Knee Biomechanics and Materials

  • Malcolm H. Pope
  • Braden C. Fleming


“Biomechanics is the study of forces and the effects that these forces have on the human body” (LeVeau 1984). From the orthopaedist’s perspective, there is a normal equilibrium between mechanical stress on the musculoskeletal system and its response to that stress. Any disturbance to this balance will eventually result in remodeling, degeneration, or failure of a structure. Within the realm of total knee replacement, it is necessary to understand fully the biomechanics of the normal joint since the objective of total knee arthroplasty is to re-establish normal joint function.


Anterior Cruciate Ligament Total Knee Arthroplasty Knee Joint Tibial Plateau Total Knee Replacement 
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.


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  1. Andriacchi T (1988) Biomechanics and gait analysis in total knee replacement. Orthop Rev 17: 470–473PubMedGoogle Scholar
  2. Andriacchi T, Galante J, Fermier R (1982) The influence of total knee replacement design on walking and stair climbing. J Bone Joint Surg (Am) 65: 1328–1335Google Scholar
  3. Balazs E, Gibbs D (1970) Chemistry and molecular biology of the intercellular matrix. Academic Press, New York, pp 1241–1253Google Scholar
  4. Barbos M, Benvenuti A (1983) Metallic debris arising from prosthetic abrasion: An investigation of biodégradation of the materials and physiology of bone. Ital J Orthop Traumatol 9: 377–386Google Scholar
  5. Bartel D, Burstein A, Santavicca E, Insall J (1982) Performance of the tibial component in total knee replacement. J Bone Joint Surg (Am) 64: 1026–1033Google Scholar
  6. Beaupre G, Vasu R, Carter C, Schurman D (1986) Epiphy- seal-based designs for tibial plateau components. II. Stress analysis in the sagittal plane. J Biomech 19: 663–673Google Scholar
  7. Bennett G, Waine H, Bauer W (1942) Changes in the knee joint at various ages. The Commonwealth Fund, New YorkGoogle Scholar
  8. Blaha J, Freeman M, Revell P, Todd R (1982) The fixation of a proximal tibial polyethylene prosthesis without cement. J Bone Joint Surg (Br) 64: 326–335Google Scholar
  9. Bobyn J, Cameron H, Abdulla D, Pilliar R, Weatherly C (1982) Biologic fixation and bone modeling with an unconstrained canine total knee prosthesis. Clin Orthop 166: 301–312PubMedGoogle Scholar
  10. Bourne R, Finlay J, Cohn N (1981) Principal strain in the human tibia before and after total knee arthroplasty. Trans Orthop Res Soc 6: 160Google Scholar
  11. Brostrom L, Gillquist J, Liljedahl S, Lindvall N (1968) Treatment of old ruptures of the anterior cruciate ligament. Lakartidmingen 65: 4479–4487Google Scholar
  12. Bullough P, Goodfellow J (1968) The significance of the fine structure of the articular cartilage. J Bone Joint Surg (Br) 50: 852–857Google Scholar
  13. Bullough P, Munuera L, Murphy J, Weinstein A (1970) The strength of the menisci as it relates to fine structure. J. Bone Joint Surg (Br) 52: 564–570Google Scholar
  14. Calderale P, Scelfo G (1987) A mathematical model of thelocomotor apparatus. Eng Med 16: 147–161PubMedCrossRefGoogle Scholar
  15. Cheal E, Hayes W, Lee C, Snyder B, Miller J (1985) Stress analysis of a condylar knee tibial component: Influence of metaphyseal shell properties and cement injection depth. J Orthop Res 3: 424–434Google Scholar
  16. Collopy M, Murray M, Gardner G, DiUlio R, Gore D (1977) Kinesiology measurements of functional performance before and after Geometric total knee replacement: One year follow-up of twenty cases. Clin Orthop 126: 196–202Google Scholar
  17. Connelly G, Rimnac C, Wright T, Hertzberg R, Manson J (1984) Fatigue crack propagation behavior of ultra high molecular weight polyethylene. J Orthop Res 2: 119–125PubMedCrossRefGoogle Scholar
