Impact of antagonistic muscle co-contraction on in vivo knee contact forces

Abstract

BackgroundThe onset and progression of osteoarthritis, but also the wear and loosening of the components of an artificial joint, are commonly associated with mechanical overloading of the structures. Knowledge of the mechanical forces acting at the joints, together with an understanding of the key factors that can alter them, are critical to develop effective treatments for restoring joint function. While static anatomy is usually the clinical focus, less is known about the impact of dynamic factors, such as individual muscle recruitment, on joint contact forces.MethodsIn this study, instrumented knee implants provided accurate in vivo tibio-femoral contact forces in a unique cohort of 9 patients, which were used as input for subject specific musculoskeletal models, to quantify the individual muscle forces during walking and stair negotiation.ResultsEven between patients with a very similar self-selected gait speed, the total tibio-femoral peak forces varied 1.7-fold, but had only weak correlation with static alignment (varus/valgus). In some patients, muscle co-contraction of quadriceps and gastrocnemii during walking added up to 1 bodyweight (~ 50%) to the peak tibio-femoral contact force during late stance. The greatest impact of co-contraction was observed in the late stance phase of stair ascent, with an increase of the peak tibio-femoral contact force by up to 1.7 bodyweight (66%).ConclusionsTreatment of diseased and failed joints should therefore not only be restricted to anatomical reconstruction of static limb axes alignment. The dynamic activation of muscles, as a key modifier of lower limb biomechanics, should also be taken into account and thus also represents a promising target for restoring function, patient mobility, and preventing future joint failure.Trial registrationGerman Clinical Trials Register: ID: DRKS00000606, date: 05.11.2010.Electronic supplementary materialThe online version of this article (10.1186/s12984-018-0434-3) contains supplementary material, which is available to authorized users.

The Capacity of Generic Musculoskeletal Simulations to Predict Knee Joint Loading Using the CAMS-Knee Datasets

“…However, while standard motion analysis measurements and rigid body mechanics can directly determine inter-segmental joint loads and moments, distribution of these loads to muscles, ligaments, and articular contact surfaces remains complicated by the inherent redundancy within the musculoskeletal system, 11 particularily with regards to muscle co-contraction. 44 Thus, in vivo validation remains a major obstacle in widespread acceptance of model predictions of knee loading and hence limits clinical translation of the technology.…”

Knee Load Distribution in Hip Osteoarthritis Patients After Total Hip Replacement

“…When muscle forces are not included in the calculation of joint load, this may lead to an underestimation of the actual load in the joint (Lloyd and Buchanan, 2001). Several studies already showed a contribution of muscular cocontraction to higher joint CF (Trepczynski et al, 2018;Hoang et al, 2019). Wesseling et al (2018) reported that 12 months after THR surgery the total CF on the ipsilateral knee were still lower compared to healthy controls.…”

How Well Do Commonly Used Co-Contraction Indices Approximate Lower Limb Joint Stiffness Trends during Gait?

“…However, the more representative method to quantify muscle co-contraction is through estimating individual muscle forces (Kellis et al, 2003), which may require advanced capabilities in neuromusculoskeletal modeling and simulation. Simulation-based studies can estimate muscle forces and compute CCI with either muscle forces (Trepczynski et al, 2018) or the joint moments generated by individual muscles (Souissi et al, 2018). Since CCI is commonly used by the clinical community, it can be used to investigate the relationship between muscle co-contraction and joint stiffness during gait.…”