Are Medial and Lateral Tibiofemoral Compressive Forces Different in Uphill Compared to Level Walking for Patients Following Total Knee Arthroplasty?

2021 ◽  
Author(s):  
Tanner Thorsen ◽  
Chen Wen ◽  
Songning Zhang
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Repeated Measures ◽  
Contact Forces ◽  
Muscle Forces ◽  
Joint Loading ◽  
Level Walking ◽  
Peak Knee ◽  
Total Knee ◽  
Uphill Walking

Abstract The purpose of this study was to determine how tibiofemoral joint compressive forces and knee joint-spanning muscle forces during uphill walking change compared to level walking in patients with total knee arthroplasty (TKA). A musculoskeletal model capable of resolving total (TCF), medial (MCF), and lateral (LCF) tibiofemoral compressive forces was used to determine compressive forces and muscle forces during level and uphill walking on a 10° incline for twenty-five post TKA patients. A 2?2 (slope: level and 10° ? limb: replaced and non-replaced) repeated measures ANOVA was used to detect differences in knee contact forces between slope and limb conditions and their interaction. Peak loading-response TCF, MCF, and LCF were greater during uphill walking than level walking for non-replaced limbs. During uphill walking, peak loading-response TCF was smaller in the replaced limb compared to non-replaced limbs with no change in MCF or LCF. Peak knee extension moment and knee extensor muscle force were smaller in replaced limbs compared to non-replaced limbs during uphill walking. During level walking, replaced and non-replaced limbs experienced rather equal joint loading, however replaced limb experienced reduced joint loading during uphill walking. Differences in joint loading between replaced and non-replaced limbs were not present during level walking, suggesting compensation from the replaced limb during the more difficult task. Uphill walking following TKA promotes more balanced loading of replaced limbs during stance, however these benefits may come at the expense of increased loading on non-replaced limbs.

scholarly journals Prediction of knee loading in native knee and total knee arthroplasty : a forward dynamics computational study

2019 ◽  
Author(s):  
◽  
Swithin Samuel Razu
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Musculoskeletal Model ◽  
Contact Forces ◽  
Muscle Forces ◽  
Model Predictions ◽  
Subject Specific ◽  
Joint Contact ◽  
Total Knee

"The goal of this dissertation is to develop a musculoskeletal model and corroborate model predictions to experimentally measured in vivo knee contact forces, in order to study the biomechanical consequences of two different total knee arthroplasty designs. The two main contributions of this dissertation are: (1) Corroboration to experimental data: The development of an EMG-driven, full-body, musculoskeletal model with subject-specific leg geometries including deformable contacts, ligaments, 6DOF knee joint, and a shoe-floor model that can concurrently predict muscle forces, ligament forces, and joint contact forces. Model predictions of tibiofemoral joint contact forces were evaluated against the subject-specific in vivo measurements from the instrumented TKR for three distinctly different styles of over ground gait. (2) Virtual surgery in TKA: The musculoskeletal modeling methodology was then used to develop a model for one healthy participant with a native knee and then virtually replacing the native knee with fixed-bearing and mobile-bearing total knee arthroplasty designs performing gait and step-up tasks. This approach minimized the biomechanical impact of variations in sex, geometry, implant size, design and positioning, ligament location and tension, and muscle forces found across patients. The differences in biomechanics were compared for the two designs. 1.2 Significance of this Research The world health organization ranks musculoskeletal disorders as the second largest contributor to disability worldwide. Conservative estimates put the national cost of direct care for musculoskeletal disease at $212.7 billion a year [1]. Many people who suffer from neuromuscular or musculoskeletal diseases may benefit from the insights gained from surgery simulations, since musculoskeletal reconstructions are commonly performed on these individuals. Improved surgical outcomes will benefit these individuals not only in the short-term, but also in the long-term, since their future rehabilitation needs may be reduced. For example, although total knee arthroplasty is a common surgical procedure for the treatment of osteoarthritis with over 700,000 procedures performed each year [2], many patients are unhappy with the ultimate results [3]. Ten to 30% of patients report [4] pain, dissatisfaction with function, and the need for further surgery such as revision after the initial surgery resulting in costs exceeding $11 billion [5]. Potentially, simulation studies that quantify the important biomechanical variables will reduce the need for revision surgeries in patients."--Introduction.

