenor ◽  
Songning Zhang
Keyword(s):  
Knee Joint ◽  
Control Strategies ◽  
Frontal Plane ◽  
Contact Forces ◽  
Muscle Forces ◽  
Muscle Control ◽  
Knee Alignment ◽  
Joint Contact ◽  
Tibiofemoral Alignment ◽  
Weight Acceptance

Static frontal plane tibiofemoral alignment is an important factor in dynamic knee alignment and knee adduction moments (KAMs). However, little is known about the relationship between alignment and compartment contact forces or muscle control strategies. The purpose of this study was to estimate medial (MCF) and lateral (LCF) compartment knee joint contact forces and muscle forces during stair ascent using a musculoskeletal model implementing subject-specific knee alignments. Kinematic and kinetic data from 20 healthy individuals with radiographically confirmed varus or valgus knee alignments were simulated using alignment specific models to predict MCFs and LCFs. Muscle forces were determined using static optimization. Independent samples t-tests compared contact and muscle forces between groups during weight acceptance and during pushoff. The varus group exhibited increased weight acceptance peak MCFs, while the valgus group exhibited increased pushoff peak LCFs. The varus group utilized increased vasti muscle forces during weight acceptance and adductor forces during pushoff. The valgus group utilized increased abductor forces during pushoff. The alignment-dependent contact forces provide evidence of the significance of frontal plane knee alignment in healthy individuals, which may be important in considering future knee joint health. The differing muscle control strategies between alignments detail-specific neuromuscular responses to control frontal plane knee loads.

Effects of knee joint angle and tilt table incline on force distribution at the feet and supporting straps

2003 ◽  
Vol 17 (8) ◽  
pp. 871-878 ◽  
Author(s):  
Claire L Morgan ◽  
Gerard P Cullen ◽  
Maria Stokes ◽  
Anthony V Swan
Keyword(s):  
Knee Joint ◽  
Joint Angle ◽  
Force Distribution ◽  
Tilt Table ◽  
Knee Joint Angle

Effects of Osmium Tetroxide on the Rabbit Knee Joint Normal Synovial Membrane

1987 ◽  
Vol 16 (1) ◽  
pp. 121-129
Author(s):  
M. Möttönen ◽  
M. Pantio ◽  
T. Nevalainen
Keyword(s):  
Knee Joint ◽  
Synovial Membrane ◽  
Osmium Tetroxide ◽  
Rabbit Knee

Radiation synovectomy of the knee joint

2006 ◽  
Vol 45 (01) ◽  
pp. 57-61
Author(s):  
M. Puille ◽  
D. Steiner ◽  
R. Bauer ◽  
R. Klett
Keyword(s):  
Knee Joint ◽  
Lymph Nodes ◽  
Geometric Mean ◽  
Radiation Synovectomy ◽  
Real Activity ◽  
Anterior View ◽  
Inguinal Lymph Nodes ◽  
The Real ◽  
Therapeutic Modalities ◽  
Real Value

Summary Aim: Multiple procedures for the quantification of activity leakage in radiation synovectomy of the knee joint have been described in the literature. We compared these procedures considering the real conditions of dispersion and absorption using a corpse phantom. Methods: We simulated different distributions of the activity in the knee joint and a different extra-articular spread into the inguinal lymph nodes. The activity was measured with a gammacamera. Activity leakage was calculated by measuring the retention in the knee joint only using an anterior view, using the geometric mean of anterior and posterior views, or using the sum of anterior and posterior views. The same procedures were used to quantify the activity leakage by measuring the activity spread into the inguinal lymph nodes. In addition, the influence of scattered rays was evaluated. Results: For several procedures we found an excellent association with the real activity leakage, shown by an r² between 0.97 and 0.98. When the real value of the leakage is needed, e. g. in dosimetric studies, simultaneously measuring of knee activity and activity in the inguinal lymph nodes in anterior and posterior views and calculation of the geometric mean with exclusion of the scatter rays was found to be the procedure of choice. Conclusion: When measuring of activity leakage is used for dosimetric calculations, the above-described procedure should be used. When the real value of the leakage is not necessary, e. g. for comparing different therapeutic modalities, several of the procedures can be considered as being equivalent.

Load-Bearing in the Ovine Medial Tibial Condyle: Effect of Meniscectomy

1993 ◽  
Vol 06 (02) ◽  
pp. 100-104 ◽  
Author(s):  
D. M. Pickles ◽  
C. R. Bellenger
Keyword(s):  
Knee Joint ◽  
Contact Area ◽  
Mammalian Species ◽  
Total Removal ◽  
Load Bearing ◽  
Human Knee ◽  
Biochemical Effects ◽  
Pressure Sensitive ◽  
Medial Meniscectomy ◽  
Tibial Condyle

SummaryTotal removal of a knee joint meniscus is followed by osteoarthritis in many mammalian species. Altered load-bearing has been observed in the human knee following meniscectomy but less is known about biochemical effects of meniscectomy in other species. Using pressure sensitive paper in sheep knee (stifle) joints it was found that, for comparable loads, the load-bearing area on the medial tibial condyle was significantly reduced following medial meniscectomy. Also, for loads of between 50 N and 500 N applied to the whole joint, the slope of the regression of contact area against load was much smaller. Following medial meniscectomy, the ability to increase contact area as load increased was markedly reduced.The load bearing area on the medial tibial condyle was reduced following meniscectomy.

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