Impact of the external knee flexion moment on patello-femoral loading derived from in vivo loads and kinematics
IntroductionAnterior knee pain and other patello-femoral (PF) complications frequently limit the success of total knee arthroplasty as the final treatment of end stage osteoarthritis. However, knowledge about the in-vivo loading conditions at the PF joint remains limited, as no direct measurements a...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Bioengineering and Biotechnology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fbioe.2024.1473951/full |
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| author | Adam Trepczynski Paul Kneifel Mark Heyland Marko Leskovar Philippe Moewis Philipp Damm William R. Taylor Stefan Zachow Georg N. Duda |
| author_facet | Adam Trepczynski Paul Kneifel Mark Heyland Marko Leskovar Philippe Moewis Philipp Damm William R. Taylor Stefan Zachow Georg N. Duda |
| author_sort | Adam Trepczynski |
| collection | DOAJ |
| description | IntroductionAnterior knee pain and other patello-femoral (PF) complications frequently limit the success of total knee arthroplasty as the final treatment of end stage osteoarthritis. However, knowledge about the in-vivo loading conditions at the PF joint remains limited, as no direct measurements are available. We hypothesised that the external knee flexion moment (EFM) is highly predictive of the PF contact forces during activities with substantial flexion of the loaded knee.Materials and methodsSix patients (65–80 years, 67–101 kg) with total knee arthroplasty (TKA) performed two activities of daily living: sit-stand-sit and squat. Tibio-femoral (TF) contact forces were measured in vivo using instrumented tibial components, while synchronously internal TF and PF kinematics were captured with mobile fluoroscopy. The measurements were used to compute PF contact forces using patient specific musculoskeletal models. The relationship between the EFM and the PF contact force was quantified using linear regression.ResultsMean peak TF contact forces of 1.97–3.24 times body weight (BW) were found while peak PF forces reached 1.75 to 3.29 times body weight (BW). The peak EFM ranged from 3.2 to 5.9 %BW times body height, and was a good predictor of the PF contact force (R2 = 0.95 and 0.88 for sit-stand-sit and squat, respectively).DiscussionThe novel combination of in vivo TF contact forces and internal patellar kinematics enabled a reliable assessment of PF contact forces. The results of the regression analysis suggest that PF forces can be estimated based solely on the EFM from quantitative gait analysis. Our study also demonstrates the relevance of PF contact forces, which reach magnitudes similar to TF forces during activities of daily living. |
| format | Article |
| id | doaj-art-f1bf15408a8040a4837da17c3eb745d2 |
| institution | Kabale University |
| issn | 2296-4185 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Bioengineering and Biotechnology |
| spelling | doaj-art-f1bf15408a8040a4837da17c3eb745d22025-01-15T06:10:35ZengFrontiers Media S.A.Frontiers in Bioengineering and Biotechnology2296-41852025-01-011210.3389/fbioe.2024.14739511473951Impact of the external knee flexion moment on patello-femoral loading derived from in vivo loads and kinematicsAdam Trepczynski0Paul Kneifel1Mark Heyland2Marko Leskovar3Philippe Moewis4Philipp Damm5William R. Taylor6Stefan Zachow7Georg N. Duda8Julius Wolff Institute, Berlin Institute of Health at Charité – Universitätsmedizin Berlin, Berlin, GermanyJulius Wolff Institute, Berlin Institute of Health at Charité – Universitätsmedizin Berlin, Berlin, GermanyJulius Wolff Institute, Berlin Institute of Health at Charité – Universitätsmedizin Berlin, Berlin, GermanyVisual and Data-Centric Computing, Zuse Institute Berlin, Berlin, GermanyJulius Wolff Institute, Berlin Institute of Health at Charité – Universitätsmedizin Berlin, Berlin, GermanyJulius Wolff Institute, Berlin Institute of Health at Charité – Universitätsmedizin Berlin, Berlin, GermanyLaboratory for Movement Biomechanics, ETH Zurich, Zürich, SwitzerlandVisual and Data-Centric Computing, Zuse Institute Berlin, Berlin, GermanyJulius Wolff Institute, Berlin Institute of Health at Charité – Universitätsmedizin Berlin, Berlin, GermanyIntroductionAnterior knee pain and other patello-femoral (PF) complications frequently limit the success of total knee arthroplasty as the final treatment of end stage osteoarthritis. However, knowledge about the in-vivo loading conditions at the PF joint remains limited, as no direct measurements are available. We hypothesised that the external knee flexion moment (EFM) is highly predictive of the PF contact forces during activities with substantial flexion of the loaded knee.Materials and methodsSix patients (65–80 years, 67–101 kg) with total knee arthroplasty (TKA) performed two activities of daily living: sit-stand-sit and squat. Tibio-femoral (TF) contact forces were measured in vivo using instrumented tibial components, while synchronously internal TF and PF kinematics were captured with mobile fluoroscopy. The measurements were used to compute PF contact forces using patient specific musculoskeletal models. The relationship between the EFM and the PF contact force was quantified using linear regression.ResultsMean peak TF contact forces of 1.97–3.24 times body weight (BW) were found while peak PF forces reached 1.75 to 3.29 times body weight (BW). The peak EFM ranged from 3.2 to 5.9 %BW times body height, and was a good predictor of the PF contact force (R2 = 0.95 and 0.88 for sit-stand-sit and squat, respectively).DiscussionThe novel combination of in vivo TF contact forces and internal patellar kinematics enabled a reliable assessment of PF contact forces. The results of the regression analysis suggest that PF forces can be estimated based solely on the EFM from quantitative gait analysis. Our study also demonstrates the relevance of PF contact forces, which reach magnitudes similar to TF forces during activities of daily living.https://www.frontiersin.org/articles/10.3389/fbioe.2024.1473951/fullpatello-femoral forceexternal knee flexion momentin vivo loading by telemetryknee kinematics by mobile fluoroscopymusculoskeletal modelling |
| spellingShingle | Adam Trepczynski Paul Kneifel Mark Heyland Marko Leskovar Philippe Moewis Philipp Damm William R. Taylor Stefan Zachow Georg N. Duda Impact of the external knee flexion moment on patello-femoral loading derived from in vivo loads and kinematics Frontiers in Bioengineering and Biotechnology patello-femoral force external knee flexion moment in vivo loading by telemetry knee kinematics by mobile fluoroscopy musculoskeletal modelling |
| title | Impact of the external knee flexion moment on patello-femoral loading derived from in vivo loads and kinematics |
| title_full | Impact of the external knee flexion moment on patello-femoral loading derived from in vivo loads and kinematics |
| title_fullStr | Impact of the external knee flexion moment on patello-femoral loading derived from in vivo loads and kinematics |
| title_full_unstemmed | Impact of the external knee flexion moment on patello-femoral loading derived from in vivo loads and kinematics |
| title_short | Impact of the external knee flexion moment on patello-femoral loading derived from in vivo loads and kinematics |
| title_sort | impact of the external knee flexion moment on patello femoral loading derived from in vivo loads and kinematics |
| topic | patello-femoral force external knee flexion moment in vivo loading by telemetry knee kinematics by mobile fluoroscopy musculoskeletal modelling |
| url | https://www.frontiersin.org/articles/10.3389/fbioe.2024.1473951/full |
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