Sensitivity of medial and lateral knee contact force predictions to frontal plane alignment and contact locations

Saliba, Christopher M.; Brandon, Scott C.E.; Deluzio, Kevin J.

doi:10.1016/j.jbiomech.2017.03.005

Cited by 25 publications

(28 citation statements)

References 34 publications

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“…Additionally, based on the results of this study, we recommend that care should be taken when selecting a modeling technique because this influences the contact moment arms, known to linearly impact medial-lateral contact forces (Lerner et al 2015;Saliba et al 2017), and thus overall identification of the best gait alteration. It is known estimated medial and lateral contact forces are sensitive to contact locations and tibiofemoral alignment (Saliba et al 2017). And furthermore, that applying individualized TF alignment and contact locations will lead to better medial and lateral force predictions compared to generic parameters (Lerner et al 2015).…”

Section: Discussionmentioning

confidence: 99%

Gait alteration strategies for knee osteoarthritis: a comparison of joint loading via generic and patient-specific musculoskeletal model scaling techniques

Dzialo

Mannisi

Halonen

et al. 2019

International Biomechanics

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Gait modifications and laterally wedged insoles are non-invasive approaches used to treat medial compartment knee osteoarthritis. However, the outcome of these alterations is still a controversial topic. This study investigates how gait alteration techniques may have a unique effect on individual patients; and furthermore, the way we scale our musculoskeletal models to estimate the medial joint contact force may influence knee loading conditions. Five patients with clinical evidence of medial knee osteoarthritis were asked to walk at a normal walking speed over force plates and simultaneously 3D motion was captured during seven conditions (0°-, 5°-, 10°-insoles, shod, toe-in, toe-out, and wide stance). We developed patient-specific musculoskeletal models, using segmentations from magnetic resonance imaging to morph a generic model to patientspecific bone geometries and applied this morphing to estimate muscle insertion sites. Additionally, models were created of these patients using a simple linear scaling method. When examining the patients' medial compartment contact force (peak and impulse) during stance phase, a 'one-size-fits-all' gait alteration aimed to reduce medial knee loading did not exist. Moreover, the different scaling methods lead to differences in medial contact forces; highlighting the importance of further investigation of musculoskeletal modeling methods prior to use in the clinical setting. ARTICLE HISTORY

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Section: Discussionmentioning

confidence: 99%

Gait alteration strategies for knee osteoarthritis: a comparison of joint loading via generic and patient-specific musculoskeletal model scaling techniques

Dzialo

Mannisi

Halonen

et al. 2019

International Biomechanics

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“…1) Linear CP trajectory (LCP): This model represents the general assumptions made in many MSK models (Johnson et al, 1981;Lerner et al, 2015;Lloyd and Buchanan, 1996;Morrison, 1970;Saliba et al, 2017;Winby et al, 2009). The contact forces, musculotendon forces and joint moment are only balanced in the frontal plane of the tibia at a given distance from the tibial plateau centreline.…”

Section: Cp Trajectoriesmentioning

confidence: 99%

“…However, the accuracy of the medial/lateral contact force estimation considerably improved by customizing the point of contact force application (Lerner et al, 2015). The estimation of intact knee joint contact forces still remains a challenge, because the medial and lateral contact forces cannot be well calculated without a good estimate of the subject's contact point (CP) trajectories (Saliba et al, 2017). Such information is very difficult to obtain in vivo because it relies on both joint kinematics and articular surface geometries.…”

Section: Introductionmentioning

confidence: 99%

“…In an earlier study, (Nissan, 1980) performed a sensitivity analysis by moving the CP 5 mm in the anterior-posterior direction and found that the posterior and anterior displacements would respectively increase the contact force by about 500N and decrease it by about 350N. More recently, Lerner et al (2015) and Saliba et al (2017) moved the CP locations only in the medial-lateral direction.…”

Section: Introductionmentioning

confidence: 99%

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Knee medial and lateral contact forces in a musculoskeletal model with subject-specific contact point trajectories

