On the biomechanical relationship between applied hip, knee and ankle joint moments and the internal knee compressive forces

Jonas Stensgaard Stoltze,John Rasmussen,Michael Skipper Andersen

doi:10.1080/23335432.2018.1499442

Jonas Stensgaard Stoltze, John Rasmussen + Show 1 more

Open Access

https://doi.org/10.1080/23335432.2018.1499442

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Journal: International Biomechanics	Publication Date: Jan 1, 2018
Citations: 18	License type: open-access

Affiliation: Aalborg University

Abstract

ABSTRACT Mechanical devices are common treating methods for knee osteoarthritis. It has the purpose of reducing the internal joint forces and unloading the damaged structure. The reduction is often achieved by alterations in the frontal plan, shifting the contact force from one compartment to the other, leaving the total compressive force unchanged. The aim of this study was to investigate how internal knee joint forces depend on applied external moments during gait. Musculoskeletal models of the gait of 10 healthy subjects were developed in the AnyBody Modelling System and used to simulate applied joint moments about different axes (load cases), each with the magnitude to compensate the net moment about the respective axis by a specified percentage. For each load case, the total, medial and lateral knee compressive force were computed and compared with a baseline case with no external moments applied. Among the investigated moments, hip flexion-extension, knee flexion-extension and ankle plantarflexion-dorsiflexion moment compensations have the most positive impact on the total knee joint compressive force, and combining the 3, each with a 40% compensation of the muscle moments, reduced the first peak by 23.6%, the second by 30.6% and the impulse by 28.6% with respect to no applied moments.

Highlights

Osteoarthritis (OA) is a chronic, progressive, longterm and multifactorial joint disease with obesity, joint malalignment and joint laxity as some of the risk factors
This study deals with non-surgical treatment and focuses on the mechanical devices available for the lower extremity to reduce internal knee joint forces, since the knee is the most widely affected joint (Felson and Zhang 1998)
A parameter study was conducted in order to investigate how the reduction of internal knee joint force depends on the amount of the externally applied moment

Summary

Introduction

Osteoarthritis (OA) is a chronic, progressive, longterm and multifactorial joint disease with obesity, joint malalignment and joint laxity as some of the risk factors. The illness causes pain, stiffness and joint malalignment due to soft tissue deterioration in the affected joint (Amin et al 2005), which limits mobility during activities of daily living and reduces quality-oflife (Silverwood et al 2015). Several intervention methods have been developed with the aim of reducing pain, increasing mobility and slowing down the progression of OA. These include physical therapy (Fitzgerald et al 2016), shoe insoles (Skou et al 2013), knee braces (Brooks 2014), ankle-foot orthoses (AFO) (Fantini Pagani et al 2013) and surgery (Gardiner et al 2016). This study deals with non-surgical treatment and focuses on the mechanical devices available for the lower extremity to reduce internal knee joint forces, since the knee is the most widely affected joint (Felson and Zhang 1998)

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