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

Jana Holder,Felix Stief,Andrea Meurer,Ursula Trinler

doi:10.3389/fbioe.2020.603907

Abstract

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.

Highlights

Hip and knee joint osteoarthritis (OA) is a common disease investigated by motion analysis laboratories
Of the 14 studies that investigated the relationship at the knee joint, three studies assessed patients according to total knee replacement (TKR) with instrumented knee prosthesis (Kutzner et al, 2013; Meyer et al, 2013; Trepczynski et al, 2014)
It can be summarized that the first peak or total maximal value of medial knee joint contact force (mKCF) were best predicted by knee adduction moment (KAM) alone and in combination with knee flexion moment (KFM)

Summary

Introduction

Hip and knee joint osteoarthritis (OA) is a common disease investigated by motion analysis laboratories. External joint moments are calculated using external forces (ground reaction forces) which are applied to the body, the kinematics of the joints, the distance from the force vector to the mass center and moments of inertia about the mass center. These parameters are the input variables for the equations of motion which define the underlying model (Pandy and Berme, 1988) (Figure 1). In patients with valgus malalignment of the lower limb, the loading around the knee joint center is important to know, but separately for the medial and lateral compartments. ID is still the most frequently used approach for evaluating the joint loading in clinical gait analysis

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Discussion

Conclusion