Advertisement

Evaluation of compressive and shear joint forces on medial and lateral compartments in knee joint during walking before and after medial open-wedge high tibial osteotomy

  • Tserenchimed Purevsuren
  • Kyungsoo Kim
  • Kyung Wook Nha
  • Yoon Hyuk Kim
Article

Abstract

The main principle of open-wedge high tibial osteotomy (HTO) is to shift the weight-bearing line of the knee joint in order to decompress the degenerated compartment and delay osteoarthritis (OA). In this study, the resultant contact forces on the medial compartment, lateral compartment, and total tibiofemoral joint were analyzed during gait for five OA patients before and after HTO in order to fully understand the effect and mechanism of HTO for the OA knee. The compressive, lateral-medial shear, and anteriorposterior shear force components of the joint force, as well as the ratio of the medial contact force to the lateral contact force, were investigated using inverse dynamic and multi-body dynamic models. Medial open-wedge HTO improved the balance of medial and lateral contact forces on the tibiofemoral joint, which demonstrated the purpose of HTO provided by clinical studies and the outcomes of a computational study. In addition to the compressive contact force, the lateral-medial shear force was also reduced during the stance phase of walking after HTO. The technology in this study provides a fundamental tool to evaluate the outcomes of HTO by considering daily and sports activities.

