Knee Joint Loads and Surrounding Muscle Forces during Stair Ascent in Patients with Total Knee Replacement

Rasnick, Robert; Standifird, Tyler; Reinbolt, Jeffrey A.; Cates, Harold E.; Zhang, Songning

doi:10.1371/journal.pone.0156282

Cited by 18 publications

(12 citation statements)

References 46 publications

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“…Kutzner et al [42] measured knee joint contact forces during various daily living activities and found that resultant forces lay typically in the range of 220% and 350% of the participant’s bodyweight. Similar values have also been reported in other in-vivo studies using instrumented implants [43,44,45]. The present study estimated approximately 2 bodyweights during sit to stand, which had the lowest contact forces of the tasks estimated; while approximately 4 bodyweights were measured during stair descent, which had the highest contact forces of the tasks estimated.…”

Section: Discussionsupporting

confidence: 90%

Estimation of the Knee Adduction Moment and Joint Contact Force during Daily Living Activities Using Inertial Motion Capture

Konrath

Karatsidis

Schepers

et al. 2019

Sensors

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Knee osteoarthritis is a major cause of pain and disability in the elderly population with many daily living activities being difficult to perform as a result of this disease. The present study aimed to estimate the knee adduction moment and tibiofemoral joint contact force during daily living activities using a musculoskeletal model with inertial motion capture derived kinematics in an elderly population. Eight elderly participants were instrumented with 17 inertial measurement units, as well as 53 opto-reflective markers affixed to anatomical landmarks. Participants performed stair ascent, stair descent, and sit-to-stand movements while both motion capture methods were synchronously recorded. A musculoskeletal model containing 39 degrees-of-freedom was used to estimate the knee adduction moment and tibiofemoral joint contact force. Strong to excellent Pearson correlation coefficients were found for the IMC-derived kinematics across the daily living tasks with root mean square errors (RMSE) between 3° and 7°. Furthermore, moderate to strong Pearson correlation coefficients were found in the knee adduction moment and tibiofemoral joint contact forces with RMSE between 0.006–0.014 body weight × body height and 0.4 to 1 body weights, respectively. These findings demonstrate that inertial motion capture may be used to estimate knee adduction moments and tibiofemoral contact forces with comparable accuracy to optical motion capture.

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Section: Discussionsupporting

confidence: 90%

Estimation of the Knee Adduction Moment and Joint Contact Force during Daily Living Activities Using Inertial Motion Capture

Konrath

Karatsidis

Schepers

et al. 2019

Sensors

View full text Add to dashboard Cite

show abstract

“…Lastly, while GRFs are a convenient variable to estimate the loading and moments experienced by the leg, 18 the true indicator of knee joint loading would be the internal joint reaction forces (which can be calculated through musculoskeletal modeling). 20 Although GRFs are correlated with modeling-based knee joint reaction forces, 26 future studies could be more exact if they examine the internal joint reaction forces.…”

Section: Discussionmentioning

confidence: 99%

Functional Resistance Training Differentially Alters Gait Kinetics After Anterior Cruciate Ligament Reconstruction: A Pilot Study

Washabaugh

Brown

Palmieri-Smith

et al. 2022

Sports Health: A Multidisciplinary Approach

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Background: Quadriceps weakness is common after anterior cruciate ligament (ACL) reconstruction and can alter gait mechanics. Functional resistance training (FRT) is a novel approach to retraining strength after injury, but it is unclear how it alters gait mechanics. Therefore, we tested how 3 different types of FRT devices: a knee brace resisting extension (unidirectional brace), a knee brace resisting extension and flexion (bidirectional brace), and an elastic band pulling backwards on the ankle (elastic band)–acutely alter gait kinetics in this population. Hypothesis: The type of FRT device will affect ground-reaction forces (GRFs) during and after the training. Specifically, the uni- and bidirectional braces will increase GRFs when compared with the elastic band. Study Design: Crossover study. Level of Evidence: Level 2. Methods: A total of 15 individuals with ACL reconstruction received FRT with each device over 3 separate randomized sessions. During training, participants walked on a treadmill while performing a tracking task with visual feedback. Sessions contained 5 training trials (180 seconds each) with rest between. Vertical and anterior-posterior GRFs were assessed on the ACL-reconstructed leg before, during, and after training. Changes in GRFs were compared across devices using 1-dimensional statistical parametric mapping. Results: Resistance applied via bidirectional brace acutely increased gait kinetics during terminal stance/pre-swing (ie, push-off), while resistance applied via elastic band acutely increased gait kinetics during initial contact/loading (ie, braking). Both braces behaved similarly, but the unidirectional brace was less effective for increasing push-off GRFs. Conclusion: FRT after ACL reconstruction can acutely alter gait kinetics during training. Devices can be applied to selectively alter gait kinetics. However, the long-term effects of FRT after ACL reconstruction with these devices are still unknown. Clinical Relevance: FRT may be applied to alter gait kinetics of the involved limb after ACL reconstruction, depending on the device used.

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“…Recently, Rasnick et al predicted the knee joint stair ascent forces for five patients implanted with a posterior stabilized TKR [33]. Average resultant peak contact forces were 2.8 BW and 3.9 BW for the peaks in the first and second half of the stair ascent activity cycle.…”

Section: Discussionmentioning

confidence: 99%

Are Instrumented Knee Forces Representative of a Larger Population of Cruciate-Retaining Total Knee Arthroplasties?

Freed

Simon

Knowlton

et al. 2017

The Journal of Arthroplasty

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Background It is not known if the loads and motions reported for instrumented knees are generalizable to a larger population of total knee replacement (TKR) patients. The purpose of this study is to: 1) report axial implant force data for chair and stair activities for a population of cruciate-retaining TKR patients and 2) compare the population forces to those measured with instrumented TKRs. Methods Twenty-three subjects with a cruciate-retaining TKR underwent motion analysis during stair ascending, stair descending, chair sitting, and chair rising activities after informed consent in this IRB approved study. Axial TKR forces were calculated using a previously validated computational model. Differences between the mean and variability of population instrumented TKR peak forces and force impulses were tested using t-tests and Levene’s test. Results Peak axial forces were 3.06, 2.74, 2.65, and 2.60 kN for stair ascent, stair descent, chair rising, and chair sitting, respectively. Force impulses were 123.3, 123.4, 153.5, and 154.0 kN*% activity cycle for stair ascent, stair descent, chair sitting, and chair rising, respectively. Population TKR and instrumented TKR peak forces were different for stair ascent (p=0.03) and stair descent (p=0.03) in the second half of the activity cycles. The variability of the peak forces and impulses were not different (p=0.106 to p=0.99) Conclusion The forces and motions presented in this study represent cruciate-retaining TKR patients and could be used for displacement-driven knee wear testing. The forces are similar to those in the literature from instrumented prostheses of an ultra-congruent cruciate-sacrificing TKR.

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Knee Joint Loads and Surrounding Muscle Forces during Stair Ascent in Patients with Total Knee Replacement

Cited by 18 publications

References 46 publications

Estimation of the Knee Adduction Moment and Joint Contact Force during Daily Living Activities Using Inertial Motion Capture

Estimation of the Knee Adduction Moment and Joint Contact Force during Daily Living Activities Using Inertial Motion Capture

Functional Resistance Training Differentially Alters Gait Kinetics After Anterior Cruciate Ligament Reconstruction: A Pilot Study

Are Instrumented Knee Forces Representative of a Larger Population of Cruciate-Retaining Total Knee Arthroplasties?

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