scholarly journals Meniscus Injury and its Surgical Treatment Does not Increase Initial Whole Knee Joint Friction

2021 ◽  
Vol 9 ◽  
Author(s):  
Luisa de Roy ◽  
Daniela Warnecke ◽  
Steffen Paul Hacker ◽  
Ulrich Simon ◽  
Lutz Dürselen ◽  
...  
Keyword(s):  
Knee Joint ◽  
Axial Load ◽  
Stance Phase ◽  
Medial Meniscus ◽  
Viscous Friction ◽  
Friction Model ◽  
Knee Joints ◽  
Root Tear ◽  
Joint Friction ◽  
Flexion Extension

While it is generally accepted that traumatic meniscus pathologies lead to degenerative articular cartilage changes in the mid-to long-term and consecutively to post-traumatic osteoarthritis (PTOA), very little is known about how such injuries initiate tribological changes within the knee and their possible impact on PTOA acceleration. Therefore, the aim of this study was to investigate the influence of three different medial meniscus states (intact, posterior root tear, total meniscectomy) on the initial whole knee joint friction. Six ovine knee joints were tested in a passive pendulum friction testing device under an axial load of 250 N and an initial deflection of 12°, representing swing phase conditions, and under an axial load of 1000 N and an initial deflection of 5°, simulating stance phase conditions. To additionally consider the influence of the time-dependent viscoelastic nature of the knee joint soft tissues on whole joint friction, the tests were performed twice, directly following load application and after 20 min creep loading of either 250 N or 1000 N axial load. On the basis of a three-dimensional joint kinematic analysis, the energy loss during the passive joint motion was analyzed, which allowed considerations on frictional and damping processes within the joint. The so-called “whole knee joint” friction was evaluated using the boundary friction model from Stanton and a viscous friction model from Crisco et al., both analyzing the passive joint flexion-extension motion in the sagittal plane. Significantly lower friction coefficients were observed in the simulated swing phase after meniscectomy (p < 0.05) compared to the intact state. No initial whole joint friction differences between the three meniscus states (p > 0.05) were found under stance phase conditions. Soft tissue creeping significantly increased all the determined friction coefficients (p < 0.05) after resting under load for 20 min. The exponential decay function of the viscous friction model provided a better fit (R2∼0.99) to the decaying flexion-extension data than the linear decay function of the boundary friction model (R2∼0.60). In conclusion, this tribological in vitro study on ovine knee joints indicated that neither a simulated posterior medial meniscus root tear nor the removal of the medial meniscus resulted in an initially increased whole joint friction.

Biomechanical responses of young adults with unilateral transfemoral amputation using two types of mechanical stance control prosthetic knee joints

2020 ◽  
Vol 44 (5) ◽  
pp. 314-322
Author(s):  
Jan Andrysek ◽  
Daniela García ◽  
Claudio Rozbaczylo ◽  
Carlos Alvarez-Mitchell ◽  
Rebeca Valdebenito ◽  
...  
Keyword(s):  
Young Adults ◽  
Knee Joint ◽  
Stance Phase ◽  
Pelvic Tilt ◽  
Swing Phase ◽  
Knee Joints ◽  
Transfemoral Amputation ◽  
Phase Duration ◽  
Prosthetic Knee ◽  
Stance Control

Background: Prosthetic knee joint function is important in the rehabilitation of individuals with transfemoral amputation. Objectives: The objective of this study was to assess the gait patterns associated with two types of mechanical stance control prosthetic knee joints—weight-activated braking knee and automatic stance-phase lock knee. It was hypothesized that biomechanical differences exist between the two knee types, including a prolonged swing-phase duration and exaggerated pelvic movements for the weight-activated braking knee during gait. Study design: Prospective crossover study. Methods: Spatiotemporal, kinematic, and kinetic parameters were obtained via instrumented gait analysis for 10 young adults with a unilateral transfemoral amputation. Discrete gait parameters were extracted based on their magnitudes and timing. Results: A 1.01% ± 1.14% longer swing-phase was found for the weight-activated braking knee (p < 0.05). The prosthetic ankle push-off also occurred earlier in the gait cycle for the weight-activated braking knee. Anterior pelvic tilt was 3.3 ± 3.0 degrees greater for the weight-activated braking knee. This range of motion was also higher (p < 0.05) and associated with greater hip flexion angles. Conclusions: Stance control affects biomechanics primarily in the early and late stance associated with prosthetic limb loading and unloading. The prolonged swing-phase time for the weight-activated braking knee may be associated with the need for knee unloading to initiate knee flexion during gait. The differences in pelvic tilt may be related to knee stability and possibly the different knee joint stance control mechanisms. Clinical relevance Understanding the influence of knee function on gait biomechanics is important in selecting and improving treatments and outcomes for individuals with lower-limb amputations. Weight-activated knee joints may result in undesired gait deviations associated with stability in early stance-phase, and swing-phase initiation in the late stance-phase of gait.

