Knee Load Distribution in Hip Osteoarthritis Patients After Total Hip Replacement
Reduced external knee adduction moments in the second half of stance after total hip replacement have been reported in hip osteoarthritis patients. This reduction is thought to shift the load from the medial to the lateral knee compartment and as such increase the risk for knee osteoarthritis. The k...
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doaj-9ed51be1d29b4c0989c7803f38d8154c2020-11-25T03:40:09ZengFrontiers Media S.A.Frontiers in Bioengineering and Biotechnology2296-41852020-09-01810.3389/fbioe.2020.578030578030Knee Load Distribution in Hip Osteoarthritis Patients After Total Hip ReplacementStefan van Drongelen0Mariska Wesseling1Jana Holder2Andrea Meurer3Felix Stief4Felix Stief5Dr. Rolf M. Schwiete Research Unit for Osteoarthritis, Orthopaedic University Hospital Friedrichsheim gGmbH, Frankfurt, GermanyHuman Movement Biomechanics Research Group, Department of Movement Sciences, KU Leuven, Leuven, BelgiumOrthopaedic University Hospital Friedrichsheim gGmbH, Frankfurt, GermanyOrthopaedic University Hospital Friedrichsheim gGmbH, Frankfurt, GermanyOrthopaedic University Hospital Friedrichsheim gGmbH, Frankfurt, GermanyGoethe University Frankfurt, Frankfurt, GermanyReduced external knee adduction moments in the second half of stance after total hip replacement have been reported in hip osteoarthritis patients. This reduction is thought to shift the load from the medial to the lateral knee compartment and as such increase the risk for knee osteoarthritis. The knee adduction moment is a surrogate for the load distribution between the medial and lateral compartments of the knee and not a valid measure for the tibiofemoral contact forces which are the result of externally applied forces and muscle forces. The purpose of this study was to investigate whether the distribution of the tibiofemoral contact forces over the knee compartments in unilateral hip osteoarthritis patients 1 year after receiving a primary total hip replacement differs from healthy controls. Musculoskeletal modeling on gait was performed in OpenSim using the detailed knee model of Lerner et al. (2015) for 19 patients as well as for 15 healthy controls of similar age. Knee adduction moments were calculated by the inverse dynamics analysis, medial and lateral tibiofemoral contact forces with the joint reaction force analysis. Moments and contact forces of patients and controls were compared using Statistical Parametric Mapping two-sample t-tests. Knee adduction moments and medial tibiofemoral contact forces of both the ipsi- and contralateral leg were not significantly different compared to healthy controls. The contralateral leg showed 14% higher medial tibiofemoral contact forces compared to the ipsilateral (operated) leg during the second half of stance. During the first half of stance, the lateral tibiofemoral contact force of the contralateral leg was 39% lower and the ratio 32% lower compared to healthy controls. In contrast, during the second half of stance the forces were significantly higher (39 and 26%, respectively) compared to healthy controls. The higher ratio indicates a changed distribution whereas the increased lateral tibiofemoral contact forces indicate a higher lateral knee joint loading in the contralateral leg in OA patients after total hip replacement (THR). Musculoskeletal modeling using a detailed knee model can be useful to detect differences in the load distribution between the medial and lateral knee compartment which cannot be verified with the knee adduction moment.https://www.frontiersin.org/article/10.3389/fbioe.2020.578030/fulljoint contact forcesmusculoskeletal modelingtotal hip replacementknee adduction momentwalkingosteoarthritis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Stefan van Drongelen Mariska Wesseling Jana Holder Andrea Meurer Felix Stief Felix Stief |
spellingShingle |
Stefan van Drongelen Mariska Wesseling Jana Holder Andrea Meurer Felix Stief Felix Stief Knee Load Distribution in Hip Osteoarthritis Patients After Total Hip Replacement Frontiers in Bioengineering and Biotechnology joint contact forces musculoskeletal modeling total hip replacement knee adduction moment walking osteoarthritis |
author_facet |
Stefan van Drongelen Mariska Wesseling Jana Holder Andrea Meurer Felix Stief Felix Stief |
author_sort |
Stefan van Drongelen |
title |
Knee Load Distribution in Hip Osteoarthritis Patients After Total Hip Replacement |
title_short |
Knee Load Distribution in Hip Osteoarthritis Patients After Total Hip Replacement |
title_full |
Knee Load Distribution in Hip Osteoarthritis Patients After Total Hip Replacement |
title_fullStr |
Knee Load Distribution in Hip Osteoarthritis Patients After Total Hip Replacement |
title_full_unstemmed |
Knee Load Distribution in Hip Osteoarthritis Patients After Total Hip Replacement |
title_sort |
knee load distribution in hip osteoarthritis patients after total hip replacement |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Bioengineering and Biotechnology |
issn |
2296-4185 |
publishDate |
2020-09-01 |
description |
Reduced external knee adduction moments in the second half of stance after total hip replacement have been reported in hip osteoarthritis patients. This reduction is thought to shift the load from the medial to the lateral knee compartment and as such increase the risk for knee osteoarthritis. The knee adduction moment is a surrogate for the load distribution between the medial and lateral compartments of the knee and not a valid measure for the tibiofemoral contact forces which are the result of externally applied forces and muscle forces. The purpose of this study was to investigate whether the distribution of the tibiofemoral contact forces over the knee compartments in unilateral hip osteoarthritis patients 1 year after receiving a primary total hip replacement differs from healthy controls. Musculoskeletal modeling on gait was performed in OpenSim using the detailed knee model of Lerner et al. (2015) for 19 patients as well as for 15 healthy controls of similar age. Knee adduction moments were calculated by the inverse dynamics analysis, medial and lateral tibiofemoral contact forces with the joint reaction force analysis. Moments and contact forces of patients and controls were compared using Statistical Parametric Mapping two-sample t-tests. Knee adduction moments and medial tibiofemoral contact forces of both the ipsi- and contralateral leg were not significantly different compared to healthy controls. The contralateral leg showed 14% higher medial tibiofemoral contact forces compared to the ipsilateral (operated) leg during the second half of stance. During the first half of stance, the lateral tibiofemoral contact force of the contralateral leg was 39% lower and the ratio 32% lower compared to healthy controls. In contrast, during the second half of stance the forces were significantly higher (39 and 26%, respectively) compared to healthy controls. The higher ratio indicates a changed distribution whereas the increased lateral tibiofemoral contact forces indicate a higher lateral knee joint loading in the contralateral leg in OA patients after total hip replacement (THR). Musculoskeletal modeling using a detailed knee model can be useful to detect differences in the load distribution between the medial and lateral knee compartment which cannot be verified with the knee adduction moment. |
topic |
joint contact forces musculoskeletal modeling total hip replacement knee adduction moment walking osteoarthritis |
url |
https://www.frontiersin.org/article/10.3389/fbioe.2020.578030/full |
work_keys_str_mv |
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