Do counteracting external frontal plane moments alter the intraarticular contact force distribution in the loaded human tibiofemoral joint?

Engel, Karsten; Brüggemann, Gert Peter; Heinrich, Kai; Potthast, Wolfgang; Liebau, Christian

doi:10.1016/j.knee.2014.12.003

Cited by 9 publications

(5 citation statements)

References 23 publications

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“…The foot progression angle, lateral trunk tilt, knee flexion angle, and walking speed may also affect knee adduction moment. Increased lateral trunk tilt and out-toeing gait may decrease the knee adduction moment, whereas bigger knee flexion angle and higher walking speed have been reported as factors that may increase the knee adduction moment [18, 20, 21]. In addition, the strength of extensor and flexor muscles of the knee and the knee joint laxity affect the adduction moment [22–24].…”

Section: Discussionmentioning

confidence: 99%

Change in adduction moment following medial open wedge high tibial osteotomy: a meta-analysis

Kim

Çelik

et al. 2019

BMC Musculoskelet Disord

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Background This meta-analysis was designed to quantify adduction moment loss, to evaluate the relationship between changes in mechanical axis alignment and adduction moment, and to assess whether sagittal plane moment is altered after medial open wedge high tibial osteotomy (HTO). Methods Following preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines, all studies reporting preoperative and postoperative peak knee adduction moment or change in peak knee adduction moment from before to after surgery in patients who underwent medial open wedge HTO were included. Results Nine studies were included in the meta-analysis. The pooled mean difference in adduction moment from before to after medial open wedge HTO was 1.44% Nm/body weight (BW)xheight (HT) (95% confidence interval [CI]: 1.33 to 1.55% Nm/BWxHT; P < 0.001; I 2 = 4%). However, flexion (0.18% Nm/BWxHT, 95% CI: -0.50 to 0.86% Nm/BWxHT; P = 0.61; I 2 = 79%) and extension (0.15% Nm/BWxHT, 95% CI, − 0.37 to 0.68% Nm/BWxHT; P = 0.56; I 2 = 46%) moments did not differ significantly from before to after surgery. Alignment correction amount and postoperative final valgus alignment were not significantly associated with difference in adduction moment from before to after surgery. Conclusion Knee adduction moment after medial open wedge HTO decreased to 60% of the preoperative level. However, this adduction moment decrement was not affected by the magnitude of alignment correction. In addition, there was no change in sagittal plane knee moment, including flexion and extension moments, from before to after medial open wedge HTO. Level of Evidence: Meta-analysis (Level II).

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Section: Discussionmentioning

confidence: 99%

Change in adduction moment following medial open wedge high tibial osteotomy: a meta-analysis

Kim

Çelik

et al. 2019

BMC Musculoskelet Disord

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“…Out-toeing gait could decrease knee adduction moment,[ 39 ]whereas increased knee flexion angle and higher walking speed have been reported to increase knee adduction moment. [ 9 , 30 , 40 ] However, none of our patients had flexion contractures of the knee joint and their walking speeds (approximately 1 m/s) during gait analysis did not differ markedly from those in previous studies. [ 28 , 41 ] This study only included patients with preoperative high tibial osteotomy, medial knee osteoarthritis and concomitant varus deformity.…”

Section: Discussionmentioning

confidence: 59%

Correlation between Quadriceps Endurance and Adduction Moment in Medial Knee Osteoarthritis

Lee

Ahn

et al. 2015

PLoS ONE

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It is not clear whether the strength or endurance of thigh muscles (quadriceps and hamstring) is positively or negatively correlated with the adduction moment of osteoarthritic knees. This study therefore assessed the relationships between the strength and endurance of the quadriceps and hamstring muscles and adduction moment in osteoarthritic knees and evaluated predictors of the adduction moment. The study cohort comprised 35 patients with unilateral medial osteoarthritis and varus deformity who were candidates for open wedge osteotomy. The maximal torque (60°/sec) and total work (180°/sec) of the quadriceps and hamstring muscles and knee adduction moment were evaluated using an isokinetic testing device and gait analysis system. The total work of the quadriceps (r = 0.429, P = 0.037) and hamstring (r = 0.426, P = 0.045) muscles at 180°/sec each correlated with knee adduction moment. Preoperative varus deformity was positively correlated with adduction moment (r = 0.421, P = 0.041). Multiple linear regression analysis showed that quadriceps endurance at 180°/sec was the only factor independently associated with adduction moment (β = 0.790, P = 0.032). The adduction moment of osteoarthritic knees correlated with the endurance, but not the strength, of the quadriceps muscle. However, knee adduction moment did not correlate with the strength or endurance of the hamstring muscle.

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“…20 According to the authors, these results may be useful to develop and optimize orthotic treatment for the adult OA population. However, in vivo studies have also been performed to investigate the dynamic effects of angular correction osteotomies in adult patients with valgus malalignment.…”

Section: Discussionmentioning

confidence: 99%

“…When reviewing the literature, a previous biomechanical study has shown that externally induced frontal plane moments may lead to a redistribution of forces within the knee joint in cadavers, possibly reducing the risk of subsequent osteoarthritis progres-sion in such joints. 20 According to the authors, these results may be useful to develop and optimize orthotic treatment for the adult OA population. However, in vivo studies have also been performed to investigate the dynamic effects of angular correction osteotomies in adult patients with valgus malalignment.…”

Section: Discussionmentioning

confidence: 99%

Rotational gait patterns in children and adolescents following tension band plating of idiopathic genua valga

Farr

Kranzl

Hahne³

et al. 2016

J. Orthop. Res.

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Literature suggests that children and adolescents with idiopathic genua valga present with considerable gait deviations in frontal and transverse planes, including altered frontal knee moments, reduced external knee rotation, and increased external hip rotation. This study aimed to evaluate gait parameters in these patients after surgical correction using tension band plating (TBP). We prospectively evaluated 24 consecutive, skeletally immature patients, who received full-length standing radiographs and three-dimensional gait analysis before and after correction, and compared the results observed to a group of 11 typically developing peers. Prior to TBP the cohort showed significantly decreased (worse) internal frontal knee moments compared to the control group. After axis correction the mean and maximum knee moments changed significantly into normalized knee moments (p < 0.0001). In the transverse plane, only the foot progression angle (p = 0.020) changed significantly following intervention. Post-correction knee moments were similar to controls (p = 0.175), but the patient cohort exhibited a significantly decreased knee external rotation (p = 0.004) and increased external hip rotation (p < 0.001) during gait. In addition, the effect of transverse plane changes on knee moments in patients with restored, straight limb axis was calculated. Hence, patients with restored alignment but persistence of decreased external knee rotation demonstrated significantly greater knee moments than those without rotational abnormalities (p = 0.001). This study found that frontal knee moments during gait normalized in children with idiopathic genua valga after surgery. However, decreased external knee rotation and increased external hip rotation during gait persisted in the study cohort. Despite radiological correction, decreased external rotation during gait was associated with increases in medial knee loading. Surgical correction for children with genua valga but normal knee moments may be detrimental, due to redistribution of dynamic knee loading into the opposite joint compartment. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1617-1624, 2017.

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Do counteracting external frontal plane moments alter the intraarticular contact force distribution in the loaded human tibiofemoral joint?

Cited by 9 publications

References 23 publications

Change in adduction moment following medial open wedge high tibial osteotomy: a meta-analysis

Change in adduction moment following medial open wedge high tibial osteotomy: a meta-analysis

Correlation between Quadriceps Endurance and Adduction Moment in Medial Knee Osteoarthritis

Rotational gait patterns in children and adolescents following tension band plating of idiopathic genua valga

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