Log in

Analysis of Contact Pressure at Knee Cartilage during Gait with Respect to Foot Progression Angle

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

Abstract

One of the main causes that make knee osteoarthritis (OA) worse is load concentration at the medial compartment of knee cartilage. It is alternatively measured by employing knee adduction moment (KAM). Since toe-in gait decreases the 1st peak of KAM, it has been considered as a non-surgical prevention of OA progressing. However, direct measures such as contact pressure at knee cartilage in motion have not been available so far. Obtaining contact pressure at knee cartilage by FE analysis is difficult because exact muscle forces are not available and because FE model should be reconstructed at every stance phase. To obtain contact pressure at knee cartilage during gait, a method employing FE analysis based on motion analysis has been used in this study. Reference FE model of lower extremities was constructed and transformed to specific stance phases of gait. Ground reaction forces and muscle forces from motion analysis were employed as loading conditions. Finally, contact pressure distributions on knee cartilage at 1st peak, mid stance, 2nd peak could be obtained with respect to foot progression angle. The result shows that toe-in gait could be effective for knee OA patients by dispersing contact pressure concentrated in medial knee compartment to lateral part.

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

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price includes VAT (Spain)

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Ahlbäck, S., Bauer, G. C., and Bohne, W. H., “Spontaneous Osteonecrosis of the Knee,” Arthritis & Rheumatology, vol. 11, no. 6, pp. 705–733, 1968.

    Article  Google Scholar 

  2. Schipplein, O. D. and Andriacchi, T. P., “Interaction between Active and Passive Knee Stabilizers during Level Walking,” Journal of Orthopaedic Research, vol. 9, no. 1, pp. 113–119, 1991.

    Article  Google Scholar 

  3. 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 

  4. Guo, M., Axe, M. J., and Manal, K., “The Influence of Foot Progression Angle on the Knee Adduction Moment during Walking and Stair Climbing in Pain Free Individuals with Knee Osteoarthritis,” Gait & Posture, vol. 26, no. 3, pp. 436–441, 2007.

    Article  Google Scholar 

  5. Jenkyn, T. R., Hunt, M. A., Jones, I. C., Giffin, J. R., and Birmingham, T. B., “Toe-Out Gait in Patients with Knee Osteoarthritis Partially Transforms External Knee Adduction Moment into Flexion Moment during Early Stance Phase of Gait: A Tri-Planar Kinetic Mechanism,” Journal of Biomechanics, vol. 41, no. 2, pp. 276–283, 2008.

    Article  Google Scholar 

  6. 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 

  7. Miyazaki, T., Wada, M., Kawahara, H., Sato, M., Baba, H., and Shimada, S., “Dynamic Load at Baseline Can Predict Radiographic Disease Progression in Medial Compartment Knee Osteoarthritis,” Annals of the Rheumatic Diseases, vol. 61, no. 7, pp. 617–622, 2002.

    Article  Google Scholar 

  8. Shull, P. B., Shultz, R., Silder, A., Dragoo, J. L., Besier, T. F., et al., “Toe-in Gait Reduces the First Peak Knee Adduction Moment in Patients with Medial Compartment Knee Osteoarthritis,” Journal of Biomechanics, vol. 46, no. 1, pp. 122–128, 2013.

    Article  Google Scholar 

  9. Simic, M., Wrigley, T., Hinman, R., Hunt, M., and Bennell, K., “Altering Foot Progression Angle in People with Medial Knee Osteoarthritis: The Effects of Varying Toe-in and Toe-out Angles are Mediated by Pain and Malalignment,” Osteoarthritis and cartilage, vol. 21, no. 9, pp. 1272–1280, 2013.

    Article  Google Scholar 

  10. Jung, Y., Koo, Y.-J., and Koo, S., “Simultaneous Estimation of Ground Reaction Force and Knee Contact Force during Walking and Squatting,” International Journal of Precision Engineering and Manufacturing, vol. 18, no. 9, pp. 1263–1268, 2017.

    Article  Google Scholar 

  11. Purevsuren, T., Kim, K., Nha, K.W., and Kim, Y. H., “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,” International Journal of Precision Engineering and Manufacturing, vol. 17, no. 10, pp. 1365–1370, 2016.

    Article  Google Scholar 

  12. Shin, S. H., Seo, S. B., Yu, M., Jeong, H. C., Cho, K. S., et al., “Muscle Activity Analysis of Lower Limb Training for Early Rehabilitation Cycling System in Supine Position,” Journal of the Korean Society for Precision Enngineering, vol. 33, no. 9, pp. 753–760, 2016.

    Article  Google Scholar 

  13. Seo, H., Jung, H., Jung, D., and Lim, D., “Characteristics of Ankle Strategy Responses to Dynamic Tilting Perturbations,” Journal of the Korean Society for Precision Engineering, vol. 35, no. 2, pp. 203–210, 2018.

    Article  Google Scholar 

  14. Ko, C.-Y., Ko, J., Kim, H. J., and Lim, D., “New Wearable Exoskeleton for Gait Rehabilitation Assistance Integrated with Mobility System,” International Journal of Precision Engineering and Manufacturing, vol. 17, no. 7, pp. 957–964, 2016.

    Article  Google Scholar 

  15. Rutherford, D. J., Hubley-Kozey, C. L., Deluzio, K. J., Stanish, W. D., and Dunbar, M., “Foot Progression Angle and the Knee Adduction Moment: A Cross-Sectional Investigation in Knee Osteoarthritis,” Osteoarthritis and Cartilage, vol. 16, no. 8, pp. 883–889, 2008.