Zeighami

Aïssaoui

Dumas

2018

Journal of Biomechanics

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Contact point (CP) trajectory is a crucial parameter in estimating medial/lateral tibio-femoral contact forces from the musculoskeletal (MSK) models. The objective of the present study was to develop a method to incorporate the subject-specific CP trajectories into the MSK model. Ten healthy subjects performed 45 s treadmill gait trials. The subject-specific CP trajectories were constructed on the tibia and femur as a function of extension-flexion using low-dose bi-plane X-ray images during a quasi-static squat. At each extension-flexion position, the tibia and femur CPs were superimposed in the three directions on the medial side, and in the anterior-posterior and proximal-distal directions on the lateral side to form the five kinematic constraints of the knee joint. The Lagrange multipliers associated to these constraints directly yielded the medial/lateral contact forces. The results from the personalized CP trajectory model were compared against the linear CP trajectory and sphere-on-plane CP trajectory models which were adapted from the commonly used MSK models. Changing the CP trajectory had a remarkable impact on the knee kinematics and changed the medial and lateral contact forces by 1.03 BW and 0.65 BW respectively, in certain subjects. The direction and magnitude of the medial/lateral contact force were highly variable among the subjects and the medial-lateral shift of the CPs alone could not determine the increase/decrease pattern of the contact forces. The suggested kinematic constraints are adaptable to the CP trajectories derived from a variety of joint models and those experimentally measured from the 3D imaging techniques.

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“…Thirdly, in the linearly scaled model, we applied a simple equilibrium in the frontal plane to distribute the total contact force and frontal moment to the medial and lateral side. As shown by Saliba et al (2017), with such an approach, the estimated forces are sensitive to this distribution. However, the specific bone geometry and contact points are not available when applying generic models and only use skin marker trajectories and force plate data as input.…”

Section: Without Normalization Volume Normalizationmentioning

confidence: 99%

How sensitive are predicted muscle and knee contact forces to normalization factors and polynomial order in the muscle recruitment criterion formulation?

Andersen

2018

International Biomechanics

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Musculoskeletal modeling is an important tool to estimate knee loads. In these models, anatomical muscles are frequently subdivided to account for wide origin/insertion areas. The specific subdivision has been shown to affect some muscle recruitment criteria and it has been suggested that normalization factors should be incorporated into models. The primary aim of this study was to investigate the effect of different muscle normalization factors in the muscle recruitment criterion and polynomial order on the estimated muscle and total, medial and lateral knee contact forces during gait. These were evaluated on three different musculoskeletal models with increasing levels of patient-specificity and knee joint model complexity for one subject from the Grand Challenge data set and evaluated against measured forces. The results showed that the introduction of the muscle normalization factors affected the estimated forces and that this effect was most pronounced when a polynomial of order two was applied. Additionally, mainly the second contact force peak was affected. Secondary investigations revealed that the predicted forces can vary substantially as a function of the knee flexor and extensor muscle strength with over one body weight difference in predicted total compressive force between 100% and 40% of the strength. Additionally, the predicted second peak during gait was found to be sensitive to the position of the pelvic skin marker positions in the model. These results imply that caution should be taken when a normalization factor is introduced to account for subdivided muscles especially for second-order recruitment criteria.

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Sensitivity of medial and lateral knee contact force predictions to frontal plane alignment and contact locations

Cited by 25 publications

References 34 publications

Gait alteration strategies for knee osteoarthritis: a comparison of joint loading via generic and patient-specific musculoskeletal model scaling techniques

Gait alteration strategies for knee osteoarthritis: a comparison of joint loading via generic and patient-specific musculoskeletal model scaling techniques

Knee medial and lateral contact forces in a musculoskeletal model with subject-specific contact point trajectories

How sensitive are predicted muscle and knee contact forces to normalization factors and polynomial order in the muscle recruitment criterion formulation?

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