In Vivo Tibiofemoral Contact Kinematics and Contact Forces During Dynamic Weight-Bearing Activities Following Total Knee Arthroplasty

2008 ◽  
Author(s):  
Kartik M. Varadarajan ◽  
Angela Moynihan ◽  
Darryl D’Lima ◽  
Clifford W. Colwell ◽  
Harry E. Rubash ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Computational Models ◽  
Imaging System ◽  
Weight Bearing ◽  
Contact Forces ◽  
Inverse Dynamic ◽  
Contact Kinematics ◽  
Total Knee

Accurate knowledge of in vivo articular contact kinematics and contact forces is required to quantitatively understand factors limiting life of total knee arthroplasty (TKA) implants, such as polyethylene component wear and implant loosening [1]. Determination of in vivo tibiofemoral contact forces has been a challenging issue in biomechanics. Historically, instrumented tibial implants have been used to measure tibiofemoral forces in vitro [2] and computational models involving inverse dynamic optimization have been used to estimate joint forces in vivo [3]. Recently, D’Lima et al. reported the first in vivo measurement of 6DOF tibiofemoral forces via an instrumented implant in a TKA patient [4]. However this technique does not provide a direct estimation of tibiofemoral contact forces in the medial and lateral compartments. Recently, a dual fluoroscopic imaging system has been used to accurately determine tibiofemoral contact locations on the medial and lateral tibial polyethylene surfaces [5]. The objective of this study was to combine the dual fluoroscope technique and the instrumented TKAs to determine the dynamic 3D articular contact kinematics and contact forces on the medial and lateral tibial polyethylene surfaces during functional activities.

scholarly journals In vivo contact kinematics and contact forces of the knee after total knee arthroplasty during dynamic weight-bearing activities

2008 ◽  
Vol 41 (10) ◽  
pp. 2159-2168 ◽  
Author(s):  
Kartik M. Varadarajan ◽  
Angela L. Moynihan ◽  
Darryl D’Lima ◽  
Clifford W. Colwell ◽  
Guoan Li
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Weight Bearing ◽  
Contact Forces ◽  
Dynamic Weight ◽  
Contact Kinematics ◽  
Total Knee

scholarly journals Correction of Varus Alignment with Peripheral Osteophyte Removal during Total Knee Arthroplasty: An Assessment with Computer Navigation

2021 ◽  
Author(s):  
Nobuhiro Nishihara ◽  
Hironari Masuda ◽  
Naoya Shimazaki ◽  
Seikai Toyooka ◽  
Hirotaka Kawano ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Repeated Measures ◽  
Soft Tissues ◽  
Mechanical Axis ◽  
Computer Navigation ◽  
Varus Deformity ◽  
Varus Alignment ◽  
Valgus Stress ◽  
Total Knee

AbstractTechniques for symmetrical balancing in flexion and extension have been described; however, the ideal technique is unclear. This study aimed to clarify whether resection of peripheral osteophytes could restore neutral hip–knee–ankle (HKA) angle of varus deformity of arthritic knees. Data from 90 varus arthritic knees that had undergone total knee arthroplasty (TKA) using a nonimage-based navigation system were analyzed. The change in the coronal mechanical axis, while applying manual valgus stress at extension and 90 degrees of knee flexion, was recorded after the following sequential procedures: (1) anterior cruciate ligament (ACL) sectioning, (2) subperiosteal stripping of the deep medial collateral ligament (MCL) from the underlying osteophytes on the medial tibia, and (3) complete removal of peripheral osteophytes from the proximal medial tibia and distal medial femoral condyle. Repeated measures of analysis of variance (ANOVA) were performed to compare the varus angle among each step, and a post hoc analysis by paired t-test was utilized to compare the parameters between baseline and each step. The varus alignment with valgus stress at extension and 90 degrees of flexion (mean: 6.0 ± 3.6 and 5.2 ± 3.9 degrees of varus, respectively) was significantly corrected to a near-neutral mechanical axis (mean: 0.9 ± 2.4 and 1.4 ± 4.2 degrees of varus, respectively) after peripheral osteophyte resection (p < 0.01, both). In many cases, varus deformity of arthritic knees could be corrected to near-neutral HKA angle by applying manual valgus stress after complete peripheral osteophyte resection. These procedures could facilitate soft tissue balancing in TKA, minimizing the risk of overrelease of the medial soft tissues.