scholarly journals Influence of Pain on Knee Joint Movement and Moment during the Stance Phase in Patients with Severe Bilateral Knee Osteoarthritis: A Pilot Study

Medicina ◽  
2019 ◽  
Vol 55 (12) ◽  
pp. 756
Author(s):  
Takashi Fukaya ◽  
Hirotaka Mutsuzaki ◽  
Koichi Mori
Keyword(s):  
Knee Joint ◽  
Knee Osteoarthritis ◽  
Stance Phase ◽  
Three Dimensional ◽  
Knee Extensor ◽  
Three Dimensions ◽  
Knee Joints ◽  
Joint Movement ◽  
Bilateral Knee ◽  
Kinematics And Kinetics

Background and Objectives: The purpose of this study was to compare the side-to-side differences in knee joint movement and moment for the degree of pain in the walking stance phase in patients with bilateral knee osteoarthritis (KOA) of comparable severity. We hypothesized that knee joint movement and moment on the side with strong pain were lower compared with the side with weak pain. Materials and Methods: We included 11 patients diagnosed with bilateral severe KOA. In all patients’ left and right knees, the Kellgren–Lawrence radiographic scoring system grade was level 4, and the femorotibial angle and knee range of motion were equivalent. Following patients’ interviews with an orthopedic surgeon, we performed a comparative study with KOA with strong pain (KOAs) as the strong painful side and KOA with weak pain (KOAw) as the weak painful side. Data for changes in bilateral knee joint angles in three dimensions during the stance phase and bilateral knee sagittal and frontal moments exerted in the early and late stance phases were extracted from kinematics and kinetics analyses. Results: Three-dimensional joint movements in the knee joint were not significantly different in all phases between KOAs and KOAw. Knee extensor moment in the early stance phase in KOAs was significantly smaller than that in KOAw. Knee abductor moment in the early and late stance phase was not significantly different between KOAs and KOAw. Conclusions: Although we found no difference in joint motion in bilateral knee joints, knee extensor moment on the side with strong pain was decreased. In patients with bilateral severe KOA, it was suggested that the magnitude of knee pain contributed to the decrease in knee joint function.

scholarly journals Designs and performance of three new microprocessor-controlled knee joints

2018 ◽  
Vol 0 (0) ◽  
Author(s):  
Julius Thiele ◽  
Christina Schöllig ◽  
Malte Bellmann ◽  
Marc Kraft
Keyword(s):  
Knee Joint ◽  
Stance Phase ◽  
Detailed Comparison ◽  
Knee Joints ◽  
Analysis Laboratory ◽  
X Ray Computed ◽  
And Performance ◽  
Walking Speeds ◽  
And Control ◽  
Flexion And Extension

Abstract A crossover design study with a small group of subjects was used to evaluate the performance of three microprocessor-controlled exoprosthetic knee joints (MPKs): C-Leg 4, Plié 3 and Rheo Knee 3. Given that the mechanical designs and control algorithms of the joints determine the user outcome, the influence of these inherent differences on the functional characteristics was investigated in this study. The knee joints were evaluated during level-ground walking at different velocities in a motion analysis laboratory. Additionally, technical analyses using patents, technical documentations and X-ray computed tomography (CT) for each knee joint were performed. The technical analyses showed that only C-Leg 4 and Rheo Knee 3 allow microprocessor-controlled adaptation of the joint resistances for different gait velocities. Furthermore, Plié 3 is not able to provide stance extension damping. The biomechanical results showed that only if a knee joint adapts flexion and extension resistances by the microprocessor all known advantages of MPKs can become apparent. But not all users may benefit from the examined functions: e.g. a good accommodation to fast walking speeds or comfortable stance phase flexion. Hence, a detailed comparison of user demands and performance of the designated knee joint is mandatory to ensure a maximum in user outcome.

scholarly journals Comparison of Biomechanical Parameters between Medial and Lateral Compartments of Human Knee Joints