  18. Fleming B, Stein A, Howe J, Pope M (1987) An in vitro comparative study of total knee arthroplasties. Trans Rehabil Eng Soc N Am 10: 256Google Scholar
  19. Fung Y (1981) Bone and cartilage. In: Biomechanics: Mechanical properties of living tissues. Springer-Verlag, New York, pp 383–413Google Scholar
  20. Garg A, Walker P (1986) The effect of the interface on the bone stresses beneath tibial components. J Biomech 19: 957–967PubMedCrossRefGoogle Scholar
  21. Goodfellow J, Bullough P (1967) The pattern of aging of the articular cartilage of the elbow joint. J Bone Joint Surg (Br) 49: 175–181Google Scholar
  22. Goodfellow J, Oconnor J (1978) The mechanics of the knee and prosthesis design. J Bone Joint Surg (Br) 60: 358–369Google Scholar
  23. Greenwald A, Black J, Matejczyk M (1981) Total knee replacement. In: The AOSS instructional course lectures, 30, pp 301–341Google Scholar
  24. Harrington I (1976) A bioengineering analysis of force actions at the knee in normal and pathological gait. J Biomed Eng 98: 167–172Google Scholar
  25. Harrison M, Scajowicz F, Trueta J (1953) Osteoarthritis of the hip: A study of the nature and evolution of the disease. J Bone Joint Surg (Br) 35: 598–626Google Scholar
  26. Hood R, Wright T, Burstein A (1983) Retrieval analysis total knee prostheses: A method and its application to 48 total condylar prostheses. J Biomed Mater Res 17: 829–842PubMedCrossRefGoogle Scholar
  27. Huson A (1974) Biomechanische Probleme des Kniegelenks.Orthopaede 3: 119–126Google Scholar
  28. Johnson J, Krug W, Nahon D, Miller J, Ahmed A (1983) An evaluation of the load bearing capability of the cancellous proximal tibia with special interest to the design of knee implants. Trans Orthop Res Soc 8: 403Google Scholar
  29. Kapandji I (1970) The knee. In: The physiology of the joints, Vol. 2, Churchill Livingstone, New York, pp 72–135Google Scholar
  30. Kettlekamp D, Chao E (1972) A method for quantitative analysis of medial and lateral compression forces at the knee during standing. Clin Orthop 83: 202–213CrossRefGoogle Scholar
  31. Kettlekamp D, Jacob A (1972) Tibiofemoral contact area - determination and implications. J Bone Joint Surg (Am) 54: 349–356Google Scholar
  32. King R (1966) On the viscosity of synovial fluids. Rheol Acta 1: 41–44CrossRefGoogle Scholar
  33. Landy M, Walker P (1985) Wear in condylar replacement knees: A ten year follow-up. Trans Orthop Res Soc 10: 96Google Scholar
  34. Laskin R (1988) Tricon-M uncemented total knee arthroplasty. A review of 96 knees followed for longer than 2 years. J Arthroplasty 3 (l): 27–38PubMedCrossRefGoogle Scholar
  35. Le Veau B (1984) Biomechanics. A summary of perspectives.Phys Ther 64: 1812Google Scholar
  36. Lewis J, Galante J (1985) Workshop on the bone-joint implant interface. J Orthop Res 3: 380–386PubMedCrossRefGoogle Scholar
  37. Lewis J, Jaycox D, Wang O (1977) Stress analysis of some features of knee prostheses by finite elements. Trans Orthop Res Soc 2: 55Google Scholar
  38. Liljedahl S, Nordstrand A (1969) Injuries to the ligaments of the knee. Injury 1: 17–24CrossRefGoogle Scholar
  39. Manley M, Stulberg B, Stern L, Watson J, Stulberg S (1987) Direct observation of micromotion at the implant bone interface with cemented and noncemented tibial components. Trans Orthop Res Soc 12: 436Google Scholar
  40. Maquet P (1984a) Mechanics of the knee. In: Biomechanics of the knee, 2nd ed. Springer-Verlag, New York, pp 9–74CrossRefGoogle Scholar
  41. Maquet P (1984b) The pathomechanics of osteoarthritis of the knee. In: Biomechanics of the knee, 2nd ed. Springer- Verlag, New York, pp 75–131CrossRefGoogle Scholar
  42. Mathur P, McDonald J, Ghormley R (1949) A study of the tensile strength of menisci. J Bone Joint Surg (Am) 31: 650–654Google Scholar
  43. Matsen FA, Sidles J, Laskin RS, Gabrini M (1988) The effects of joint line position in total knee replacement. Trans of the 54th Annual Meeting of the American Academy of Orthopaedic Surgeons, p 42Google Scholar