Keywords

High tibial osteotomy Contact force Tibiofemoral joint Inverse dynamic Multi-body simulation 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    D D’Lima, D., Fregly, B. J., Patil, S., Steklov, N., and Colwell, C. W., “Knee Joint Forces: Prediction, Measurement, and Significance,” Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine, Vol. 226, No. 2, pp. 95–102, 2012.CrossRefGoogle Scholar
  2. 2.
    Baliunas, A. J., Hurwitz, D. E., Ryals, A. B., Karrar, A., Case, J., et al., “Increased Knee Joint Loads during Walking are Present in Subjects with Knee Osteoarthritis,” Osteoarthritis and Cartilage, Vol. 10, No. 7, pp. 573–579, 2002.CrossRefGoogle Scholar
  3. 3.
    Dearborn, J. T., Eakin, C. L., and Skinner, H. B., “Medial Compartment Arthrosis of the Knee,” American Journal of Orthopedics, Vol. 25, No. 1, pp. 18–26, 1996.Google Scholar
  4. 4.
    Sharma, L., Song, J., Felson, D. T., Shamiyeh, E., and Dunlop, D. D., “The Role of Knee Alignment in Disease Progression and Functional Decline in Knee Osteoarthritis,” JAMA, Vol. 286, No. 2, pp. 188–195, 2001.CrossRefGoogle Scholar
  5. 5.
    Creaby, M. W., Wang, Y., Bennell, K. L., Hinman, R. S., Metcalf, B. R., et al., “Dynamic Knee Loading is Related to Cartilage Defects and Tibial Plateau Bone Area in Medial Knee Osteoarthritis,” Osteoarthritis and Cartilage, Vol. 18, No. 11, pp. 1380–1385, 2010.CrossRefGoogle Scholar
  6. 6.
    Hunt, M. A., Birmingham, T. B., Giffin, J. R., and Jenkyn, T. R., “Associations among Knee Adduction Moment, Frontal Plane Ground Reaction Force, and Lever Arm during Walking in Patients with Knee Osteoarthritis,” Journal of Biomechanics, Vol. 39, No. 12, pp. 2213–2220, 2006.CrossRefGoogle Scholar
  7. 7.
    Harding, G. T., Hubley-Kozey, C. L., Dunbar, M. J., Stanish, W. D., and Wilson, J. L. A., “Body Mass Index Affects Knee Joint Mechanics during Gait Differently with and without Moderate Knee Osteoarthritis,” Osteoarthritis and Cartilage, Vol. 20, No. 11, pp. 1234–1242, 2012.CrossRefGoogle Scholar
  8. 8.
    Lewek, M. D., Rudolph, K. S., and Snyder-Mackler, L., “Control of Frontal Plane Knee Laxity during Gait in Patients with Medial Compartment Knee Osteoarthritis,” Osteoarthritis and Cartilage, Vol. 12, No. 9, pp. 745–751, 2004.CrossRefGoogle Scholar
  9. 9.
    Nha, K. W., Dorj, A., Feng, J., Shin, J. H., Kim, J. I., et al., “Application of Computational Lower Extremity Model to Investigate Different Muscle Activities and Joint Force Patterns in Knee Osteoarthritis Patients during Walking,” Computational and Mathematical Methods in Medicine, Vol. 2013, Article ID: 314280, 2013.MathSciNetCrossRefzbMATHGoogle Scholar
  10. 10.
    Rönn, K., Reischl, N., Gautier, E., and Jacobi, M., “Current Surgical Treatment of Knee Osteoarthritis,” Arthritis, Vol. 2011, Article ID: 454873, 2011.CrossRefGoogle Scholar
  11. 11.
    Amis, A. A., “Biomechanics of High Tibial Osteotomy,” Knee Surgery, Sports Traumatology, Arthroscopy, Vol. 21, No. 1, pp. 197–205, 2013.CrossRefGoogle Scholar
  12. 12.
    Richmond, J. C., “Surgery for Osteoarthritis of the Knee,” Rheumatic Disease Clinics of North America, Vol. 34, No. 3, pp. 815–825, 2008.CrossRefGoogle Scholar
  13. 13.
    Hernigou, P., Medevielle, D., Debeyre, J., and Goutallier, D., “Proximal Tibial Osteotomy for Osteoarthritis with Varus Deformity. A Ten to Thirteen-Year Follow-up Study,” The Journal of Bone and Joint Surgery. American Volume, Vol. 69, No. 3, pp. 332–354, 1987.Google Scholar
  14. 14.
    DeMeo, P. J., Johnson, E. M., Chiang, P. P., Flamm, A. M., and Miller, M. C., “Midterm Follow-up of Opening-Wedge High Tibial Osteotomy,” The American Journal of Sports Medicine, Vol. 38, No. 10, pp. 2077–2084, 2010.CrossRefGoogle Scholar
  15. 15.
