scholarly journals Application of Computational Lower Extremity Model to Investigate Different Muscle Activities and Joint Force Patterns in Knee Osteoarthritis Patients during Walking

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Kyung Wook Nha ◽  
Ariunzaya Dorj ◽  
Jun Feng ◽  
Jun Ho Shin ◽  
Jong In Kim ◽  
...  

Many experimental and computational studies have reported that osteoarthritis in the knee joint affects knee biomechanics, including joint kinematics, joint contact forces, and muscle activities, due to functional restriction and disability. In this study, differences in muscle activities and joint force patterns between knee osteoarthritis (OA) patients and normal subjects during walking were investigated using the inverse dynamic analysis with a lower extremity musculoskeletal model. Extensor/flexor muscle activations and torque ratios and the joint contact forces were compared between the OA and normal groups. The OA patients had higher extensor muscle forces and lateral component of the knee joint force than normal subjects as well as force and torque ratios of extensor and flexor muscles, while the other parameters had little differences. The results explained that OA patients increased the level of antagonistic cocontraction and the adduction moment on the knee joint. The presented findings and technologies provide insight into biomechanical changes in OA patients and can also be used to evaluate the postoperative functional outcomes of the OA treatments.

2018 ◽  
Vol 34 (5) ◽  
pp. 419-423 ◽  
Author(s):  
Christopher M. Saliba ◽  
Allison L. Clouthier ◽  
Scott C.E. Brandon ◽  
Michael J. Rainbow ◽  
Kevin J. Deluzio

Abnormal loading of the knee joint contributes to the pathogenesis of knee osteoarthritis. Gait retraining is a noninvasive intervention that aims to reduce knee loads by providing audible, visual, or haptic feedback of gait parameters. The computational expense of joint contact force prediction has limited real-time feedback to surrogate measures of the contact force, such as the knee adduction moment. We developed a method to predict knee joint contact forces using motion analysis and a statistical regression model that can be implemented in near real-time. Gait waveform variables were deconstructed using principal component analysis, and a linear regression was used to predict the principal component scores of the contact force waveforms. Knee joint contact force waveforms were reconstructed using the predicted scores. We tested our method using a heterogenous population of asymptomatic controls and subjects with knee osteoarthritis. The reconstructed contact force waveforms had mean (SD) root mean square differences of 0.17 (0.05) bodyweight compared with the contact forces predicted by a musculoskeletal model. Our method successfully predicted subject-specific shape features of contact force waveforms and is a potentially powerful tool in biofeedback and clinical gait analysis.


2021 ◽  
Author(s):  
Martin Huber ◽  
Matthew Eschbach ◽  
Kazem Kazerounian ◽  
Horea T. Ilies

Abstract Knee osteoarthritis (OA) is a disease that compromises the cartilage inside the knee joint, resulting in pain and impaired mobility. Bracing is a common treatment, however currently prescribed braces cannot treat bicompartmental knee OA, fail to consider the muscle weakness that typically accompanies the disease, and utilize hinges that restrict the knee's natural biomechanics. We have developed and evaluated a brace which addresses these shortcomings. This process has respected three principal design goals: reducing the load experienced across the entire knee joint, generating a supportive moment to aid the muscles in shock absorption, and interfering minimally with gait kinematics. Load reduction is achieved via the compression of medial and lateral leaf springs, and magnetorheological dampers provide the supportive moment during knee loading. A novel, personalized joint mechanism replaces a traditional hinge to reduce interference with knee kinematics. Using motion capture gait analysis, we evaluated the basic functionality of a prototype device. We calculated, via inverse dynamics analysis, the reaction forces at the knee joint and the moments generated by the leg muscles during gait. Comparing these values between braced and unbraced trials allowed us to evaluate the system's effectiveness. Kinematic measurements showed the extent to which the brace interfered with natural gait characteristics. Of the three design goals: a reduction in knee contact forces was demonstrated; increased shock absorption was observed, but not to statistical significance; and natural gait was largely preserved. The techniques presented in this paper could lead to improved OA treatment through patient-specific braces.


Author(s):  
Yinghu Peng ◽  
Duo Wai-Chi Wong ◽  
Yan Wang ◽  
Tony Lin-Wei Chen ◽  
Qitao Tan ◽  
...  

Flatfoot is linked to secondary lower limb joint problems, such as patellofemoral pain. This study aimed to investigate the influence of medial posting insoles on the joint mechanics of the lower extremity in adults with flatfoot. Gait analysis was performed on fifteen young adults with flatfoot under two conditions: walking with shoes and foot orthoses (WSFO), and walking with shoes (WS) in random order. The data collected by a vicon system were used to drive the musculoskeletal model to estimate the hip, patellofemoral, ankle, medial and lateral tibiofemoral joint contact forces. The joint contact forces in WSFO and WS conditions were compared. Compared to the WS group, the second peak patellofemoral contact force (p < 0.05) and the peak ankle contact force (p < 0.05) were significantly lower in the WSFO group by 10.2% and 6.8%, respectively. The foot orthosis significantly reduced the peak ankle eversion angle (p < 0.05) and ankle eversion moment (p < 0.05); however, the peak knee adduction moment increased (p < 0.05). The reduction in the patellofemoral joint force and ankle contact force could potentially inhibit flatfoot-induced lower limb joint problems, despite a greater knee adduction moment.


