Knee Joint Biomechanics in Physiological Conditions and How Pathologies Can Affect It: A Systematic Review

Zhang, Li; Liu, Geng; Han, Bing; Wang, Zhe; Yan, Yuzhou; Ma, Jianbing; Wei, Pingping

doi:10.1155/2020/7451683

Cited by 46 publications

(33 citation statements)

References 130 publications

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“…The knee joint is the main lower limb motor joint and the most vulnerable and susceptible joint. 22 The KERs can improve the leg movement ability, reduce the movement consumption, and provide power and assistance for the lower limb movement. Kamali et al 23 proposed a kind of knee exoskeleton, as shown in Figure 6.…”

Section: Resultsmentioning

confidence: 99%

Lower limb rehabilitation exoskeleton robot: A review

Zhou

Yang

Xue

2021

Advances in Mechanical Engineering

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Lower limb rehabilitation exoskeleton robots (LLRERs) play a positive role in lower limb rehabilitation and assistance for patients with lower limb disorders, and they are helpful to improve patients’ physical status. More and more experiments pay more attention to the kinematic and dynamic data characteristics of different patient groups. However, it is not clear whether these devices have broad adaptability and their clinical significance, so it is necessary to summarize and analyze these research results. This paper summarizes the LLRERs prototype and product in recent years, also compares the advantages and disadvantages of the theory and technology used in these research, and compares the functional characteristics of the devices, finally summarizes the aspects of the LLRERs to be improved. These devices apply advanced theories, techniques or structures, as well as human kinematics and dynamics data. However, due to the complexity of human body characteristics and movement rules, the theory or technology applied in the study design of LLRERs remains to be further studied, which can be improved in many aspects, such as improve the human-computer cooperation of equipment or carry out clinical trials. This paper can provide reference for researchers and designers in the future study, as well as understanding and selecting LLRERs for all kinds of therapist and patients.

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Section: Resultsmentioning

confidence: 99%

Lower limb rehabilitation exoskeleton robot: A review

Zhou

Yang

Xue

2021

Advances in Mechanical Engineering

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“…Furthermore, an anterior-posterior and lateral knee weight-bearing view, a Rosenberg and a Merchant and Lauren view were performed to achieve a better pre-operative radiographic planning [ 17 ]. Furthermore, the joint line convergence angle (JLCA) was also investigated for intra-articular deformity [ 18 ]. Radiographic measurements to reduce intra-observer variability were repeated by the expert surgeon (LS) after two weeks.…”

Section: Methodsmentioning

confidence: 99%

Kinetic Sensors for Ligament Balance and Kinematic Evaluation in Anatomic Bi-Cruciate Stabilized Total Knee Arthroplasty

Sabatini

Bosco

Barberis

et al. 2021

Sensors

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Sensor technology was introduced to intraoperatively analyse the differential pressure between the medial and lateral compartments of the knee during primary TKA using a sensor to assess if further balancing procedures are needed to achieve a “balanced” knee. The prognostic role of epidemiological and radiological parameters was also analysed. A consecutive series of 21 patients with primary knee osteoarthritis were enrolled and programmed for TKA in our unit between 1 September 2020 and 31 March 2021. The VERASENSE Knee System (OrthoSensor Inc., Dania Beach, FL, USA) has been proposed as an instrument that quantifies the differential pressure between the compartments of the knee intraoperatively throughout the full range of motion during primary TKA, designed with a J-curve anatomical femoral design and a PS “medially congruent” polyethylene insert. Thirteen patients (61.90%) showed a “balanced” knee, and eight patients (38.10%) showed an intra-operative “unbalanced” knee and required additional procedures. A total of 13 additional balancing procedures were performed. At the end of surgical knee procedures, a quantitatively balanced knee was obtained in all patients. In addition, a correlation was found between the compartment pressure of phase I and phase II at 10° of flexion and higher absolute pressures were found in the medial compartment than in the lateral compartment in each ROM degree investigated. Moreover, those pressure values showed a trend to decrease with the increase in flexion degrees in both compartments. The “Kinetic Tracking” function displays the knee’s dynamic motion through the full ROM to evaluate joint kinetics. The obtained kinetic traces reproduced the knee’s medial pivot and femoral rollback, mimicking natural knee biomechanics. Moreover, we reported a statistically significant correlation between the need for soft tissue or bone resection rebalancing and severity of the initial coronal deformity (>10°) and a preoperative JLCA value >2°. The use of quantitative sensor-guided pressure evaluation during TKA leads to a more reproducible “balanced” knee. The surgeon, evaluating radiological parameters before surgery, may anticipate difficulties in knee balance and require those devices to achieve the desired result objectively.

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“…Since the medial tibiofemoral joint has a larger contact surface, the length of the medial femoral condyle is greater than that of the lateral. Also, the limitations of cruciate-collateral ligaments and quadriceps femoris on knee motion result in the knee joint self-locking as an eccentric wheel to maintain the stability of the joint during the knee extension motion [8]. Regarding the importance of the external moment of the knee, Wu et al [20] stated that abnormal external rota-tion of the knee during the stance phase is a common cause of lateral deviation of the patella in people with gastrocsoleus complex shortness, which is a known risk factor for patellofemoral pain.…”

Section: Discussionmentioning

confidence: 99%

“…Knee impairments are common physical problems that impact the normal living ability and mental health of patients affected by them. The knee's influences mainly include supporting body weight, assisting lower limb swing, and absorbing strike shock [8].…”

Section: Introductionmentioning

confidence: 99%

Functional stretching decreases knee joint loading in male athletes with gastroc--soleus tightness

2021

JOMH

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Background and objective: Tightness of the gastroc--soleus muscle complex is one of the limiting factors of the ankle joint's range of motion (ROM) during daily activities. The aim of this study was to investigate the effectiveness of functional and extra-functional stretching of the gastrocnemius--soleus complex on knee joint loading in athletes with limited ankle dorsiﬂexion. Material and methods: In this cross-sectional study, 30 male athletes with gastrocnemius--soleus shortness were recruited and randomly divided into three equal-size groups of functional stretching, extra-functional stretching, and a control group. The extra-functional stretching group performed stretching exercises three times per day for eight weeks. The functional stretching group was instructed to change their gait pattern via increased heel strike during daily activities. Results: None of the stretching programs reduced the knee ﬂexion angle in heel contact (p > 0.05). The knee ﬂexion angle was signiﬁcantly increased in the stance phase in the functional group (p ≤ 0.05). Walking speed was increased signiﬁcantly in the extra-functional group (p ≤ 0.05). The knee adductor moment and external rotation moment decreased signiﬁcantly in the functional group (p ≤ 0.05). Conclusion: An eight-week functional stretching program in this study led to a reduction of knee loading in the frontal and horizontal planes in comparison to the extra-functional stretching group, demonstrating the effectiveness of functional stretching in improving knee joint biomechanics during walking.

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Knee Joint Biomechanics in Physiological Conditions and How Pathologies Can Affect It: A Systematic Review

Cited by 46 publications

References 130 publications

Lower limb rehabilitation exoskeleton robot: A review

Lower limb rehabilitation exoskeleton robot: A review

Kinetic Sensors for Ligament Balance and Kinematic Evaluation in Anatomic Bi-Cruciate Stabilized Total Knee Arthroplasty

Functional stretching decreases knee joint loading in male athletes with gastroc--soleus tightness

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