The influence of the test setup on knee joint kinematics – A meta-analysis of tibial rotation

Hacker, Steffen; Ignatius, Anita; Dürselen, Lutz

doi:10.1016/j.jbiomech.2016.07.025

Cited by 13 publications

(10 citation statements)

References 23 publications

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“…36 . The results were contained in the range of values generated from the experimental data, with the exception of tibial internal/external rotation, which was less pronounced but exhibited the screw-home mechanism in accordance with literature 34 . The screw-home mechanism describes an external rotation of the tibia relative to the femur in the final stage of knee extension movement 50 .…”

Section: Methodssupporting

confidence: 76%

“…Although computational studies have shown great potential in clinical decision-making 11,12,17,18,21,38,45,48,53,54 , they are associated with uncertainties regarding the prediction of realistic contact conditions. On the other hand, experimental studies 16,24,26,34,36,55 lack the consideration of the complex soft tissue structures acting at the lower extremity. Moreover, human cadaver specimens do not allow reproducible and comparable evaluations of different parameters due to the limited acquisition of samples and their decay.…”

Section: Discussionmentioning

confidence: 99%

“…Generally, we have been able to show that both the screw-home and the femoral rollback mechanisms can be demonstrated in CR-TKR in close approximation. In other words, our HiL setup is capable of predicting the typical kinematics patterns 34,51 of the knee joint under reproducible conditions. Additionally, several clinical phenomena have been observed, e.g., a loss of the physiological screw-home mechanism in agreement with the findings reported by other research groups 26,30,34 .…”

Section: Discussionmentioning

confidence: 99%

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Effect of surgical parameters on the biomechanical behaviour of bicondylar total knee endoprostheses – A robot-assisted test method based on a musculoskeletal model

Kebbach

Grawe

Geier

et al. 2019

Sci Rep

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The complicated interplay of total knee replacement (TKR) positioning and patient-specific soft tissue conditions still causes a considerable number of unsatisfactory outcomes. Therefore, we deployed a robot-assisted test method, in which a six-axis robot moved and loaded a bicondylar cruciate-retaining (CR)-TKR in a virtual lower extremity emulated by a musculoskeletal multibody model. This enabled us to systematically analyse the impact of the posterior cruciate ligament (PCL), tibial slope, and tibial component rotation on TKR function while considering the physical implant components and physiological-like conditions during dynamic motions. The PCL resection yielded a decrease of femoral rollback by 4.5 mm and a reduction of tibiofemoral contact force by 50 N. A reduced tibial slope led to an increase of tibiofemoral contact force by about 170 N and a decrease of femoral rollback up to 1.7 mm. Although a higher tibial slope reduced the contact force, excessive tibial slopes should be avoided to prevent joint instability. Contrary to an external rotation of the tibial component, an internal rotation clearly increased the contact force and lateral femoral rollback. Our data contribute to improved understanding the biomechanics of TKRs and show the capabilities of the robot-assisted test method based on a musculoskeletal multibody model as a preoperative planning tool.

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Section: Methodssupporting

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Effect of surgical parameters on the biomechanical behaviour of bicondylar total knee endoprostheses – A robot-assisted test method based on a musculoskeletal model

Kebbach

Grawe

Geier

et al. 2019

Sci Rep

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“…This typical screw-home mechanism is an involuntary, passive movement stabilising the knee joint in extension and is caused by the asymmetry between the femoral condyles and the tibial plateau (Piazza and Cavanagh, 2000). According to the literature, the screw-home mechanism begins between 25° and 36° of knee flexion and is normally ~5° to 12° of external rotation (Bull et al, 2008; Müller et al, 2009; Sharma et al, 2012; Hacker et al, 2016). Our measurements are in accordance with these findings, proving the unconstrained motion of the joint specimens.…”

Section: Discussionmentioning

confidence: 99%

German Society of Biomechanics (DGfB) Young Investigator Award 2019: Proof-of-Concept of a Novel Knee Joint Simulator Allowing Rapid Motions at Physiological Muscle and Ground Reaction Forces

Schall¹,

Seitz²,

Hacker³

et al. 2019

Front. Bioeng. Biotechnol.