2016 ◽  
Vol 25 (3) ◽  
pp. 213-218
Author(s):  
Charlie A. Hicks-Little ◽  
Richard D. Peindl ◽  
Tricia J. Hubbard-Turner ◽  
Mitchell L. Cordova

Context:Knee osteoarthritis (OA) is a debilitating disease that affects an estimated 27 million Americans. Changes in lowerextremity alignment and joint laxity have been found to redistribute the medial and/or lateral loads at the joint. However, the effect that changes in anteroposterior knee-joint laxity have on lower-extremity alignment and function in individuals with knee OA remains unclear.Objective:To examine anteroposterior knee-joint laxity, lower-extremity alignment, and subjective pain, stiffness, and function scores in individuals with early-stage knee OA and matched controls and to determine if a relationship exists among these measures.Design:Case control.Setting:Sports-medicine research laboratory.Participants:18 participants with knee OA and 18 healthy matched controls.Intervention:Participants completed the Western Ontario McMaster (WOMAC) osteoarthritis questionnaire and were tested for total anteroposterior knee-joint laxity (A-P) and knee-joint alignment (ALIGN).Main Outcome Measures:WOMAC scores, A-P (mm), and ALIGN (°).Results:A significant multivariate main effect for group (Wilks’ Λ = 0.30, F7,26 = 8.58, P < .0001) was found. Knee-OA participants differed in WOMAC scores (P < .0001) but did not differ from healthy controls on ALIGN (P = .49) or total A-P (P = .66). No significant relationships were identified among main outcome measures.Conclusion:These data demonstrate that participants with early-stage knee OA had worse pain, stiffness, and functional outcome scores than the matched controls; however, ALIGN and A-P were no different. There was no association identified among participants’ subjective scores, ALIGN, or A-P measures in this study.


Author(s):  
Jana Holder ◽  
Ursula Trinler ◽  
Andrea Meurer ◽  
Felix Stief

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.


Author(s):  
Benjamin J. Fregly ◽  
Yi-Chung Lin ◽  
Jonathan P. Walter ◽  
Marcus G. Pandy ◽  
Scott A. Banks ◽  
...  

Musculoskeletal computer models capable of predicting muscle and joint contact forces accurately during human movement could facilitate the design of improved joint replacements and new clinical treatments for articular cartilage defects or movement-related disorders [1]. A primary challenge to developing such predictions is the non-uniqueness of the calculated muscle forces, often referred to as the “muscle redundancy problem” [2]. Since more muscles act on the skeleton than the number of degrees of freedom in the skeleton, an infinite number of possible muscle force solutions exist.


Author(s):  
Hannah J. Lundberg ◽  
Markus A. Wimmer

Detailed knowledge of in vivo knee contact forces and the contribution from muscles, ligaments, and other soft-tissues to knee joint function are essential for evaluating total knee replacement (TKR) designs. We have recently developed a mathematical model for calculating knee joint contact forces using parametric methodology (Lundberg et al., 2009). The numerical model calculates a “solution space” of three-dimensional contact forces for both the medial and lateral compartments of the tibial plateau. The solution spaces are physiologically meaningful, and represent the result of balancing the external moments and forces by different strategies.


Author(s):  
Chris A. McGibbon ◽  
Scott Brandon ◽  
Emily L. Bishop ◽  
Chris Cowper-Smith ◽  
Edmund N. Biden

Objective: Off-loader knee braces have traditionally focused on redistributing loads away from either the medial or lateral tibiofemoral (TF) compartments. In this article, we study the potential of a novel “tricompartment unloader” (TCU) knee brace intended to simultaneously unload both the patellofemoral (PF) and TF joints during knee flexion. Three different models of the TCU brace are evaluated for their potential to unload the knee joint.Methods: A sagittal plane model of the knee was used to compute PF and TF contact forces, patellar and quadriceps tendon forces, and forces in the anterior and posterior cruciate ligaments during a deep knee bend (DKB) test using motion analysis data from eight participants. Forces were computed for the observed (no brace) and simulated braced conditions. A sensitivity and validity analysis was conducted to determine the valid output range for the model, and Statistical Parameter Mapping was used to quantify the effectual region of the different TCU brace models.Results: PF and TF joint force calculations were valid between ~0 and 100 degrees of flexion. All three simulated brace models significantly (p &lt; 0.001) reduced predicted knee joint loads (by 30–50%) across all structures, at knee flexion angles &gt;~30 degrees during DKB.Conclusions: The TCU brace is predicted to reduce PF and TF knee joint contact loads during weight-bearing activity requiring knee flexion angles between 30 and 100 degrees; this effect may be clinically beneficial for pain reduction or rehabilitation from common knee injuries or joint disorders. Future work is needed to assess the range of possible clinical and prophylactic benefits of the TCU brace.


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