Biomechanical Characteristics of the Knee Joint during Gait in Obese versus Normal Subjects

Abstract

Knee osteoarthritis (OA) is a growing source of pain and disability. Obesity is the most important avoidable risk factor underlying knee OA. The processes by which obesity impacts osteoarthritis are of tremendous interest to osteoarthritis researchers and physicians, where the joint mechanical load is one of the pathways generally thought to cause or intensify the disease process. In the current work, we developed a hybrid framework that simultaneously incorporates a detailed finite element model of the knee joint within a musculoskeletal model to compute lower extremity muscle forces and knee joint stresses in normal-weight (N) and obese (OB) subjects during the stance phase gait. This model accounts for the synergy between the active musculature and passive structures. In comparing OB subjects and normal ones, forces significantly increased in all muscle groups at most instances of stance. Mainly, much higher activation was computed with lateral hamstrings and medial gastrocnemius. Cartilage contact average pressure was mostly supported by the medial plateau and increased by 22%, with a larger portion of the load transmitted via menisci. This medial compartment experienced larger relative movement and cartilage stresses in the normal subjects and continued to do so with a higher level in the obese subjects. Finally, the developed bioengineering frame and the examined parameters during this investigation might be useful clinically in evaluating the initiation and propagation of knee OA.

Knee joint biomechanics and cartilage damage prediction during landing: A hybrid MD-FE-musculoskeletal modeling

“…The geometry of the tibiofemoral joint was adjusted to align with the dimension reported in the Simtk.org open knee public domain repository [11]. In the model, bones were represented as rigid bodies [19][20][21][22][23] utilizing shell elements (S4R), whereas articular cartilages, ligaments, and menisci were depicted through reduced integration brick elements (C3D8R), as shown in Fig 1 . Details of the knee model were presented in the S1 File and our prior works [24][25][26][27].…”

Model Properties and Clinical Application in the Finite Element Analysis of Knee Joint: A Review

“…95 Fadi et al developed a musculoskeletal model to study lower limb muscle strength and knee joint stress in average-weight and obese people, finding that obese people had significantly greater muscle strength, greater relative motion of the medial compartment in the knee, and relatively more significant cartilage stress. 96 Arjmand et al proposed an FEM to accurately quantify the changes in mechanical parameters in normal populations and patients with OA, 97 finding that the bone stress in the proximal tibia was higher in patients with OA, which might be necessary for understanding the pathogenesis of knee OA. 97 Peter et al explored the influence of the morphology of the distal femoral epiphysis surface on the epiphysis biomechanics through finite element modeling and found that a complex-shaped articular surface could reduce the stress on the epiphysis during knee flexion.…”

“…Fadi et al . developed a musculoskeletal model to study lower limb muscle strength and knee joint stress in average‐weight and obese people, finding that obese people had significantly greater muscle strength, greater relative motion of the medial compartment in the knee, and relatively more significant cartilage stress 96 …”

Current evidence for non‐pharmaceutical, non‐surgical treatments of canine osteoarthritis

“…Obesity is also a risk factor for canine OA, with a recent systematic review for canine OA risk factors concluding that overweight dogs were significantly more likely to develop stifle OA secondary to cranial cruciate ligament disease (Anderson et al 2020). Obesity leads to increased compressive forces on load-bearing joints and alters joint kinematics during gait (Brady et al 2013, Al Khatib et al 2022. A biochemical as well as biomechanical link between obesity and OA is likely, as adipose tissue is a metabolically active endocrine organ synthesising and secreting hormones such as adipokines (Coelho et al 2013).…”

“…2013, Al Khatib et al . 2022). A biochemical as well as biomechanical link between obesity and OA is likely, as adipose tissue is a metabolically active endocrine organ synthesising and secreting hormones such as adipokines (Coelho et al .…”