    Birmingham, T. B., Giffin, J. R., Chesworth, B. M., Bryant, D. M., Litchfield, R. B., et al., “Medial Opening Wedge High Tibial Osteotomy: A Prospective Cohort Study of Gait, Radiographic, and Patient-Reported Outcomes,” Arthritis Care & Research, Vol. 61, No. 5, pp. 648–657, 2009.CrossRefGoogle Scholar
  16. 16.
    Lind, M., McClelland, J., Wittwer, J. E., Whitehead, T. S., Feller, J. A., and Webster, K. E., “Gait Analysis of Walking before and after Medial Opening Wedge High Tibial Osteotomy,” Knee Surgery, Sports Traumatology, Arthroscopy., Vol. 21, No. 1, pp. 74–81, 2013.CrossRefGoogle Scholar
  17. 17.
    Jung, W.-H., Takeuchi, R., Chun, C.-W., Lee, J.-S., Ha, J.-H., Kim, J.-H., and Jeong, J.-H., “Second-Look Arthroscopic Assessment of Cartilage Regeneration after Medial Opening-Wedge High Tibial Osteotomy,” Arthroscopy: The Journal of Arthroscopic & Related Surgery, Vol. 30, No. 1, pp. 72–79, 2014.CrossRefGoogle Scholar
  18. 18.
    Agneskirchner, J. D., Hurschler, C., Wrann, C. D., and Lobenhoffer, P., “The Effects of Valgus Medial Opening Wedge High Tibial Osteotomy on Articular Cartilage Pressure of the Knee: A Biomechanical Study,” Arthroscopy: The Journal of Arthroscopic & Related Surgery, Vol. 23, No. 8, pp. 852–861, 2007.CrossRefGoogle Scholar
  19. 19.
    Yang, N. H., Canavan, P. K., and Nayeb-Hashemi, H., “The Effect of the Frontal Plane Tibiofemoral Angle and Varus Knee Moment on the Contact Stress and Strain at the Knee Cartilage,” Journal of Applied Biomechanics, Vol. 26, No. 4, pp. 432–443, 2010.CrossRefGoogle Scholar
  20. 20.
    Yang, N. H., Nayeb-Hashemi, H., Canavan, P. K., and Vaziri, A., “Effect of Frontal Plane Tibiofemoral Angle on the Stress and Strain at the Knee Cartilage during the Stance Phase of Gait,” Journal of Orthopaedic Research, Vol. 28, No. 12, pp. 1539–1547, 2010.CrossRefGoogle Scholar
  21. 21.
    Bhatnagar, T. and Jenkyn, T. R., “Internal Kinetic Changes in the Knee due to High Tibial Osteotomy are Well-Correlated with Change in External Adduction Moment: An Osteoarthritic Knee Model,” Journal of Biomechanics, Vol. 43, No. 12, pp. 2261–2266, 2010.CrossRefGoogle Scholar
  22. 22.
    Purevsuren, T., Dorj, A., Kim, K., and Kim, Y. H., “Prediction of Medial and Lateral Contact Force of the Knee Joint during Normal and Turning Gait after Total Knee Replacement,” Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine, Vol. 230, No. 4, pp. 288–297, 2016.CrossRefGoogle Scholar
  23. 23.
    Kwon, O. S., Purevsuren, T., Kim, K., Park, W. M., Kwon, T.-K., and Kim, Y. H., “Influence of Bundle Diameter and Attachment Point on Kinematic Behavior in Double Bundle Anterior Cruciate Ligament Reconstruction using Computational Model,” Computational and Mathematical Methods in Medicine, Vol. 2014, Article ID: 948292, 2014.MathSciNetCrossRefGoogle Scholar
  24. 24.
    De Leva, P., “Adjustments to Zatsiorsky-Seluyanov’s Segment Inertia Parameters,” Journal of Biomechanics, Vol. 29, No. 9, pp. 1223–1230, 1996.CrossRefGoogle Scholar
  25. 25.
    Bell, A. L., Brand, R. A., and Pedersen, D. R., “Prediction of Hip Joint Centre Location from External Landmarks,” Human Movement Science, Vol. 8, No. 1, pp. 3–16, 1989.CrossRefGoogle Scholar
  26. 26.
    Wu, G., Siegler, S., Allard, P., Kirtley, C., Leardini, A., et al., “ISB Recommendation on Definitions of Joint Coordinate System of Various Joints for the Reporting of Human Joint Motion -Part I: Ankle, Hip, and Spine,” Journal of Biomechanics, Vol. 35, No. 4, pp. 543–548, 2002.CrossRefGoogle Scholar
  27. 27.
    Grood, E. S. and Suntay, W. J., “A Joint Coordinate System for the Clinical Description of Three-Dimensional Motions: Application to the Knee,” Journal of Biomechanical Engineering, Vol. 105, No. 2, pp. 136–144, 1983.CrossRefGoogle Scholar
  28. 28.