2020 ◽  
Vol 14 (1) ◽  
pp. 74-86
Author(s):  
Ashwin Kumar Devaraj ◽  
Kiran Kumar V Acharya ◽  
Raviraja Adhikari
Keyword(s):  
Knee Joint ◽  
Contact Area ◽  
Medial Meniscus ◽  
Knee Joints ◽  
Maximum Compressive Stress ◽  
Full Extension ◽  
Tibial Cartilage ◽  
Human Knee ◽  
Compressive Stresses ◽  
Biomechanical Parameters

Background: The knowledge of biomechanics helps in predicting stresses in different parts of the knee joint during daily activities. Objective: The objective of this study is to evaluate the biomechanical parameters of the knee joint, such as contact pressure, contact area, and maximum compressive stress, at full extension position during the gait cycle. Methods: The three-dimensional finite element models of human knee joints are developed from magnetic resonance images (MRI) of multiple healthy subjects. The knee joints are subjected to an axial compressive force of 1150 N at full extension position. Results: The maximum compressive stresses on the medial and lateral tibial cartilages were 2.98±0.51 MPa and 2.57±0.53 MPa, respectively. The maximum compressive stresses on the medial and lateral menisci were 2.81±0.92 MPa and 2.52±0.97 MPa, respectively. The contact area estimated on medial and lateral tibial cartilages were 701±89 mm2 and 617±63 mm2, respectively. Conclusion: The results were validated using experimental and numerical results from literature and were found to be in good agreement. The magnitude of maximum compressive stress and the contact pressure was found to be higher at the medial portion of the cartilages as compared to that in the lateral portion of the cartilages. This study shows that the medial meniscus is more prone to tear under severe loading conditions, as the stresses in the medial meniscus are higher than that in the lateral meniscus. The total contact area in the medial tibial cartilage is larger than that in the lateral tibial cartilage.

Experimental and Finite Element Investigations on the Biomechanical Effects of Meniscal Tears in the Knee Joint: A Review

2021 ◽  
Vol 50 ◽  
pp. 1-14
Author(s):  
Ashwin Kumar Devaraj ◽  
Kiran Kumar V. Acharya ◽  
Raviraja Adhikari
Keyword(s):  
Finite Element Analysis ◽  
Finite Element ◽  
Knee Joint ◽  
Contact Pressure ◽  
Medial Meniscus ◽  
Lateral Meniscus ◽  
Knee Joints ◽  
Meniscal Tears ◽  
Element Analysis ◽  
Biomechanical Response

The knowledge of the complex biomechanical behaviour of the injured knee joints is of paramount importance in various clinical situations. A review of the biomechanical effects of meniscal tears based on experimental and finite element analysis has not been reported in the literature. The objective of this study is to present a review of experimental and finite element investigations on the consequences of meniscal tears such as longitudinal, radial, horizontal cleavage and root tears in the medial and lateral menisci. It is found that larger longitudinal tear in the medial meniscus has a significant impact on the magnitude of strain in the meniscus associated with a dramatic increase in CP in the tibial cartilage. Also, the untreated fragment of the torn meniscus leads to a significant rise in contact pressure in the cartilage resulting in the progressive degeneration of the cartilage surface. The radial tears in the lateral meniscus of more than 66% width and those in the medial meniscus of more than 75% width result in a substantial increase in the contact pressure in the cartilage compared to that in the intact knee joint. The root tears in the menisci demonstrate a significant influence on the biomechanical response of the knee joint. The results of finite element analysis studies are compared with experimental findings. Finally, some recommendations for future work are proposed to predict the realistic biomechanical response of the knee joints with meniscal tears. The results of this study present a rationale that could help surgeons in making clinical decisions when managing patients with meniscal tears.

Examination of Knee Joint Moments on the Function of Knee-Ankle-Foot Orthoses During Walking

2013 ◽  
Vol 29 (4) ◽  
pp. 474-480 ◽  
Author(s):  
Jan Andrysek ◽  
Susan Klejman ◽  
John Kooy
Keyword(s):  
Knee Joint ◽  
Stance Phase ◽  
Knee Extension ◽  
Knee Joints ◽  
Foot Orthoses ◽  
Variable Effect ◽  
Stance Control ◽  
Ankle Foot Orthoses ◽  
Control Knee ◽  
Load Transducer