Self Cite

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The in vitro determination of realistic loads acting in knee ligaments, articular cartilage, menisci and their attachments during daily activities require the creation of physiological muscle forces, ground reaction force and unconstrained kinematics. However, no in vitro test setup is currently available that is able to simulate such physiological loads during squatting and jump landing exercises. Therefore, a novel knee joint simulator allowing such physiological loads in combination with realistic, rapid movements is presented. To gain realistic joint positions and muscle forces serving as input parameters for the simulator, a combined in vivo motion analysis and inverse dynamics (MAID) study was undertaken with 11 volunteers performing squatting and jump landing exercises. Subsequently, an in vitro study using nine human knee joint specimens was conducted to prove the functionality of the simulator. To do so, slow squatting without muscle force simulation representing quasi-static loading conditions and slow squatting and jump landing with physiological muscle force simulation were carried out. During all tests ground reaction force, tibiofemoral contact pressure, and tibial rotation characteristics were simultaneously recorded. The simulated muscle forces obtained were in good correlation (0.48 ≤ R ≤ 0.92) with those from the in vivo MAID study. The resulting vertical ground reaction force showed a correlation of R = 0.93. On the basis of the target parameters of ground reaction force, tibiofemoral contact pressure and tibial rotation, it could be concluded that the knee joint load was loaded physiologically. Therefore, this is the first in vitro knee joint simulator allowing squatting and jump landing exercises in combination with physiological muscle forces that finally result in realistic ground reaction forces and physiological joint loading conditions.

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“…However, in their experiments, the effect of coordinated muscle forces was neglected, and close-to-physiological hip and ankle joint forces were not applied. In fact, these two problems are common in assessment of TKI performance by either computer simulation [10][11][12][13][14] or in-vitro experiment [15][16][17] based on the OKR 18,19 or the Kansas Knee Simulator (KKS) 20,21 . In reality, muscle forces do play an important role in joint motion because medium to high quadriceps, hamstrings, and gastrocnemius activities are produced during squatting.…”

Section: Introductionmentioning

confidence: 99%

Preliminary study of a customised total knee implant with musculoskeletal and dynamic squatting simulation

Wang

2019

Proc Inst Mech Eng H

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Customised total knee replacement could be the future therapy for knee joint osteoarthritis. A preliminary design of a customised total knee implant based on knee anatomy was studied in this article. To evaluate its biomechanical performance, a dynamic finite element model based on the Oxford knee rig was created to simulate a squatting motion. Unlike previous research, this dynamic model was simulated with patient-specific muscle and joint loads that were calculated from an OpenSim musculoskeletal model. The dynamic response of the customised total knee implant was simulated under three cruciate ligament scenarios: both cruciate ligaments retained, only anterior cruciate ligament removed and both cruciate ligaments removed. In addition, an off-the-shelf symmetric total knee implant with retained cruciate ligaments was simulated for comparison analysis. The customised total knee implant with both cruciate ligaments retained showed larger ranges of femoral external rotation and posterior translation than the symmetric total knee implant. The motion of the customised total knee implant was also in good agreement with a healthy knee. There were no big differences in the tibiofemoral compressive forces in the customised total knee implant model under the three scenarios. These forces were generally consistent with other experimental and simulation results. However, the customised total knee implant design resulted in larger tibiofemoral compressive force than the symmetric total knee implant after 50° knee flexion, which was caused by the larger tibiofemoral relative motion.

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The influence of the test setup on knee joint kinematics – A meta-analysis of tibial rotation

Cited by 13 publications

References 23 publications

Effect of surgical parameters on the biomechanical behaviour of bicondylar total knee endoprostheses – A robot-assisted test method based on a musculoskeletal model

Effect of surgical parameters on the biomechanical behaviour of bicondylar total knee endoprostheses – A robot-assisted test method based on a musculoskeletal model

German Society of Biomechanics (DGfB) Young Investigator Award 2019: Proof-of-Concept of a Novel Knee Joint Simulator Allowing Rapid Motions at Physiological Muscle and Ground Reaction Forces

Preliminary study of a customised total knee implant with musculoskeletal and dynamic squatting simulation

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