Patellofemoral Stresses during Open and Closed Kinetic Chain Exercises

Cohen, Zohara A.; Roglic, Hrvoje; Grelsamer, Ronald P.; Henry, Jack; Levine, William N.; Mow, Van C.; Ateshian, Gerard A.

doi:10.1177/03635465010290041701

Cited by 114 publications

(82 citation statements)

References 39 publications

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“…It is for these reasons that the loads applied in the finite element analyses of this study (~150 N) remain sub-physiologic in order to maintain the peak strain magnitudes below 0.2 (Table 4), with contact stresses in the range 0.25-0.29 MPa. In contrast, physiologic contact forces in closed kinematic chain activities of the patellofemoral joint can be as high as 4,000 N [53], with contact stresses as high as 8 MPa.…”

Section: Discussionmentioning

confidence: 93%

Inhomogeneous Cartilage Properties Enhance Superficial Interstitial Fluid Support and Frictional Properties, But Do Not Provide a Homogeneous State of Stress

Krishnan

Park

Eckstein

et al. 2003

Journal of Biomechanical Engineering

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115

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It has been well established that articular cartilage is compositionally and mechanically inhomogeneous through its depth. To what extent this structural inhomogeneity is a prerequisite for appropriate cartilage function and integrity, is not well understood. The first hypothesis to be tested in this study was that the depth-dependent inhomogeneity of the cartilage acts to maximize the interstitial fluid load support at the articular surface, to provide efficient frictional and wear properties. The second hypothesis was that the inhomogeneity produces a more homogeneous state of elastic stress in the matrix than would be achieved with uniform properties. We have, for the first time, simultaneously determined depth-dependent tensile and compressive properties of human patellofemoral cartilage from unconfined compression stress-relaxation tests. The experimental measurements were then implemented with the finite element method to compute the response of an inhomogeneous and homogeneous cartilage layer to loading. The results show that the tensile modulus increases significantly from 4.1±1.9MPa in the deep zone to 8.3±3.7MPa at the superficial zone, while the compressive modulus decreases from 0.73±0.26MPa to 0.28±0.16MPa. The finite element models demonstrate that structural inhomogeneity acts to increase the interstitial fluid load support at the articular surface. However, the state of stress, strain, or strain energy density in the solid matrix remained inhomogeneous through the depth of the articular layer, whether or not inhomogeneous material properties were employed. We suggest that increased fluid load support at the articular surface enhances the frictional and wear properties of articular cartilage, but that the tissue is not functionally adapted to produce homogeneous stress, strain, or strain energy density distributions. Interstitial fluid pressurization, but not a homogeneous elastic stress distribution, appears thus to be a prerequisite for the functional and morphological integrity of the cartilage.

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Section: Discussionmentioning

confidence: 93%

Inhomogeneous Cartilage Properties Enhance Superficial Interstitial Fluid Support and Frictional Properties, But Do Not Provide a Homogeneous State of Stress

Krishnan

Park

Eckstein

et al. 2003

Journal of Biomechanical Engineering

Self Cite

115

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“…Like the current study, a near-linear relationship between patellar contact area and knee angles has been reported between 0° to 90° knee angles in several studies involving weight-bearing exercises. 3,9,17,23,26 …”

Section: Biomechanical Modelmentioning

confidence: 99%

Patellofemoral Joint Force and Stress Between a Short- and Long-Step Forward Lunge

Escamilla¹,

Zheng²,

MacLeod³

et al. 2008

J Orthop Sports Phys Ther

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“…The majority of published three-dimensional multibody simulations that included a knee contact model are quasi-static [7][8][9][10][11][12][13], which prevents the prediction of muscle and ligament forces alongside joint contact pressures during dynamic conditions. Over a decade ago, Piazza and Delp [14] produced a forward-dynamic simulation of a step-up task that combined forces from 13 EMG driven muscles crossing a prosthetic knee, forces from collateral ligaments modeled as nonlinear elastic springs, and forces from rigid contacts defined between tibio-femoral and patella-femoral prosthetic component geometries.…”

Section: Introductionmentioning

confidence: 99%

Multibody Muscle Driven Model of an Instrumented Prosthetic Knee During Squat and Toe Rise Motions

Stylianou¹,

Guess²,

Kia

2013

Journal of Biomechanical Engineering

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Detailed knowledge of knee joint kinematics and dynamic loading is essential for improving the design and outcomes of surgical procedures, tissue engineering applications, prosthetics design, and rehabilitation. The need for dynamic computational models that link kinematics, muscle and ligament forces, and joint contacts has long been recognized but such body-level forward dynamic models do not exist in recent literature. A main barrier in using computational models in the clinic is the validation of the in vivo contact, muscle, and ligament loads. The purpose of this study was to develop a full body, muscle driven dynamic model with subject specific leg geometries and validate it during squat and toe-rise motions. The model predicted loads were compared to in vivo measurements acquired with an instrumented knee implant. Data for this study were provided by the "Grand Challenge Competition to Predict In-Vivo Knee Loads" for the 2012 American Society of Mechanical Engineers Summer Bioengineering Conference. Data included implant and bone geometries, ground reaction forces, EMG, and the instrumented knee implant measurements. The subject specific model was developed in the multibody framework. The knee model included three ligament bundles for the lateral collateral ligament (LCL) and the medial collateral ligament (MCL), and one bundle for the posterior cruciate ligament (PCL). The implanted tibia tray was segmented into 326 hexahedral elements and deformable contacts were defined between the elements and the femoral component. The model also included 45 muscles on each leg. Muscle forces were computed for the muscle driven simulation by a feedback controller that used the error between the current muscle length in the forward simulation and the muscle length recorded during a kinematics driven inverse simulation. The predicted tibia forces and torques, ground reaction forces, electromyography (EMG) patterns, and kinematics were compared to the experimentally measured values to validate the model. Comparisons were done graphically and by calculating the mean average deviation (MAD) and root mean squared deviation (RMSD) for all outcomes. The MAD value for the tibia vertical force was 279 N for the squat motion and 325 N for the toe-rise motion, 45 N and 53 N for left and right foot ground reaction forces during the squat and 94 N and 82 N for toe-rise motion. The maximum MAD value for any of the kinematic outcomes was 7.5 deg for knee flexion-extension during the toe-rise motion.

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Patellofemoral Stresses during Open and Closed Kinetic Chain Exercises

Cited by 114 publications

References 39 publications

Inhomogeneous Cartilage Properties Enhance Superficial Interstitial Fluid Support and Frictional Properties, But Do Not Provide a Homogeneous State of Stress

Inhomogeneous Cartilage Properties Enhance Superficial Interstitial Fluid Support and Frictional Properties, But Do Not Provide a Homogeneous State of Stress

Patellofemoral Joint Force and Stress Between a Short- and Long-Step Forward Lunge

Multibody Muscle Driven Model of an Instrumented Prosthetic Knee During Squat and Toe Rise Motions

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