scholarly journals Medial knee joint contact force in the intact limb during walking in recently ambulatory service members with unilateral limb loss: a cross-sectional study

PeerJ ◽  
2017 ◽  
Vol 5 ◽  
pp. e2960 ◽  
Author(s):  
Ross H. Miller ◽  
Rebecca L. Krupenevich ◽  
Alison L. Pruziner ◽  
Erik J. Wolf ◽  
Barri L. Schnall
Keyword(s):  
Knee Joint ◽  
Limb Loss ◽  
Service Members ◽  
Model Parameters ◽  
Joint Loading ◽  
Cross Sectional ◽  
Medial Knee ◽  
Knee Oa ◽  
Joint Contact ◽  
Intact Limb

BackgroundIndividuals with unilateral lower limb amputation have a high risk of developing knee osteoarthritis (OA) in their intact limb as they age. This risk may be related to joint loading experienced earlier in life. We hypothesized that loading during walking would be greater in the intact limb of young US military service members with limb loss than in controls with no limb loss.MethodsCross-sectional instrumented gait analysis at self-selected walking speeds with a limb loss group (N = 10, age 27 ± 5 years, 170 ± 36 days since last surgery) including five service members with transtibial limb loss and five with transfemoral limb loss, all walking independently with their first prosthesis for approximately two months. Controls (N = 10, age 30 ± 4 years) were service members with no overt demographical risk factors for knee OA. 3D inverse dynamics modeling was performed to calculate joint moments and medial knee joint contact forces (JCF) were calculated using a reduction-based musculoskeletal modeling method and expressed relative to body weight (BW).ResultsPeak JCF and maximum JCF loading rate were significantly greater in limb loss (184% BW, 2,469% BW/s) vs. controls (157% BW, 1,985% BW/s), with large effect sizes. Results were robust to probabilistic perturbations to the knee model parameters.DiscussionAssuming these data are reflective of joint loading experienced in daily life, they support a “mechanical overloading” hypothesis for the risk of developing knee OA in the intact limb of limb loss subjects. Examination of the evolution of gait mechanics, joint loading, and joint health over time, as well as interventions to reduce load or strengthen the ability of the joint to withstand loads, is warranted.

scholarly journals Effect of a Home Program of Hip Abductor Exercises on Knee Joint Loading, Strength, Function, and Pain in People With Knee Osteoarthritis: A Clinical Trial

2010 ◽  
Vol 90 (6) ◽  
pp. 895-904 ◽  
Author(s):  
Elizabeth A. Sled ◽  
Latif Khoja ◽  
Kevin J. Deluzio ◽  
Sandra J. Olney ◽  
Elsie G. Culham
Keyword(s):  
Knee Joint ◽  
Functional Performance ◽  
Knee Adduction Moment ◽  
Control Group ◽  
Joint Loading ◽  
Medial Knee ◽  
Knee Oa ◽  
Sit To Stand ◽  
Hip Abductor ◽  
Knee Joint Loading

BackgroundHip abductor muscle weakness may result in impaired frontal-plane pelvic control during gait, leading to greater medial compartment loading in people with knee osteoarthritis (OA).ObjectiveThis study investigated the effect of an 8-week home strengthening program for the hip abductor muscles on knee joint loading (measured by the external knee adduction moment during gait), strength (force-generating capacity), and function and pain in individuals with medial knee OA.DesignThe study design was a nonequivalent, pretest-posttest, control group design.SettingTesting was conducted in a motor performance laboratory.PatientsAn a priori sample size calculation was performed. Forty participants with knee OA were matched for age and sex with a control group of participants without knee OA.InterventionParticipants with knee OA completed a home hip abductor strengthening program.MeasurementsThree-dimensional gait analysis was performed to obtain peak knee adduction moments in the first 50% of the stance phase. Isokinetic concentric strength of the hip abductor muscles was measured using an isokinetic dynamometer. The Five-Times-Sit-to-Stand Test was used to evaluate functional performance. Knee pain was assessed with the Western Ontario and McMaster Universities Osteoarthritis Index questionnaire.ResultsFollowing the intervention, the OA group demonstrated significant improvement in hip abductor strength, but not in the knee adduction moment. Functional performance on the sit-to-stand test improved in the OA group compared with the control group. The OA group reported decreased knee pain after the intervention.LimitationsGait strategies that may have affected the knee adduction moment, including lateral trunk lean, were not evaluated in this study.ConclusionsHip abductor strengthening did not reduce knee joint loading but did improve function and reduce pain in a group with medial knee OA.

