scholarly journals Influence of Sex and Knee Joint Rotation on Patellofemoral Joint Stress through a Mathematical Modelling Study

2021 ◽  
Author(s):  
Tomoya Takabayashi ◽  
Mutsuaki Edama ◽  
Takuma Inai ◽  
Yuta Tokunaga ◽  
Masayoshi Kubo
Keyword(s):  
Knee Joint ◽  
Patellofemoral Joint ◽  
Pain Syndrome ◽  
Quadriceps Muscle ◽  
Joint Rotation ◽  
Joint Stress ◽  
Joint Flexion ◽  
Males And Females ◽  
Underlying Mechanisms ◽  
Neutral Conditions

Abstract Background: Females are two times as likely to experience patellofemoral pain syndrome (PFPS) than males; however, the reason for this sex difference remains unclear. Patellofemoral joint (PFJ) stress is believed to contribute to PFPS alterations through knee joint rotation alignment, but the influence of knee joint rotation conditions on PFJ stress is unclear. We aimed to investigate the influence of sex and knee joint rotation alignment on PFJ stress. Methods: Simulation ranges were set to knee joint flexion angles of 10°-45° (common to both sexes) and extension moments of 0-240 Nm (males) and 0-220 Nm (females). The quadriceps force and effective lever arm length at the quadriceps muscle were determined as a function of the knee joint flexion angle and extension moment. The PFJ contact area, which is specific to sex, and knee joint rotation was calculated from cadaver data, and PFJ stress was estimated. Results: In all knee joint rotation conditions, PFJ stress was higher in females than in males. Additionally, PFJ stress in males and females was the largest under neutral conditions compared with other rotation conditions. Conclusion: The results may be useful for understanding the underlying mechanisms contributing to the differences in PFPS in males and females.

scholarly journals Influence of Sex And Knee Joint Rotation On Patellofemoral Joint Stress Through A Mathematical Modelling Study

2021 ◽  
Author(s):  
Takabayashi Tomoya ◽  
Edama Mutsuaki ◽  
Inai Takuma ◽  
Tokunaga Yuta ◽  
Kubo Masayoshi
Keyword(s):  
Knee Joint ◽  
Patellofemoral Joint ◽  
Pain Syndrome ◽  
Quadriceps Muscle ◽  
Joint Rotation ◽  
Joint Stress ◽  
Joint Flexion ◽  
Males And Females ◽  
Underlying Mechanisms ◽  
Neutral Conditions

Abstract Background: Females are two times as likely to experience patellofemoral pain syndrome (PFPS) than males; however, the reason for this sex difference remains unclear. Patellofemoral joint (PFJ) stress is believed to contribute to PFPS alterations through knee joint rotation alignment, but the influence of knee joint rotation conditions on PFJ stress is unclear. We aimed to investigate the influence of sex and knee joint rotation alignment on PFJ stress. Methods: Simulation ranges were set to knee joint flexion angles of 10°-45° (common to both sexes) and extension moments of 0-240 Nm (males) and 0-220 Nm (females). The quadriceps force and effective lever arm length at the quadriceps muscle were determined as a function of the knee joint flexion angle and extension moment. The PFJ contact area, which is specific to sex, and knee joint rotation was calculated from cadaver data, and PFJ stress was estimated. Results: In all knee joint rotation conditions, PFJ stress was higher in females than in males. Additionally, PFJ stress in males and females was the largest under neutral conditions compared with other rotation conditions. Conclusion: The results may be useful for understanding the underlying mechanisms contributing to the differences in PFPS in males and females.