An Improved Tibial Force Sensor to Compute Contact Forces and Contact Locations In Vitro After Total Knee Arthroplasty

2017 ◽  
Vol 139 (4) ◽  
Author(s):  
Joshua D. Roth ◽  
Stephen M. Howell ◽  
Maury L. Hull
Keyword(s):  
Total Knee Arthroplasty ◽  
Contact Force ◽  
Knee Arthroplasty ◽  
Force Sensor ◽  
Contact Forces ◽  
Contact Kinematics ◽  
Tibial Insert ◽  
Total Knee ◽  
Mean Square Errors

Contact force imbalance and contact kinematics (i.e., motion of the contact location in each compartment during flexion) of the tibiofemoral joint are both important predictors of a patient's outcome following total knee arthroplasty (TKA). Previous tibial force sensors have limitations in that they either did not determine contact forces and contact locations independently in the medial and lateral compartments or only did so within restricted areas of the tibial insert, which prevented them from thoroughly evaluating contact force imbalance and contact kinematics in vitro. Accordingly, the primary objective of this study was to present the design and verification of an improved tibial force sensor which overcomes these limitations. The improved tibial force sensor consists of a modified tibial baseplate which houses independent medial and lateral arrays of three custom tension–compression transducers each. This sensor is interchangeable with a standard tibial component because it accommodates tibial articular surface inserts with a range of sizes and thicknesses. This sensor was verified by applying known loads at known locations over the entire surface of the tibial insert to determine the errors in the computed contact force and contact location in each compartment. The root-mean-square errors (RMSEs) in contact force are ≤ 6.1 N which is 1.4% of the 450 N full-scale output. The RMSEs in contact location are ≤ 1.6 mm. This improved tibial force sensor overcomes the limitations of the previous sensors and therefore should be useful for in vitro evaluation of new alignment goals, new surgical techniques, and new component designs in TKA.

Patellar contact forces with and without patellar resurfacing in total knee arthroplasty

1999 ◽  
Vol 14 (5) ◽  
pp. 603-609 ◽  
Author(s):  
R. Singerman ◽  
S.M. Gabriel ◽  
C.B. Maheshwer ◽  
J.W. Kennedy
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Contact Forces ◽  
Patellar Resurfacing ◽  
Total Knee

scholarly journals Computational Framework for Determining Patient-Specific Total Knee Arthroplasty Loading

2013 ◽  
Vol 7 (4) ◽  
Author(s):  
Hannah J. Lundberg ◽  
Markus A. Wimmer
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Joint ◽  
Knee Arthroplasty ◽  
Joint Kinematics ◽  
Contact Forces ◽  
Patient Specific ◽  
Force Model ◽  
Computational Framework ◽  
Knee Joint Kinematics ◽  
Total Knee

The purpose of this work is to describe a computational framework for predicting total knee arthroplasty loads which are necessary for accurate preclinical testing of implant designs. Inputs required include patient knee joint kinematics, and implant type, size, and physiological alignment. Computational models used in the framework include the calculation of knee joint kinematics and kinetics, prediction of the contact path, a model to determine muscle forces, and a force model to obtain parametric solutions for implant forces. The resulting knee implant forces have been validated in two studies, and in both the model accurately predicted differences in knee joint loading. To date, implant contact forces have been predicted for 35 patients with four different implant types. Forces have been calculated for walking, chair, and stair activities.

Sign in / Sign up

Export Citation Format

Share Document