scholarly journals The Effect of Hip Bracing on Gait in Patients with Medial Knee Osteoarthritis

Arthritis ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
David Wallace ◽  
Christa Barr
Keyword(s):  
Knee Joint ◽  
Knee Osteoarthritis ◽  
External Rotation ◽  
Protective Mechanism ◽  
Joint Loading ◽  
Medial Knee ◽  
Medial Knee Osteoarthritis ◽  
Knee Oa ◽  
Repeated Measures Design ◽  
Knee Joint Loading

Objective. Impaired hip motion has been associated with heightened medial knee joint loading in patients with knee osteoarthritis (OA). A hip external rotation strap designed to pull the femur into external rotation and abduction may serve as one protective mechanism. The primary aim of our study is to determine if the strap decreases medial knee joint loading during level walking in people with knee OA. Design. This study is a single-day repeated measures design. Methods. 15 volunteers with medial knee OA underwent motion analysis data collection during two randomly assigned walking conditions: (1) wearing the strap and (2) control (no strap). Primary outcome measures were peak pelvis, hip and knee joint motions, and torques. These outcomes were averaged across five trials for each condition. Results. Hip abduction (), trunk lean towards the stance limb () and pelvic tilt () significantly increased with the strap versus control trials. Knee adduction loading did not significantly change with the strap (). Conclusion. The use of the hip external rotation strap resulted in angular changes at the hip and pelvis which may be beneficial for patients with medial knee osteoarthritis.

scholarly journals Association of Varus Thrust With Pain and Stiffness and Activities of Daily Living in Patients With Medial Knee Osteoarthritis

2016 ◽  
Vol 96 (2) ◽  
pp. 167-175 ◽  
Author(s):  
Naoto Fukutani ◽  
Hirotaka Iijima ◽  
Takahiko Fukumoto ◽  
Daisuke Uritani ◽  
Eishi Kaneda ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Predictor Variable ◽  
Cross Sectional Study ◽  
Sensitivity Analyses ◽  
Varus Alignment ◽  
Cross Sectional ◽  
Medial Knee ◽  
Knee Oa

Background Increasing evidence highlights potential associations between varus thrust and health domains associated with knee osteoarthritis (OA). Objective The aim of this study was to investigate the association between varus thrust and 2 subcategories—“pain and stiffness” and “activities of daily living (ADL)”—of the Japanese Knee Osteoarthritis Measure (JKOM). Design This was a cross-sectional study. Methods In total, 296 outpatients with knee OA visiting orthopedic clinics were enrolled. The inclusion criteria were age ≥50 years, medial knee OA and Kellgren-Lawrence (K/L) grade ≥1 in one or both knees, and the ability to walk independently. Standard posterior-anterior knee radiographs were measured for varus alignment. Participants were video recorded while walking and were evaluated for the presence or absence of varus thrust. Pain and stiffness of the knee joint and ADL were evaluated using the JKOM. Multivariate regressions (outcomes: pain and stiffness and ADL; predictor variable: varus thrust) were performed. Results Varus thrust was present in 46 (16.2%) of 284 patients. Multivariate regression analyses demonstrated that varus thrust is independently associated with pain and stiffness, adjusted for age, sex, body mass index, K/L grade, and varus alignment (β=.17, P=.005). However, the association between varus thrust and ADL was not significant (β=.11, P=.058). Based on sensitivity analyses, including participants of K/L grade 1 had little influence on this analysis. Limitations Only 16.2% of participants had a varus thrust. Moreover, a cause-effect relationship between varus thrust and pain and stiffness remains unknown due to the cross-sectional design of this study. Conclusions Varus thrust was associated with pain and stiffness in patients with medial knee OA. However, the association between varus thrust and ADL did not reach significance.

scholarly journals A Systematic Review of the Associations Between Inverse Dynamics and Musculoskeletal Modeling to Investigate Joint Loading in a Clinical Environment

2020 ◽  
Vol 8 ◽  
Author(s):  
Jana Holder ◽  
Ursula Trinler ◽  
Andrea Meurer ◽  
Felix Stief
Keyword(s):  
Knee Joint ◽  
Clinical Decision Making ◽  
Inverse Dynamics ◽  
Clinical Decision ◽  
Contact Forces ◽  
Musculoskeletal Modeling ◽  
Joint Loading ◽  
Joint Moments ◽  
Internal Joint ◽  
Joint Contact