Elevated Knee Joint Kinetics and Reduced Ankle Kinetics Are Present During Jogging and Hopping After Achilles Tendon Ruptures

2017 ◽  
Vol 45 (5) ◽  
pp. 1124-1133 ◽  
Author(s):  
Richard W. Willy ◽  
Annelie Brorsson ◽  
Hayley C. Powell ◽  
John D. Willson ◽  
Roy Tranberg ◽  
...  
Keyword(s):  
Knee Joint ◽  
Lower Extremity ◽  
Achilles Tendon ◽  
Patellofemoral Joint ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Joint Power ◽  
Joint Stress ◽  
Joint Kinetics ◽  
Joint Loads

Background: Deficits in plantarflexor function are common after an Achilles tendon rupture. These deficits may result in an altered distribution of joint loads during lower extremity tasks. Hypothesis: We hypothesized that, regardless of treatment, the Achilles tendon–ruptured limb would exhibit deficits in ankle kinematics and joint power while exhibiting elevated knee joint power and patellofemoral joint loads during walking, jogging, and hopping. We further hypothesized that this loading pattern would be most evident during jogging and hopping. Study Design: Controlled laboratory study. Methods: Thirty-four participants (17 participants treated surgically, 17 treated nonsurgically) were tested at a mean 6.1 ± 2.0 years after an Achilles tendon rupture. Lower extremity kinematics and kinetics were assessed while participants completed walking, jogging, and single-legged hopping trials. Patellofemoral joint stress was calculated via a musculoskeletal model. Data were analyzed via mixed-model repeated analyses of variance (α = .05) and the limb symmetry index (LSI). Results: No differences ( P ≥ .05) were found between the surgical and nonsurgical groups. In both groups, large side-to-side deficits in the plantarflexion angle at toeoff (LSI: 53.5%-73.9%) were noted during walking, jogging, and hopping in the involved limb. Side-to-side deficits in the angular velocity were only present during jogging (LSI: 93.5%) and hopping (LSI: 92.5%). This pattern was accompanied by large deficits in eccentric (LSI: 80.8%-94.7%) and concentric (LSI: 82.2%-84.7%) ankle joint powers in the involved limb during all tasks. Interestingly, only jogging and hopping demonstrated greater knee joint loads when compared with the uninvolved limb. Concentric knee power was greater during jogging (LSI: 117.2%) and hopping (LSI: 115.9%) compared with the uninvolved limb. Similarly, peak patellofemoral joint stress was greater in the involved limb during jogging (LSI: 107.5%) and hopping (LSI: 107.1%), while only hopping had a greater loading rate of patellofemoral joint stress (LSI: 110.9%). Conclusion: Considerable side-to-side deficits in plantarflexor function were observed during walking, jogging, and hopping in patients after an Achilles tendon rupture. As a possible compensation, increased knee joint loads were present but only during jogging and hopping. Clinical Relevance: These data suggest that after an Achilles tendon rupture, patients may be susceptible to greater mechanical loading of the knee during sporting tasks, regardless of surgical or nonsurgical treatment.

scholarly journals New opportunities to correct equvinus foot deformity in orthopedic-traumatological practice

2018 ◽  
Vol 35 (5) ◽  
pp. 19-23
Author(s):  
N. B. Schekolova ◽  
A. M. Zinovyev ◽  
V. G. Kozyukov ◽  
A. E. Tokarev ◽  
Ya. V. Nenakhova
Keyword(s):  
Knee Joint ◽  
Pain Syndrome ◽  
Quadriceps Muscle ◽  
Individual Choice ◽  
Foot Deformity ◽  
Joint Stability ◽  
Locomotor System ◽  
New Variant ◽  
Model Efficiency ◽  
Posterior Position

Aim. To prove the efficiency of using a new variant of leg tutor for correction of locomotor system pathology in treatment of equvinus foot deformity. Materials and methods. A mean age of 23 patients with hemiparesis and equvinus foot deformity was 42.5 years. Tonus and strength of legs was assessed. Angulometric and stabilometric studies were realized. Results. The developed model of leg tutor was used. To eliminate equvinus foot deformity, hyperextension of the knee joint was gradually eliminated using individual choice of the heel form and height, thus strengthening a quadriceps muscle of the thigh. The knee joint stability increased, the intensity of pain syndrome reduced. Arthropathies and deformities of the knee joint were prevented. Innovation of the developed model is the following: a soft glue-based responsive side of textile band “Contact” “Velcro” was stably fixed to the outside surface of posterior third of the plantar part of tutor sleeve. To the responsive side of a textile band, there were fixed removable heel pads (heels from microporous rubber of different height (from 5 to 25 mm) with a responsive hard (with hooks) part of textile band “Contact” “Velcro”). Tutor provided the ability to move and guaranteed stable holding of the extremity segments in the posterior position. There was observed a positive dynamics of changes in the muscular tonus of paralyzed leg. Conclusions. The developed tutor model can be used in orthopedic-traumatological practice to correct equvinus foot deformity; the model efficiency is confirmed by clinical and stabilometric parameters.

