Dual-Joint Modeling for Estimation of Total Knee Replacement Contact Forces During Locomotion

2013 ◽  
Vol 135 (2) ◽  
Author(s):  
Michael W. Hast ◽  
Stephen J. Piazza
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Knee Flexion ◽  
Joint Modeling ◽  
Contact Forces ◽  
Emg Activity ◽  
Single Subject ◽  
Grand Challenge ◽  
Total Knee

Model-based estimation of in vivo contact forces arising between components of a total knee replacement is challenging because such forces depend upon accurate modeling of muscles, tendons, ligaments, contact, and multibody dynamics. Here we describe an approach to solving this problem with results that are tested by comparison to knee loads measured in vivo for a single subject and made available through the Grand Challenge Competition to Predict in vivo Tibiofemoral Loads. The approach makes use of a “dual-joint” paradigm in which the knee joint is alternately represented by (1) a ball-joint knee for inverse dynamic computation of required muscle controls and (2) a 12 degree-of-freedom (DOF) knee with elastic foundation contact at the tibiofemoral and patellofemoral articulations for forward dynamic integration. Measured external forces and kinematics were applied as a feedback controller and static optimization attempted to track measured knee flexion angles and electromyographic (EMG) activity. The resulting simulations showed excellent tracking of knee flexion (average RMS error of 2.53 deg) and EMG (muscle activations within ±10% envelopes of normalized measured EMG signals). Simulated tibiofemoral contact forces agreed qualitatively with measured contact forces, but their RMS errors were approximately 25% of the peak measured values. These results demonstrate the potential of a dual-joint modeling approach to predict joint contact forces from kinesiological data measured in the motion laboratory. It is anticipated that errors in the estimation of contact force will be reduced as more accurate subject-specific models of muscles and other soft tissues are developed.

Calculated Axial Forces at the Knee in Total Knee Replacement Patients During Chair and Stair Activities

2012 ◽  
Author(s):  
Hannah J. Lundberg ◽  
Christopher B. Knowlton ◽  
Diego Orozco ◽  
Markus A. Wimmer
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Contact Forces ◽  
Force Output ◽  
Stair Ascent ◽  
Numeric Model ◽  
Axial Forces ◽  
Joint Contact ◽  
Total Knee

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.

scholarly journals A Hertzian Integrated Contact Model of the Total Knee Replacement Implant for the Estimation of Joint Contact Forces

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Tien Tuan Dao ◽  
Philippe Pouletaut
Keyword(s):  
Total Knee Replacement ◽  
Elastic Properties ◽  
Knee Replacement ◽  
Material Properties ◽  
Contact Forces ◽  
Contact Model ◽  
Patient Specific ◽  
Joint Contact ◽  
Total Knee

The prediction of lower limb muscle and contact forces may provide useful knowledge to assist the clinicians in the diagnosis as well as in the development of appropriate treatment for musculoskeletal disorders. Research studies have commonly estimated joint contact forces using model-based muscle force estimation due to the lack of a reliable contact model and material properties. The objective of this present study was to develop a Hertzian integrated contact model. Then, in vivo elastic properties of the Total Knee Replacement (TKR) implant were identified using in vivo contact forces leading to providing reliable material properties for modeling purposes. First, a patient specific rigid musculoskeletal model was built. Second, a STL-based implant model was designed to compute the contact area evolutions during gait motions. Finally, a Hertzian integrated contact model was defined for the in vivo identification of elastic properties (Young’s modulus and Poisson coefficient) of the instrumented TKR implant. Our study showed a potential use of a new approach to predict the contact forces without knowledge of muscle forces. Thus, the outcomes may lead to accurate and reliable prediction of human joint contact forces for new case study.

scholarly journals Using Musculoskeletal Models to Estimate in vivo Total Knee Replacement Kinematics and Loads: Effect of Differences Between Models

2021 ◽  
Vol 9 ◽  
Author(s):  
Cristina Curreli ◽  
Francesca Di Puccio ◽  
Giorgio Davico ◽  
Luca Modenese ◽  
Marco Viceconti
Keyword(s):  
Finite Element ◽  
Knee Joint ◽  
Total Knee Replacement ◽  
Finite Element Model ◽  
Knee Replacement ◽  
Element Model ◽  
Assessment Process ◽  
Grand Challenge ◽  
Total Knee