  44. Mears D (1979) Mechanical behaviors of real materials. In: Materials in Orthopaedic surgery, 1st ed. Williams Wilkins, Baltimore, pp 92–106Google Scholar
  45. Mena D, Mansour J, Simon S (1981) Analysis and synthesis of human swing leg motion during gait and its clinical applications. B Biomech 14: 823–832CrossRefGoogle Scholar
  46. Menschik A (1974) Mechanik des Kniegelenkes: I. Z Orthop 112: 481–495PubMedGoogle Scholar
  47. Miegel R, Walker P, Nelson P . (1986) A compliant interface for total knee arthroplasty. J Orthop Res 4:486– 493Google Scholar
  48. Mikosz R (1985) Mathematical model for the study of forces in the human knee joint during locomotion. University of Illinois, Chicago. ThesisGoogle Scholar
  49. Mikosz R, Andriacchi T, Andersson G (1988) Analysis of factors influencing the prediction of muscle forces at the knee. J Orthop Res 6: 205–214PubMedCrossRefGoogle Scholar
  50. Miller J (1989) Fixation in total knee arthroplasty. In: Insall J (ed) Surgery of the knee. Churchill Livingstone, New York, pp 717–728Google Scholar
  51. Minns R (1981) Forces at the knee joint: anatomical considerations. J Biomech 14: 633–643PubMedCrossRefGoogle Scholar
  52. Mirra J, Amstutz H, Matos M, Gold R (1976) The pathology of the joint tissues and its clinical relevance in prosthesis failure. Clin Orthop 117: 221–240PubMedGoogle Scholar
  53. Mirra J, Marder R, Amstutz H (1982) The pathology of failed total joint arthroplasty. Clin Orthop 170: 175–183PubMedGoogle Scholar
  54. Miura H, Whitesides L, Easley J, Amador D (1988) Effects of screws and sleeve on initial fixation in uncemented total knee tibial component. Pamphlet from the DePaul Biomechanics Laboratories, 12255 DePaul Drive, Bridgeton, MO, 63044Google Scholar
  55. Morrison J (1968) Bioengineering analysis of force actions transmitted by the knee joint. J Biomed Eng 2: 164–170Google Scholar
  56. Morrison J (1970a) The function of the knee joint in various activities. B Biomed Eng 4: 573–580Google Scholar
  57. Morrison J (1970b) The mechanics of the knee joint during normal walking. J Biomech 3: 51–61PubMedCrossRefGoogle Scholar
  58. Muller W (1938) Kinematics. In: The knee: form, function, and ligament reconstruction. Springer-Verlag, New York, pp 8–28Google Scholar
  59. Nisell R (1985) On the biomechanics of the knee. Acta Orthop Scand 216: 11Google Scholar
  60. Palmer I (1938) On the injuries to the ligaments of the knee joint. Acta Chir Scand 81 [Suppl] 53Google Scholar
  61. Rittman N, Kettlekamp D, Pryor P, Schwartzkopf G, Hill- berry B (19181) Analysis of patterns of knee motion walking for four types of total knee implants. Clin Orthop 155: 111–117Google Scholar
  62. Rose R, Crugnola A, Reis M . (1979) On the origins of high in vivo wear rates in polyethylene components in total joint prostheses. Clin Orthop 145: 277–286PubMedGoogle Scholar
  63. Rostoker W, Chao E, Galante J (1978) The appearance of wear on polyethylene - A comparison of in vivo and in vitro wear surfaces. J Biomed Mater Res 12: 317–335PubMedCrossRefGoogle Scholar
  64. Ryd L, Lindstrand A, Rosenquist R, Selrik G (1986) Tibial component fixation in knee arthroplasty. Clin Orthop 213: 141–149PubMedGoogle Scholar
  65. Seedhom B, Dowson D, Wright V, Longton E (1972) A technique for the study of geometry and contact in normal and artificial knee joints. Wear 20: 189–199CrossRefGoogle Scholar
  66. Seireg A, Arvikar R (1975) The prediction of Musculoskeletal load sharing and joint forces in the lower extremities during walking. J Biomech 8: 89–102PubMedCrossRefGoogle Scholar
  67. Shoemaker S, Markolf K, Finerman G (1982) In vitro stability of the implanted total condylar prosthesis. J Bone Joint Surg (Am) 64: 1201–1213Google Scholar