    Guess, T. M. and Stylianou, A., “Simulation of Anterior Cruciate Ligament Deficiency in a Musculoskeletal Model with Anatomical Knees,” Open Biomed. Eng. J, Vol. 6, No. 1, pp. 23–32, 2012.CrossRefGoogle Scholar
  29. 29.
    Amis, A. A., Senavongse, W., and Bull, A. M., “Patellofemoral Kinematics during Knee Flexion-Extension: An in vitro Study,” Journal of Orthopaedic Research, Vol. 24, No. 12, pp. 2201–2211, 2006.CrossRefGoogle Scholar
  30. 30.
    Purevsuren, T., Elias, J. J., Kim, K., and Kim, Y. H., “Dynamic Simulation of Tibial Tuberosity Realignment: Model Evaluation,” Computer Methods in Biomechanics and Biomedical Engineering, Vol. 18, No. 14, pp. 1606–1610, 2015.CrossRefGoogle Scholar
  31. 31.
    Guess, T. M., Thiagarajan, G., Kia, M., and Mishra, M., “A Subject Specific Multibody Model of the Knee with Menisci,” Medical Engineering & Physics, Vol. 32, No. 5, pp. 505–515, 2010.CrossRefGoogle Scholar
  32. 32.
    Guess, T. M., “Forward Dynamics Simulation using a Natural Knee with Menisci in the Multibody Framework,” Multibody System Dynamics, Vol. 28, No. 1-2, pp. 37–53, 2012.CrossRefGoogle Scholar
  33. 33.
    Fregly, B. J., D’Lima, D. D., and Colwell, C. W., “Effective Gait Patterns for Offloading the Medial Compartment of the Knee,” Journal of Orthopaedic Research, Vol. 27, No. 8, pp. 1016–1021, 2009.CrossRefGoogle Scholar
  34. 34.
    Erhart, J. C., Dyrby, C. O., D’Lima, D. D., Colwell, C. W., and Andriacchi, T. P., “Changes in in vivo Knee Loading with a Variable-Stiffness Intervention Shoe Correlate with Changes in the Knee Adduction Moment,” Journal of Orthopaedic Research, Vol. 28, No. 12, pp. 1548–1553, 2010.CrossRefGoogle Scholar
  35. 35.
    Kumar, D., Manal, K. T., and Rudolph, K. S., “Knee Joint Loading during Gait in Healthy Controls and Individuals with Knee Osteoarthritis,” Osteoarthritis and Cartilage, Vol. 21, No. 2, pp. 298–305, 2013.CrossRefGoogle Scholar
  36. 36.
    Winby, C. R., Lloyd, D. G., Besier, T. F., and Kirk, T. B., “Muscle and External Load Contribution to Knee Joint Contact Loads during Normal Gait,” Journal of Biomechanics, Vol. 42, No. 14, pp. 2294–2300, 2009.CrossRefGoogle Scholar
  37. 37.
    Zhao, D., Banks, S. A., Mitchell, K. H., D’Lima, D. D., Colwell, C. W., and Fregly, B. J., “Correlation between the Knee Adduction Torque and Medial Contact Force for a Variety of Gait Patterns,” Journal of Orthopaedic Research, Vol. 25, No. 6, pp. 789–797, 2007.CrossRefGoogle Scholar
  38. 38.
    Kutzner, I., Trepczynski, A., Heller, M. O., and Bergmann, G., “Knee Adduction Moment and Medial Contact Force–Facts about their Correlation during Gait,” PLoS One, Vol. 8, No. 12, Paper No. e81036, 2013.CrossRefGoogle Scholar
  39. 39.
    Meyer, A. J., D’Lima, D. D., Besier, T. F., Lloyd, D. G., Colwell, C. W., and Fregly, B. J., “Are External Knee Load and EMG Measures Accurate Indicators of Internal Knee Contact Forces during Gait?” Journal of Orthopaedic Research, Vol. 31, No. 6, pp. 921–929, 2013.CrossRefGoogle Scholar
  40. 40.
    Walter, J. P., D’Lima, D. D., Colwell, C. W., and Fregly, B. J., “Decreased Knee Adduction Moment does not Guarantee Decreased Medial Contact Force during Gait,” Journal of Orthopaedic Research, Vol. 28, No. 10, pp. 1348–1354, 2010.CrossRefGoogle Scholar

Copyright information

© Korean Society for Precision Engineering and Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Tserenchimed Purevsuren
    • 1
  • Kyungsoo Kim
    • 2
  • Kyung Wook Nha
    • 3
  • Yoon Hyuk Kim
    • 1
  1. 1.Department of Mechanical EngineeringKyung Hee UniversityGyeonggi-doSouth Korea
  2. 2.Department of Applied MathematicsKyung Hee UniversityGyeonggi-doSouth Korea
  3. 3.Department of Orthopaedic SurgeryInje University, Ilsan Paik HospitalGyeonggi-doSouth Korea

Personalised recommendations