Skip to main content
SpringerLink
Log in

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

  • Published:
International Journal of Precision Engineering and Manufacturing Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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. 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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  MathSciNet  MATH  Google Scholar 

  10. Rönn, K., Reischl, N., Gautier, E., and Jacobi, M., “Current Surgical Treatment of Knee Osteoarthritis,” Arthritis, Vol. 2011, Article ID: 454873, 2011.

    Article  Google Scholar 

  11. Amis, A. A., “Biomechanics of High Tibial Osteotomy,” Knee Surgery, Sports Traumatology, Arthroscopy, Vol. 21, No. 1, pp. 197–205, 2013.

    Article  Google Scholar 

  12. Richmond, J. C., “Surgery for Osteoarthritis of the Knee,” Rheumatic Disease Clinics of North America, Vol. 34, No. 3, pp. 815–825, 2008.

    Article  Google Scholar 

  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. 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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  MathSciNet  Google Scholar 

  24. De Leva, P., “Adjustments to Zatsiorsky-Seluyanov’s Segment Inertia Parameters,” Journal of Biomechanics, Vol. 29, No. 9, pp. 1223–1230, 1996.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Mechanical Engineering, Kyung Hee University, 1732, Deogyeong-daero, Giheung-gu, Yongin-si, Gyeonggi-do, 17104, South Korea

    Tserenchimed Purevsuren & Yoon Hyuk Kim

  2. Department of Applied Mathematics, Kyung Hee University, 1732, Deogyeong-daero, Giheung-gu, Yongin-si, Gyeonggi-do, 17104, South Korea

    Kyungsoo Kim

  3. Department of Orthopaedic Surgery, Inje University, Ilsan Paik Hospital, 170, Juhwa-ro, Ilsanseo-gu, Goyang-si, Gyeonggi-do, 10380, South Korea

    Kyung Wook Nha

Authors
  1. Tserenchimed Purevsuren
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kyungsoo Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kyung Wook Nha
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yoon Hyuk Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yoon Hyuk Kim.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Purevsuren, T., Kim, K., Nha, K.W. et al. 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. Int. J. Precis. Eng. Manuf. 17, 1365–1370 (2016). https://doi.org/10.1007/s12541-016-0162-1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12541-016-0162-1

Keywords

Search

Navigation