  68. Simon S, Paul I, Mansour J, Munro M, Abernethy P, Radin E (1981) Peak dynamic force in human gait. J Biomech 14: 817–822PubMedCrossRefGoogle Scholar
  69. Simon S, Trieshmann H, Burdett R, Ewald F, Sledge C (1983) Quantitative gait analysis after total knee arthroplasty for monarticular degenerative arthritis. J Bone Joint Surg (Am) 65: 605–613Google Scholar
  70. Stein A, Fleming B, Howe J, Pope M (1987) Total knee arthroplasty kinematics: An in vivo evaluation of four different designs. J Arthroplasty [Suppl] S31–S36Google Scholar
  71. Thatcher J, Zhou X, Walker P (1987) Inherent laxity in total knee prostheses. J Arthroplasty 2 (3): 199–206PubMedCrossRefGoogle Scholar
  72. Townsend P, Diamond R, Wyatt P (1979) Aspects of tibial plateau design: Condyle and stem deflections by micromotion and photo-elastic analysis. Trans Orthop Res Soc 4: 251Google Scholar
  73. Treharne R, Young R, Young S (1981) Wear of artificial joint materials III: Simulation of the knee joint using a computer controlled system. Eng Med 10: 137–142Google Scholar
  74. Vainionpaa S, Laike E, Kirves P, Tiusanen P (1981) Tibial osteotomy for osteoarthritis of the knee. J Bone Joint Surg (Am) 63: 938–946Google Scholar
  75. Vasu R, Carter D, Schurman D, Beaupre G (1986) Epiphy- seal-based designs for tibial plateau components. I. Stress analysis in the frontal plane. J Biomech 19: 647–662Google Scholar
  76. Walker P (1977a) Friction and wear in artificial joints. In: Human joints and their artificial replacements. Thomas, Illinois, pp 368–422Google Scholar
  77. Walker P (1977b) Lubrication and degeneration. In: Human joints and their artificial replacements. Thomas, Illinois, pp 211–252Google Scholar
  78. Walker P (1989) Requirements for successful total knee replacements. Design considerations. Orthop Clin N Am 20: 15–29Google Scholar
  79. Walker P, Hajek J (1972) The load-bearing areas in the knee joint. J Biomech 5: 581–589PubMedCrossRefGoogle Scholar
  80. Walker P, Hsieh H (1977) Conformity in condylar replacement knee prostheses. J Bone Joint Surg (Br) 59: 222–228Google Scholar
  81. Walker P, Seitelman D (1978) The interdependence of rotational stiffness and contact stress in condylar replacement knee prostheses. Trans Orthop Res Soc 3: 152Google Scholar
  82. Walker P, Zhou X (1987) The dilemma of surface design in total knee replacement. Trans Orthop Res Soc 12: 291Google Scholar
  83. Walker P, Reilly D, Ben-Dov M (1980) Load transfer in the upper femur before and after tibial component attachment. Trans Orthop Res Soc 5: 16Google Scholar
  84. Walker P, Greene D, Reilly D . (1981) Fixation of tibial components of prostheses. J Bone Joint Surg (Am) 63: 258–267Google Scholar
  85. Whittle M (1985) Dynamic assessment of knee joint function. Eng Med 15 (2): 71–75CrossRefGoogle Scholar
  86. Wismans J, Veldpaus F, Janssen J, Huson A, Struben P (1980) A three dimensional mathematical model of the knee joint. J Biomech 13: 677–685PubMedCrossRefGoogle Scholar
  87. Wright T, Bartel D (1986) The problem of surface damage in polyethylene total knee components. Clin Orthop 205: 67–74PubMedGoogle Scholar
  88. Wright T, Fukubayashi T, Burstein A (1981) The effect of carbon fiber reinforcement on contact area, contact pressure, and time dependent deformation in polyethylene tibial components. J Biomed Mater Res 15: 719–730PubMedCrossRefGoogle Scholar
  89. Wright T, Rimnac C, Faris P, Bansel M (1988) Analysis of surface damage in retrieved carbon fiber reinforced and plain polyethylene tibial components from posterior stabilized tibial components. J Bone Joint Surg (Am) 0: 1312–1319Google Scholar

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© Springer-Verlag London Limited 1991

Authors and Affiliations

  • Malcolm H. Pope
  • Braden C. Fleming

There are no affiliations available

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