Internal kinetic changes in the knee due to high tibial osteotomy are well-correlated with change in external adduction moment: An osteoarthritic knee model

被引:24
作者
Bhatnagar, Timothy [2 ,3 ]
Jenkyn, Thomas R. [1 ,2 ,3 ,4 ]
机构
[1] Univ Western Ontario, Fac Engn, Dept Mech & Mat Engn, London, ON N6A 5B9, Canada
[2] Univ Western Ontario, Wolf Orthopaed Biomech Lab, Fowler Kennedy Sport Med Clin, London, ON N6A 5B9, Canada
[3] Univ Western Ontario, Fac Engn, Grad Program Biomed Engn, London, ON N6A 5B9, Canada
[4] Univ Western Ontario, Sch Kinesiol, Fac Hlth Sci, London, ON N6A 5B9, Canada
关键词
Knee osteoarthritis; Adduction moment; Optimization model; Gait analysis; Internal loading; Walking gait; GROUND-REACTION FORCE; FINITE-ELEMENT MODEL; IN-VIVO; TIBIOFEMORAL JOINT; WALKING SPEED; MUSCLE FORCES; CONTACT; KINEMATICS; SENSITIVITY; GAIT;
D O I
10.1016/j.jbiomech.2010.05.001
中图分类号
Q6 [生物物理学];
学科分类号
071011 [生物物理学];
摘要
In-vivo quantification of loads in the constitutive structures of the osteoarthritic knee can provide clinical insight, particularly when planning a surgery like the opening-wedge high tibial osteotomy (HTO). A computational knee model was created to estimate internal kinetics during walking gait. An optimization approach partitioned loads between the muscles, ligaments, medial and lateral contact surfaces of the tibial-femoral joint. Three kinetic measures were examined in 30 HTO patients: external knee adduction moment (EKAM), medial compartment load (ML) and the medial-to-lateral compartment loads ratio (MLR). Three time points were compared: immediately pre-HTO, 6 and 12 months post-HTO. Three hypotheses were tested: (1) HTO reduces an EKAM, an ML and an MLR, (2) these measures are not significantly different at 6 and 12 months post-HTO, and (3) the change in the impulse of EKAM due to a HTO is well-correlated with the impulse of an MLR. The three hypotheses were confirmed. First peak of an EKAM during stance phase was reduced significantly by 1.70% BW-ht. ML and MLR at the same instance were reduced significantly by 0.56%BW and 1.0, respectively. These measures were not significantly different between 6 and 12 months post-HID. Changes in impulse of an EKAM and an MLR were moderately well-correlated between the pre-HTO and 6 months post-HTO time points (R-2=0.5485). Therefore, the external measure EKAM-impulse is a good proxy of the internal kinetic measure of an MLR-impulse, explaining about 55% of the variance in the change due to a HTO intervention. (C) 2010 Elsevier Ltd. All rights reserved.
引用
收藏
页码:2261 / 2266
页数:6
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