The influence of alignment on the musculo-skeletal loading conditions at the knee

Abstract

This study demonstrated a clear dependence of the individual joint loads on axial knee alignment. Based on the sensitivity of joint loading to valgus mal-alignment, more than 3 degrees of over-correction of a varus deformity to valgus should be carefully reconsidered.

Repeatability and reproducibility of OSSCA, a functional approach for assessing the kinematics of the lower limb

“…The consistency model ICC (3,4) was chosen, in order to offer the proportion of reliability attributable to inter-day and inter-observer measurements, fitting to our study design. Additionally, to assess inter-measure variance, an analysis of variance (ANOVA) using a mixed linear model was performed for the factors ''day'' and ''observer'', where inter-day variance (low repeatability) and inter-observer variance (low reproducibility) were tested for statistical significance.…”

“…By providing access to subject specific motion patterns, movement analysis allows quantitative assessment of a range of functional and kinematic parameters and can therefore provide a direct comparison for the efficacy of interventional approaches [1,2], or complement imaging and physical examination findings to support clinical decisions. Furthermore, the additional registration of synchronous external kinetic data can provide essential information for the determination of internal loading conditions using musculoskeletal analyses [3][4][5].…”

Patellofemoral joint contact forces during activities with high knee flexion

“…10,11 Computational models of the musculoskeletal system provide access to the internal loads at the tibiofemoral (TF) and PF joints based on external measurements, and can be used to systematically explore the effects of factors relevant to the internal loading conditions. [12][13][14] While early studies estimated PF forces using 2D analyses, 15 recent models can predict 3D muscle and joint contact forces by employing more complex quasistatic or dynamic optimization techniques. [16][17][18] Here, a large variation in PF forces is apparent, especially for activities involving high knee flexion, 1 with PF forces during squatting ranging from 1.9 19 to 3.1 BW 15 at 1008 flexion.…”

Frontal plane alignment: An imageless method to predict the mechanical femoral–tibial angle (mFTA) based on functional determination of joint centres and axes

“…Lower limb mal-alignment is known to alter the loading conditions at the knee [5]. The accurate assessment of limb alignment therefore plays an important role in clinical monitoring, as well as in studies that aim to elucidate the influence of, e.g.…”

“…Frontal plane mal-alignment [1] has been shown to cause increased adduction moments [2][3][4] and knee contact forces [5], as well as altered medio-lateral distribution of the tibio-femoral contact force [6]. Accurate quantification of frontal plane alignment is therefore important for determining the biomechanical conditions in the knee, particularly in the context of muscular imbalance [7], joint instability [8], or bony deformities [1,9], as well as for monitoring therapeutic interventions at the knee.…”