Effects of Anterior Knee Displacement During Squatting on Patellofemoral Joint Stress

2018 ◽  
Vol 27 (3) ◽  
pp. 237-243 ◽  
Author(s):  
Thomas W. Kernozek ◽  
Naghmeh Gheidi ◽  
Matthew Zellmer ◽  
Jordan Hove ◽  
Becky L. Heinert ◽  
...  
Keyword(s):  
Patellofemoral Joint ◽  
Reaction Force ◽  
Three Dimensional ◽  
Pain Syndrome ◽  
Patellofemoral Pain Syndrome ◽  
Patellofemoral Pain ◽  
Muscle Forces ◽  
Joint Stress ◽  
Hip Flexion ◽  
Anterior Knee

Context:Squatting is a common rehabilitation training exercise for patellofemoral pain syndrome (PFPS). Patellofemoral joint stress (PFJS) during squatting with more anterior knee displacement has not been systematically investigated.Objective:To compare PFJS during squatting using 2 techniques: squat while keeping the knees behind the toes (SBT) and squat while allowing the knees to go past the toes (SPT).Setting:University research laboratory.Participants:Twenty-five healthy females (age: 22.69 (0.74) y; height: 169.39 (6.44) cm; mass: 61.55 (9.74) kg) participated.Main Outcome Measures:Three-dimensional kinematic and kinetic data were collected at 180 and 1800 Hz, respectively. A musculoskeletal model was used to calculate muscle forces through static optimization. These muscle forces were used in a patellofemoral joint model to estimate PFJS.Results:The magnitudes of PFJS, reaction force, and quadriceps force were higher (P < .001) during SPT compared with the SBT technique. Knee flexion, hip flexion, and ankle dorsiflexion angles were reduced when using the SBT technique.Conclusions:Findings provide some general support for minimizing forward knee translation during squats for patients that may have patellofemoral pain syndrome.

scholarly journals Twelve-Week Gait Retraining Reduced Patellofemoral Joint Stress during Running in Male Recreational Runners

2020 ◽  
Vol 2020 ◽  
pp. 1-9 ◽  
Author(s):  
Baofeng Wang ◽  
Yang Yang ◽  
Xini Zhang ◽  
Junqing Wang ◽  
Liqin Deng ◽  
...  
Keyword(s):  
Patellofemoral Joint ◽  
Pain Syndrome ◽  
Control Group ◽  
Biomechanical Property ◽  
Force Model ◽  
Gait Retraining ◽  
Joint Stress ◽  
Joint Force ◽  
Peak Knee ◽  
Recreational Runners

Purpose. To explore the changes in knee sagittal angle and moment and patellofemoral joint (PFJ) force and stress before and after 12-week gait retraining. Methods. A total of 30 healthy male recreational runners were randomized into a control group (n=15) who ran in their original strike pattern using minimalist shoes or experimental group (n=15) who ran in a forefoot strike pattern using minimalist shoes during the 12-week gait retraining. The kinematic and kinetic data of the dominant leg of the participants during the 12 km/h running were collected by 3D motion capture systems and 3D force platforms. Besides, the biomechanical property of the PFJ was calculated on the basis of the joint force model and the regression equation of the contact area. Results. After the 12-week gait retraining, 78% of the rearfoot strikers turned into forefoot strikers. Peak knee extension moment and peak PFJ stress decreased by 13.8% and 13.3% without altering the running speed, respectively. Meanwhile, no changes in maximum knee flexion angle/extension moment and PFJ force/stress were observed for the control group. Conclusion. The 12-week gait retraining effectively reduced the PFJ stress, thereby providing a potential means of reducing the risk of patellofemoral pain syndrome while running.

