Intra-Articular Knee Contact Force Estimation During Walking Using Force-Reaction Elements and Subject-Specific Joint Model2

Abstract

Joint contact forces measured with instrumented knee implants have not only revealed general patterns of joint loading but also showed individual variations that could be due to differences in anatomy and joint kinematics. Musculoskeletal human models for dynamic simulation have been utilized to understand body kinetics including joint moments, muscle tension, and knee contact forces. The objectives of this study were to develop a knee contact model which can predict knee contact forces using an inverse dynamics-based optimization solver and to investigate the effect of joint constraints on knee contact force prediction. A knee contact model was developed to include 32 reaction force elements on the surface of a tibial insert of a total knee replacement (TKR), which was embedded in a full-body musculoskeletal model. Various external measurements including motion data and external force data during walking trials of a subject with an instrumented knee implant were provided from the Sixth Grand Challenge Competition to Predict in vivo Knee Loads. Knee contact forces in the medial and lateral portions of the instrumented knee implant were also provided for the same walking trials. A knee contact model with a hinge joint and normal alignment could predict knee contact forces with root mean square errors (RMSEs) of 165 N and 288 N for the medial and lateral portions of the knee, respectively, and coefficients of determination (R2) of 0.70 and -0.63. When the degrees-of-freedom (DOF) of the knee and locations of leg markers were adjusted to account for the valgus lower-limb alignment of the subject, RMSE values improved to 144 N and 179 N, and R2 values improved to 0.77 and 0.37, respectively. The proposed knee contact model with subject-specific joint model could predict in vivo knee contact forces with reasonable accuracy. This model may contribute to the development and improvement of knee arthroplasty.

Alterations of musculoskeletal models for a more accurate estimation of lower limb joint contact forces during normal gait: A systematic review

“…Musculoskeletal modelling is a computational methodology used to investigate musculotendon forces and joint contact forces during a movement, which cannot be easily measured (Chèze et al, 2015;Erdemir et al, 2007;Pandy and Andriacchi, 2010). In particular, recent literature has demonstrated that a high accuracy in the estimation of the hip or tibiofemoral joint contact forces can be obtained, but induced the use of an extensive personalisation of the model parameters (Ding et al, 2016;Gerus et al, 2013;Jung et al, 2016;Kia et al, 2014;Marra et al, 2014). However, the construction of subject-specific models remains a time consuming procedure that requires not always available data, such as medical imaging.…”

Three-Dimensional Kinematic Coupling of the Healthy Knee During Treadmill Walking

“…However, it is difficult to quantify knee laxity and joint contact loads unless a force sensor is implanted in the human joint. Prior studies estimated joint kinetics from external forces and joint kinematics through musculoskeletal simulation [5,6], wherein accurate joint kinematics play important roles. A knee model with a one degree-of-freedom hinge joint that ignores secondary knee kinematics decreases the accuracy of estimated ligament and cartilage loading patterns in musculoskeletal simulation [5,7].…”

“…Prior studies estimated joint kinetics from external forces and joint kinematics through musculoskeletal simulation [5,6], wherein accurate joint kinematics play important roles. A knee model with a one degree-of-freedom hinge joint that ignores secondary knee kinematics decreases the accuracy of estimated ligament and cartilage loading patterns in musculoskeletal simulation [5,7]. Also, the moment arms of leg muscles, which determine joint kinetics results in musculoskeletal simulations, are sensitive to secondary knee kinematics for a musculoskeletal model simulation [8].…”

Anthropometric shape parameters in obese subjects

“…More model manipulation and data collection is necessary in the future to generate better and more reliable results. Figure 45: Comparison of knee contact forces to previous experimental study [92].…”

“…The graph on the right (BMI: 24) is from a previous study involving the use of AnyBody to calculate knee contact force after TKA, but was conducted in a cadaveric specimen. [92]. The fact that there was new geometry and a new alignment to the joint following TKA will likely play a bit of a role in changing the knee contact force, especially if the knee was aligned for mechanical or for kinematic purposes [93].…”