The goal of this study was to investigate clinically relevant biomechanical conditions relating to the setup and alignment of knee-ankle-foot orthoses and the influence of these conditions on knee extension moments and orthotic stance control during gait. Knee moments were collected using an instrumented gait laboratory and concurrently a load transducer embedded at the knee-ankle-foot orthosis knee joint of four individuals with poliomyelitis. We found that knee extension moments were not typically produced in late stance-phase of gait. Adding a dorsiflexion stop at the orthotic ankle significantly decreased the knee flexion moments in late stance-phase, while slightly flexing the knee in stance-phase had a variable effect. The findings suggest that where users of orthoses have problems initiating swing-phase flexion with stance control orthoses, an ankle dorsiflexion stop may be used to enhance function. Furthermore, the use of stance control knee joints that lock while under flexion may contribute to more inconsistent unlocking of the stance control orthosis during gait.

scholarly journals Prevalence and Structural Abnormal Findings of Injured Knee Joint among Adult Patients detected by Magnetic Resonance Imaging Study of 70 Cases in a tertiary hospital of Bangladesh

2021 ◽  
Vol 8 (2) ◽  
pp. 80-84
Author(s):  
Mahbuba Shirin ◽  
Salahuddin Al Azad ◽  
Farzana Alam ◽  
Md Menhazul Islam
Keyword(s):  
Knee Joint ◽  
Medial Meniscus ◽  
Left Knee ◽  
Knee Joints ◽  
Cruciate Ligaments ◽  
Resonance Imaging ◽  
Anterior Cruciate Ligaments ◽  
Study Population ◽  
Anterior Cruciate ◽  
Injured Knee

Background: Magnetic resonance imaging is a very useful diagnostic tool for the detection of abnormalities of injured knee joint. Objective: This present study was performed to see the different abnormalities of injured knee joint detected by MRI among adult patients. Methodology: This cross-sectional study was conducted in the Department of Radiology and Imaging at Bangabandhu Sheikh Mujib Medical University (BSSMU), Dhaka, Bangladesh from January to June 2021 for a period of six months. The patients in the age group of equal or more than 18 years with both male and female who were visiting Department of Orthopaedics at BSMMU, Dhaka with history of knee injuries were subjected to MRI were selected as study population. MRI findings of the knee joint were analyzed for the presence of any signal changes or lesions of varying severity for the structures of menisci, cartilage, bone marrow, tendons and ligaments of injured knee joint. Results: A total number of 65 cases of knee joints were analyzed. The mean with the SD of age of the study population was 35.34±13.371. The left knee (60.0%) was more involved than right knee (40.0%). The lesion in femur and tibia were found in 10(15.4%) cases and 8(12.3%) cases respectively. Out of 65 knee joints there were 41 joints were found the tear of anterior cruciate ligament. The complete, interstial tear in the anterior cruciate ligaments were 26(40.0%) and 15(23.1%) knee joints respectively. However, anterior cruciate ligaments of 24(36.9%) knee joints were found normal. Medial meniscus (36.9%) was more involved than lateral meniscus (18.5%). Conclusion: In conclusion young adult male are more commonly affected their left knee joint with the tearing of complete tear of anterior cruciate ligaments and involvement of medial meniscus. Journal of Current and Advance Medical Research, July 2021;8(2):80-84

Visualization of Cartilage from Knee Joint Magnetic Resonance Images and Quantitative Assessment to Study the Effect of Age, Gender and Body Mass Index (BMI) in Progressive Osteoarthritis (OA)

2019 ◽  
Vol 15 (6) ◽  
pp. 565-572
Author(s):  
Mallikarjunaswamy Shivagangadharaiah Matada ◽  
Mallikarjun Sayabanna Holi ◽  
Rajesh Raman ◽  
Sujana Theja Jayaramu Suvarna
Keyword(s):  
Body Mass Index ◽  
Magnetic Resonance ◽  
Knee Joint ◽  
Body Mass ◽  
3D Visualization ◽  
Cartilage Degradation ◽  
Magnetic Resonance Images ◽  
Cartilage Thickness ◽  
Knee Joints ◽  
Data Set

