The Electronic Knee

  • C. W. ColwellJr.
  • D. D. D’Lima


The knee is a complex joint that is difficult to model accurately. Although significant advances have been made in mathematical modeling, these have yet to be successfully validated in vivo. Direct measurement of knee forces could lead to a better understanding of the stresses seen in total knee arthroplasty. This would enable more accurate mathematical and in vitro modeling of the knee, which could then be used to evaluate and to implement relevant improvements in implant design. An instrumented knee prosthesis was used for wireless measurement of tibial forces. Accurate measurement of these forces can yield insights into the stresses generated during common activities of daily living. The tibiofemoral force data can be used to develop better biomechanical knee models and in vitro wear tests and can be used to evaluate the effect of improvements in implant design and bearing surfaces, rehabilitation protocols, and orthotics. This may lead to refinement of surgical techniques and to enhancement of prosthetic design that will improve the function, quality of life, and longevity of total knee arthroplasty. Given the current increase in the number of older persons who are at higher risk for chronic musculoskeletal disorders, a significant positive impact on clinical outcomes and patient health care could be anticipated.


Total Knee Arthroplasty Unicompartmental Knee Arthroplasty Polyethylene Insert Tibial Tray Time Body Weight 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Blunn GW et al (1991) The dominance of cyclic sliding in producing wear in total knee replacements. Clin Orthop Rel Res 273:253–260Google Scholar
  2. 2.
    D’Lima DD et al (2001) Polyethylene wear and variations in knee kinematics. Clin Orthop Rel Res 392/124–130Google Scholar
  3. 3.
    Kaufman KR et al (1996) Instrumented implant for measuring tibiofemoral forces. Journal of biomechanics. J Biomech 29:667–671PubMedGoogle Scholar
  4. 4.
    Perry J et al (1975) Analysis of knee-joint forces during flexed-knee stance. J Bone Joint Surg [Am] 57:961–967PubMedGoogle Scholar
  5. 5.
    Bergmann G et al (1993) Hip joint loading during walking and running, measured in two patients. J Biomech 26:969–990PubMedGoogle Scholar
  6. 6.
    Kotzar GM et al (1991) Telemeterized in vivo hip joint force data: a report on two patients after total hip surgery. J Orthop Res 9:621–633PubMedGoogle Scholar
  7. 7.
    Davy DT et al (1988) Telemetric force measurements across the hip after total arthroplasty. J Bone Joint Surg [Am] 70:45–50PubMedGoogle Scholar
  8. 8.
    Hodge WA et al (1989) Contact pressures from an instrumented hip endoprosthesis. J Bone Joint Surg [Am] 71:1378–1386PubMedGoogle Scholar
  9. 9.
    Rohlmann A et al (1995) Telemeterized load measurement using instrumented spinal internal fixators in a patient with degenerative instability. Spine 20:2683–2689PubMedGoogle Scholar
  10. 10.
    Taylor SJ et al (1998) The forces in the distal femur and the knee during walking and other activities measured by telemetry. J Arthroplasty 13/4:428–437CrossRefGoogle Scholar
  11. 11.
    Lutz GE et al (1993) Comparison of tibiofemoral joint forces during open-kinetic-chain and closed-kinetic-chain exercises. J Bone Joint Surg [Am] 75:732–739PubMedGoogle Scholar
  12. 12.
    Nisell R et al (1989) Tibiofemoral joint forces during isokinetic knee extension. Am J Sports Med 17:49–54PubMedGoogle Scholar
  13. 13.
    Collins JJ (1995) The redundant nature of locomotor optimization laws. J Biomech 28:251–267CrossRefPubMedGoogle Scholar
  14. 14.
    Wilk KE et al (1996) A comparison of tibiofemoral joint forces and electromyographic activity during open and closed kinetic chain exercises. Am J Sports Med 24:518–527PubMedGoogle Scholar
  15. 15.
    Li G et al (1998) Prediction of muscle recruitment and its effect on joint reaction forces during knee exercises. Ann Biomed Eng 26:725–733CrossRefPubMedGoogle Scholar
  16. 16.
    Li G et al (1999) Prediction of antagonistic muscle forces using inverse dynamic optimization during flexion/extension of the knee. J Biomech Eng 121:316–322PubMedGoogle Scholar
  17. 17.
    Seireg A et al (1973) A mathematical model for evaluation of forces in lower extremeties of the musculo-skeletal system. J Biomech 6:313–326CrossRefPubMedGoogle Scholar
  18. 18.
    Ellis MI et al (1984) Forces in the knee joint whilst rising from a seated position. J Biomed Eng 6:113–120PubMedGoogle Scholar
  19. 19.
    Kaufman KR et al (1991) Dynamic joint forces during knee isokinetic exercise. Am J Sports Med 19:305–316PubMedGoogle Scholar
  20. 20.
    An KN et al (1984) Determination of muscle and joint forces: a new technique to solve the indeterminate problem. J Biomech Eng 106:364–367PubMedGoogle Scholar
  21. 21.
    Crowninshield RD et al (1981) A physiologically based criterion of muscle force prediction in locomotion. J Biomech 14:793–801CrossRefPubMedGoogle Scholar
  22. 22.
    Pedersen DR et al (1987) Direct comparison of muscle force predictions using linear and nonlinear programming. J Biomech Eng 109:192–199PubMedGoogle Scholar
  23. 23.
    Herzog W et al (1991) Validation of optimization models that estimate the forces exerted by synergistic muscles. J Biomech 24[Suppl 1]:31–39CrossRefPubMedGoogle Scholar
  24. 24.
    Grady-Benson JC et al (1992) The influence of joint line location on tibiofemoral forces after total knee arthroplasty. Trans Orthop Res Soc 17:324–324Google Scholar
  25. 25.
    Singerman R et al (1999) In vitro forces in the normal and cruciate-deficient knee during simulated squatting motion. J Biomech Eng 121:234–242PubMedGoogle Scholar
  26. 26.
    D’Lima DD et al (1999) An implantable telemetry system to measure intra-articular tibial forces. Trans 45th Orthop Res Soc 24Google Scholar
  27. 27.
    D’Lima DD et al (2005) An implantable telemetry device to measure intra-articular tibial forces. J Biomech 38:299–304CrossRefPubMedGoogle Scholar
  28. 28.
    Stiehl JB et al (1999) In vivo determination of condylar lift-off and screw-home in a mobile-bearing total knee arthroplasty. J Arthroplasty 14:293–299CrossRefPubMedGoogle Scholar
  29. 29.
    Morris BA et al (2001) e-Knee: Evolution of the electronic knee prosthesis: Telemetry technology development. J Bone Joint Surg [Am] 83[Suppl 2]:62–66CrossRefPubMedGoogle Scholar
  30. 30.
    D’Lima DD et al (2004) In vitro and in vivo measurement of dynamic soft-tissue balance during total knee arthroplasty with an instrumental tibial prosthesis. Trans 50th Orthop Res Society 29:301Google Scholar

Copyright information

© Springer Medizin Verlag Heidelberg 2005

Authors and Affiliations

  • C. W. ColwellJr.
  • D. D. D’Lima

There are no affiliations available

Personalised recommendations