The assessment of knee or hip joint loading by external joint moments is mainly used to draw conclusions on clinical decision making. However, the correlation between internal and external loads has not been systematically analyzed. This systematic review aims, therefore, to clarify the relationship between external and internal joint loading measures during gait. A systematic database search was performed to identify appropriate studies for inclusion. In total, 4,554 articles were identified, while 17 articles were finally included in data extraction. External joint loading parameters were calculated using the inverse dynamics approach and internal joint loading parameters by musculoskeletal modeling or instrumented prosthesis. It was found that the medial and total knee joint contact forces as well as hip joint contact forces in the first half of stance can be well predicted using external joint moments in the frontal plane, which is further improved by including the sagittal joint moment. Worse correlations were found for the peak in the second half of stance as well as for internal lateral knee joint contact forces. The estimation of external joint moments is useful for a general statement about the peak in the first half of stance or for the maximal loading. Nevertheless, when investigating diseases as valgus malalignment, the estimation of lateral knee joint contact forces is necessary for clinical decision making because external joint moments could not predict the lateral knee joint loading sufficient enough. Dependent on the clinical question, either estimating the external joint moments by inverse dynamics or internal joint contact forces by musculoskeletal modeling should be used.

Relationship between pain and medial knee joint loading in mild radiographic knee osteoarthritis

2007 ◽  
Vol 57 (7) ◽  
pp. 1254-1260 ◽  
Author(s):  
Laura E. Thorp ◽  
Dale R. Sumner ◽  
Markus A. Wimmer ◽  
Joel A. Block
Keyword(s):  
Knee Joint ◽  
Knee Osteoarthritis ◽  
Joint Loading ◽  
Medial Knee ◽  
Knee Joint Loading ◽  
Radiographic Knee Osteoarthritis

scholarly journals RADIOLOGICAL ASSESSMENT OF KNEE JOINT WIDTH DIFFERENCES IN OLDER ADULTS WITH SYMPTOMATIC MEDIAL KNEE OSTEOARTHRITIS

2021 ◽  
Author(s):  
SAMWON YOON ◽  
YOUNGJOO CHA ◽  
HYUNSIK YOON ◽  
KYOUNGTAE KIM ◽  
ILBONG PARK ◽  
...  
Keyword(s):  
Older Adults ◽  
Knee Joint ◽  
Knee Osteoarthritis ◽  
Joint Space Width ◽  
Lower Limbs ◽  
Unaffected Side ◽  
Medial Knee ◽  
Knee Oa ◽  
Affected Side ◽  
Significant Difference

Knee osteoarthritis (OA) is a degenerative articular disease. The knee joint space width (JSW) is used for grading the severity of knee OA. However, there is a lack of research on differences in the widths of knee joints between both lower limbs in unilateral OA. The purpose of this research was to examine the radiological difference in the affected knee joint and contralateral knee joint by analyzing unilateral older adults with medial knee OA using both knees’ JSW differences. Twenty-five subjects with unilateral medial knee OA participated. X-ray radiographs were used to assess knee JSW, and the paired [Formula: see text]-test was performed to assess the knee joint gap width between the affected side and the unaffected side in the respective medial and lateral sides. The independent [Formula: see text]-test compared the differences between the lateral and medial knee JSWs on the affected side and unaffected side. The paired [Formula: see text]-test did not show a significant difference in the medial and lateral knee JSW on the affected side compared to the unaffected side ([Formula: see text]; 0.11). Meanwhile, the independent [Formula: see text]-test revealed a significant difference between the affected and unaffected sides ([Formula: see text]). This study showed no significant changes in affected knee JSWs compared to unaffected sides, but the difference between the lateral and medial JSWs was significant between the knees affected and unaffected by OA in the older adults with medial knee OA.

Estimation of In-Vivo Quadriceps Forces of the Knee: A Combined In-Vivo Patellofemoral Joint Kinematics Measurement and Finite Element Prediction

2011 ◽  
Author(s):  
Koichi Kobayashi ◽  
Guoan Li
Keyword(s):  
Knee Joint ◽  
Load Transfer ◽  
Weight Bearing ◽  
Knee Oa ◽  
Moment Arms ◽  
Joint Reaction Forces ◽  
Joint Contact ◽  
Reaction Forces ◽  
Knee Pathology

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.

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