Background: Osteoarthritis (OA) is a degenerative disease of joint cartilage affecting the elderly people around the world. Visualization and quantification of cartilage is very much essential for the assessment of OA and rehabilitation of the affected people. Magnetic Resonance Imaging (MRI) is the most widely used imaging modality in the treatment of knee joint diseases. But there are many challenges in proper visualization and quantification of articular cartilage using MRI. Volume rendering and 3D visualization can provide an overview of anatomy and disease condition of knee joint. In this work, cartilage is segmented from knee joint MRI, visualized in 3D using Volume of Interest (VOI) approach. Methods: Visualization of cartilage helps in the assessment of cartilage degradation in diseased knee joints. Cartilage thickness and volume were quantified using image processing techniques in OA affected knee joints. Statistical analysis is carried out on processed data set consisting of 110 of knee joints which include male (56) and female (54) of normal (22) and different stages of OA (88). The differences in thickness and volume of cartilage were observed in cartilage in groups based on age, gender and BMI in normal and progressive OA knee joints. Results: The results show that size and volume of cartilage are found to be significantly low in OA as compared to normal knee joints. The cartilage thickness and volume is significantly low for people with age 50 years and above and Body Mass Index (BMI) equal and greater than 25. Cartilage volume correlates with the progression of the disease and can be used for the evaluation of the response to therapies. Conclusion: The developed methods can be used as helping tool in the assessment of cartilage degradation in OA affected knee joint patients and treatment planning.

scholarly journals The Effects of External Loads and Muscle Forces on the Knee Joint Ligaments during Walking: A Musculoskeletal Model Study

2021 ◽  
Vol 11 (5) ◽  
pp. 2356
Author(s):  
Carlo Albino Frigo ◽  
Lucia Donno
Keyword(s):  
Knee Joint ◽  
Cruciate Ligament ◽  
Musculoskeletal Model ◽  
Optimization Approach ◽  
Muscle Forces ◽  
Collateral Ligaments ◽  
Flexion Extension ◽  
Lateral Collateral Ligaments ◽  
Gastrocnemius Muscles ◽  
External Loads

A musculoskeletal model was developed to analyze the tensions of the knee joint ligaments during walking and to understand how they change with changes in the muscle forces. The model included the femur, tibia, patella and all components of cruciate and collateral ligaments, quadriceps, hamstrings and gastrocnemius muscles. Inputs to the model were the muscle forces, estimated by a static optimization approach, the external loads (ground reaction forces and moments) and the knee flexion/extension movement corresponding to natural walking. The remaining rotational and translational movements were obtained as a result of the dynamic equilibrium of forces. The validation of the model was done by comparing our results with literature data. Several simulations were carried out by sequentially removing the forces of the different muscle groups. Deactivation of the quadriceps produced a decrease of tension in the anterior cruciate ligament (ACL) and an increase in the posterior cruciate ligament (PCL). By removing the hamstrings, the tension of ACL increased at the late swing phase, while the PCL force dropped to zero. Specific effects were observed also at the medial and lateral collateral ligaments. The removal of gastrocnemius muscles produced an increase of tension only on PCL and lateral collateral ligaments. These results demonstrate how musculoskeletal models can contribute to knowledge about complex biomechanical systems as the knee joint.

scholarly journals Study on Friction in Automotive Shock Absorbers Part 1: Friction Simulation Using a Dynamic Friction Model in the Contact Zone of an FEM Model

Vehicles ◽  
2021 ◽  
Vol 3 (2) ◽  
pp. 212-232
Author(s):  
Ludwig Herzog ◽  
Klaus Augsburg
Keyword(s):  
Ride Comfort ◽  
Viscous Friction ◽  
Simulation Method ◽  
Friction Model ◽  
Model Parameters ◽  
Dynamic Friction ◽  
Friction Modeling ◽  
Shock Absorbers ◽  
Operation Conditions ◽  
Wide Range

The important change in the transition from partial to high automation is that a vehicle can drive autonomously, without active human involvement. This fact increases the current requirements regarding ride comfort and dictates new challenges for automotive shock absorbers. There exist two common types of automotive shock absorber with two friction types: The intended viscous friction dissipates the chassis vibrations, while the unwanted solid body friction is generated by the rubbing of the damper’s seals and guides during actuation. The latter so-called static friction impairs ride comfort and demands appropriate friction modeling for the control of adaptive or active suspension systems. In this article, a simulation approach is introduced to model damper friction based on the most friction-relevant parameters. Since damper friction is highly dependent on geometry, which can vary widely, three-dimensional (3D) structural FEM is used to determine the deformations of the damper parts resulting from mounting and varying operation conditions. In the respective contact zones, a dynamic friction model is applied and parameterized based on the single friction point measurements. Subsequent to the parameterization of the overall friction model with geometry data, operation conditions, material properties and friction model parameters, single friction point simulations are performed, analyzed and validated against single friction point measurements. It is shown that this simulation method allows for friction prediction with high accuracy. Consequently, its application enables a wide range of parameters relevant to damper friction to be investigated with significantly increased development efficiency.

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