Modeling the resistance mechanism of passive knee joint flexion and extension for use in rehabilitation equipment

2021 ◽  
pp. 095441192199013
Author(s):  
Mansoor Amiri ◽  
Farhad Tabatabai Ghomsheh ◽  
Farshad Ghazalian
Keyword(s):  
Knee Joint ◽  
Sagittal Plane ◽  
Resistance Mechanism ◽  
Time Dependent ◽  
Coefficient Of Determination ◽  
Joint Movement ◽  
Elastic Coefficient ◽  
Knee Movement ◽  
Joint Flexion ◽  
Flexion And Extension

The purpose of this study was to model the resistance mechanism of Passive Knee Joint Flexion and Extension to create a similar torque mechanism in rehabilitation equipment. In order to better model the behavior of passive knee tissues, it is necessary to exactly calculate the two coefficients of elasticity of time-independent and time-dependent parts. Ten healthy male volunteers (mean height 176.4+/−4.59 cm) participated in this study. Passive knee joint flexion and extension occurred at velocities of 15, 45, and 120 (degree/s), and in five consecutive cycles and within the range of 0 to 100° of knee movement on the sagittal plane on Cybex isokinetic dynamometer. To ensure that the muscles were relaxed, the electrical activity of knee muscles was recorded. The elastic coefficient, (KS) increased with elevating the passive velocity in flexion and extension. The elastic coefficient, (KP) was observed to grow with the passive velocity increase. While, the viscous coefficient (C) diminished with passive velocity rise in extension and flexion. The heightened passive velocity of the motion resulted in increased hysteresis (at a rate of 42%). The desired of passive velocity is lower so that there is less energy lost and the viscoelastic resistance of the tissue in the movement decreases. The Coefficient of Determination, R2 between the model-responses and experimental curves in the extension was 0.96 < R2 < 0.99 and in flexion was 0.95 < R2 < 0.99. This modeling is capable of predicting the true performance of the components of passive knee movement and we can create a resistance mechanism in the rehabilitation equipment to perform knee joint movement. Quantitative measurements of two elastic coefficients of Time-independent and Time-dependent parts passive knee joint coefficients should be used for better accurate simulation the behavior of passive tissues in the knee which is not seen in other studies.

scholarly journals Evaluation and Validation of a Joint Stress Test to Induce Activity-Related Knee Joint Discomfort — a Prospective Case-Control Study

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Christiane Schön ◽  
Claudia Reule ◽  
Katharina Knaub ◽  
Antje Micka ◽  
Manfred Wilhelm ◽  
...  
Keyword(s):  
Knee Joint ◽  
Healthy Subjects ◽  
Stress Test ◽  
Osteoarthritis Of The Knee ◽  
Time Interval ◽  
Short Time Interval ◽  
Joint Stress ◽  
Joint Health ◽  
The Impact ◽  
Health Function

Abstract Background The assessment of improvement or maintenance of joint health in healthy subjects is a great challenge. The aim of the study was the evaluation of a joint stress test to assess joint discomfort in subjects with activity-related knee joint discomfort (ArJD). Results Forty-five subjects were recruited to perform the single-leg-step-down (SLSD) test (15 subjects per group). Subjects with ArJD of the knee (age 22–62 years) were compared to healthy subjects (age 24–59 years) with no knee joint discomfort during daily life sporting activity and to subjects with mild-to-moderate osteoarthritis of the knee joint (OA, Kellgren score 2–3, age 42–64 years). The subjects performed the SLSD test with two different protocols: (I) standardization for knee joint discomfort; (II) standardization for load on the knee joint. In addition, range of motion (ROM), reach test, acute pain at rest and after a single-leg squat and knee injury, and osteoarthritis outcome score (KOOS) were assessed. In OA and ArJD subjects, knee joint discomfort could be reproducibly induced in a short time interval of less than 10 min (200 steps). In healthy subjects, no pain was recorded. A clear differentiation between study groups was observed with the SLSD test (maximal step number) as well as KOOS questionnaire, ROM, and reach test. In addition, a moderate to good intra-class correlation was shown for the investigated outcomes. Conclusions These results suggest the SLSD test is a reliable tool for the assessment of knee joint health function in ArJD and OA subjects to study the improvements in their activities. Further, this model can be used as a stress model in intervention studies to study the impact of stress on knee joint health function.

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