Computational analysis of knee joint stability following total knee arthroplasty |
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| Institution: | 1. The Biomechanics Group, Department of Mechanical Engineering, Imperial College London, London, UK;2. Corin Ltd, Cirencester, UK;3. Department of Orthopaedic Surgery, Ziekenhuis Oost-Limburg, Genk, Belgium;4. Department of Orthopaedic Surgery, UZ Ghent, Ghent, Belgium;5. The Musculoskeletal Surgery Lab, Department of Surgery and Cancer, Imperial College London, London, UK;1. Department of Biomechanics, University of Nebraska at Omaha, Omaha, NE 68182, USA;2. Division of Physical Therapy Education, University of Nebraska Medical Center, Omaha, NE 68198, USA;3. Miller Orthopedic Specialists, Council Bluffs, IA 51503, USA;1. State Key Laboratory for Manufacturing System Engineering, School of Mechanical Engineering, Xi''an Jiaotong University, Xi''an, China;2. Medical and Biological Engineering, School of Engineering, University of Hull, Hull, UK;3. Institute of Medical and Biological Engineering, School of Mechanical Engineering, University of Leeds, Leeds, UK |
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| Abstract: | The overall objective of this study was to introduce knee joint power as a potential measure to investigate knee joint stability following total knee arthroplasty (TKA). Specific aims were to investigate whether weakened knee joint stabilizers cause abnormal kinematics and how it influences the knee joint kinetic (i.e., power) in response to perturbation.Patient-specific musculoskeletal models were simulated with experimental gait data from six TKA patients (baseline models). Muscle strength and ligament force parameter were reduced by up to 30% to simulate weak knee joint stabilizers (weak models). Two different muscle recruitment criteria were tested to examine whether altered muscle recruitment pattern can mask the influence of weakened stabilizers on the knee joint kinematics and kinetics. Level-walking knee joint kinematics and kinetics were calculated though force-dependent kinematic and inverse dynamic analyses. Bode analysis was then recruited to estimate the knee joint power in response to a simulated perturbation.Weak models resulted in larger anterior-posterior (A-P) displacement and internal-external (I-E) rotation compared to baseline (I-E: 18.4 ± 8.5 vs. 11.6 ± 5.7 (deg), A-P: 9.7 ± 5.6 vs. 5.5 ± 4.1 (mm)). Changes in muscle recruitment criterion however altered the results such that A-P and I-E were not notably different from baseline models. In response to the simulated perturbation, weak models versus baseline models generated a delayed power response with unbounded magnitudes. Perturbed power behavior of the knee remained unaltered regardless of the muscle recruitment criteria.In conclusion, impairment at the knee joint stabilizers may or may not lead to excessive joint motions but it notably affects the knee joint power in response to a perturbation. Whether perturbed knee joint power is associated with the patient-reported outcome requires further investigation. |
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| Keywords: | Total knee arthroplasty Instability Knee kinematics Gait Bode analysis |
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