Total knee replacement (TKR) is one of the most performed orthopedic surgeries to treat knee joint diseases in the elderly population. Although the survivorship of knee implants may extend beyond two decades, the poor outcome rate remains considerable. A recent computational approach used to better understand failure modes and improve TKR outcomes is based on the combination of musculoskeletal (MSK) and finite element models. This combined multiscale modeling approach is a promising strategy in the field of computational biomechanics; however, some critical aspects need to be investigated. In particular, the identification and quantification of the uncertainties related to the boundary conditions used as inputs to the finite element model due to a different definition of the MSK model are crucial. Therefore, the aim of this study is to investigate this problem, which is relevant for the model credibility assessment process. Three different generic MSK models available in the OpenSim platform were used to simulate gait, based on the experimental data from the fifth edition of the “Grand Challenge Competitions to Predict in vivo Knee Loads.” The outputs of the MSK analyses were compared in terms of relative kinematics of the knee implant components and joint reaction (JR) forces and moments acting on the tibial insert. Additionally, the estimated knee JRs were compared with those measured by the instrumented knee implant so that the “global goodness of fit” was quantified for each model. Our results indicated that the different kinematic definitions of the knee joint and the muscle model implemented in the different MSK models influenced both the motion and the load history of the artificial joint. This study demonstrates the importance of examining the influence of the model assumptions on the output results and represents the first step for future studies that will investigate how the uncertainties in the MSK models propagate on disease-specific finite element model results.

Preoperative Low Back Pain Affects Recovery in Knee Flexion Range of Motion Following Total Knee Replacement

2016 ◽  
Vol 28 (1-2) ◽  
pp. 47-55
Author(s):  
Hannah M. Ashworth ◽  
Christian N. Warner ◽  
Saurabh P Mehta ◽  
Franklin D. Shuler ◽  
Ali Oliashirazi
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Total Knee Replacement ◽  
Range Of Motion ◽  
Knee Replacement ◽  
Knee Flexion ◽  
Low Back ◽  
Total Knee

scholarly journals Knee Flexion and Daily Activities in Patients following Total Knee Replacement: A Comparison with ISO Standard 14243

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Markus A. Wimmer ◽  
William Nechtow ◽  
Thorsten Schwenke ◽  
Kirsten C. Moisio
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Knee Flexion ◽  
Daily Activities ◽  
Wear Testing ◽  
Significant Difference ◽  
Flexion Extension ◽  
Total Knee ◽  
Stair Walking ◽  
The Many

Walking is only one of many daily activities performed by patients following total knee replacement (TKR). The purpose of this study was to examine the hypotheses (a) that subject activity characteristics are correlated with knee flexion range of motion (ROM) and (b) that there is a significant difference between the subject’s flexion/extension excursion throughout the day and the ISO specified input for knee wear testing. In order to characterize activity, the number of walking and stair stepping cycles, the time spent with dynamic and stationary activities, the number of activity sequences, and the knee flexion/extension excursion of 32 TKR subjects were collected during daily activity. Flexion/extension profiles were compared with the ISO 14243 simulator input profile using a level crossing classification algorithm. Subjects took an average of 3102 (range: 343–5857) walking cycles including 65 (range: 0–319) stair stepping cycles. Active and passive ROMs were positively correlated with stair walking time, stair step counts, and stair walking sequences. Simulated knee motion according to ISO showed significantly fewer level crossings at the flexion angles 20–40° and beyond 50° than those measured with the monitor. This suggests that implant wear testing protocols should contain more cycles and a variety of activities requiring higher knee flexion angles with incorporated resting/transition periods to account for the many activity sequences.

scholarly journals Urinary Prothrombin Fragment 1+2 in relation to Development of Non-Symptomatic and Symptomatic Venous Thromboembolic Events following Total Knee Replacement

Thrombosis ◽  
2011 ◽  
Vol 2011 ◽  
pp. 1-6
Author(s):  
Lars C. Borris ◽  
Morten Breindahl ◽  
Michael R. Lassen ◽  
Ákos F. Pap
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Operative Procedure ◽  
Clinical Test ◽  
Prothrombin Fragment ◽  
Venous Thromboembolic Events ◽  
Venous Thromboembolic ◽  
Patients At Risk ◽  
Total Knee

Prothrombin fragment 1+2 is excreted in urine (uF1+2) as a result of in vivo thrombin generation and can be a marker of coagulation status after an operative procedure. This study compared uF1+2 levels in patients with symptomatic and non-symptomatic venous thromboembolism (VTE) after total knee replacement (TKR) and in event-free sex- and age-matched controls. Significantly higher median uF1+2 levels were seen in the VTE patients on days 1, 3, and the day of venography (mostly day 7) after TKR compared with controls. The uF1+2 levels tended to be high in some patients with symptomatic VTE; however, the discriminatory efficacy of the test could not be evaluated. In conclusion, this study showed that patients with VTE tend to have significantly higher uF1+2 levels compared with patients without events between days 1 and 7 after TKR surgery. Measurement of uF1+2 could provide a simple, non-invasive clinical test to identify patients at risk of VTE.

Delayed knee flexion is a safe and effective pathway for Total Knee Replacement

Physiotherapy ◽  
2020 ◽  
Vol 108 ◽  
pp. 45
Author(s):  
Cathy Jenkins ◽  
William Jackson ◽  
Nicholas Bottomley ◽  
Andrew Price ◽  
David Murray ◽  
...  
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Knee Flexion ◽  
Total Knee
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