    Article  Google Scholar 

  16. Bencke, J., Christiansen, D., Jensen, K., Okholm, A., Sonne-Holm, S., and Bandholm, T., “Measuring Medial Longitudinal Arch Deformation during Gait. A Reliability Study,” Gait & Posture, vol. 35, no. 3, pp. 400–404, 2012.

    Article  Google Scholar 

  17. Chen, G., Li, X.-C., Wu, G.-Q., Zhang, S.-X., **ong, X.-F., et al., “Three-Dimensional Reconstruction of Digitized Human Liver: Based on Chinese Visible Human,” Chinese Medical Journal, vol. 123, no. 2, pp. 146–150, 2010.

    Google Scholar 

  18. Yasuda, K., van Eck, C. F., Hoshino, Y., Fu, F. H., and Tashman, S., “Anatomic Single-and Double-Bundle Anterior Cruciate Ligament Reconstruction, Part 1: Basic Science,” The American Journal of Sports Medicine, vol. 39, no. 8, pp. 1789–1800, 2011.

    Article  Google Scholar 

  19. Claes, S., Vereecke, E., Maes, M., Victor, J., Verdonk, P., and Bellemans, J., “Anatomy of the Anterolateral Ligament of the Knee,” Journal of Anatomy, vol. 223, no. 4, pp. 321–328, 2013.

    Article  Google Scholar 

  20. Kiapour, A., Kiapour, A. M., Kaul, V., Quatman, C. E., Wordeman, S. C., et al., “Finite Element Model of the Knee for Investigation of Injury Mechanisms: Development and Validation,” Journal of Biomechanical Engineering, Vol. 136, No. 1, Paper No. 011002, 2014.

    Google Scholar 

  21. Attarian, D. E., McCrackin, H. J., DeVito, D. P., McElhaney, J. H., and Garrett Jr, W. E., “Biomechanical Characteristics of Human Ankle Ligaments,” Foot & Ankle, vol. 6, no. 2, pp. 54–58, 1985.

    Article  Google Scholar 

  22. Siegler, S., Block, J., and Schneck, C. D., “The Mechanical Characteristics of the Collateral Ligaments of the Human Ankle Joint,” Foot & Ankle, vol. 8, no. 5, pp. 234–242, 1988.

    Article  Google Scholar 

  23. Corazza, F., O’connor, J., Leardini, A., and Castelli, V. P., “Ligament Fibre Recruitment and Forces for the Anterior Drawer Test at the Human Ankle Joint,” Journal of Biomechanics, vol. 36, no. 3, pp. 363–372, 2003.

    Article  Google Scholar 

  24. Butler, D. L., Kay, M. D., and Stouffer, D. C., “Comparison of Material Properties in Fascicle-Bone Units from Human Patellar Tendon and Knee Ligaments,” Journal of Biomechanics, vol. 19, no. 6, pp. 425–432, 1986.

    Article  Google Scholar 

  25. Quapp, K. and Weiss, J., “Material Characterization of Human Medial Collateral Ligament,” Journal of Biomechanical Engineering, vol. 120, no. 6, pp. 757–763, 1998.

    Article  Google Scholar 

  26. Shirazi, R., Shirazi-Adl, A., and Hurtig, M., “Role of Cartilage Collagen Fibrils Networks in Knee Joint Biomechanics under Compression,” Journal of Biomechanics, vol. 41, no. 16, pp. 3340–3348, 2008.

    Article  Google Scholar 

  27. Fukubayashi, T. and Kurosawa, H., “The Contact Area and Pressure Distribution Pattern of the Knee: A Study of Normal and Osteoarthrotic Knee joints,” Acta Orthopaedica Scandinavica, vol. 51, Nos. 1–6, pp. 871–879, 1980.

    Article  Google Scholar 

  28. Kurosawa, H., Fukubayashi, T., and Nakajima, H., “Load-Bearing Mode of the Knee Joint: Physical Behavior of the Knee Joint with or without Menisci,” Clinical Orthopaedics and Related Research, no. 149, pp. 283–290, 1980.

    Google Scholar 

  29. Krause, W. R., Pope, M. H., Johnson, R. J., and Wilder, D. G., “Mechanical Changes in the Knee after Meniscectomy,” The Journal of Bone and Joint Surgery. American Volume, vol. 58, no. 5, pp. 599–604, 1976.

    Article  Google Scholar 

  30. Walker, P. S. and Erkman, M. J., “The Role of the Menisci in Force Transmission Across the Knee,” Clinical Orthopaedics and Related Research, no. 109, pp. 184–192, 1975.

    Article  Google Scholar 

  31. Inaba, H. I., Arai, M. A., and Watanabe, W. W., “Influence of the Varus-Valgus Instability on the Contact of the Femoro-Tibial Joint,” Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine, vol. 204, no. 1, pp. 61–64, 1990.

    Article  Google Scholar 

  32. Anderson, D. D., Goldsworthy, J. K., Li, W., Rudert, M. J., Tochigi, Y., and Brown, T. D., “Physical Validation of a Patient-Specific Contact Finite Element Model of the Ankle,” Journal of Biomechanics, vol. 40, no. 8, pp. 1662–1669, 2007.

    Article  Google Scholar 

  33. Park, S., Shim, J., Yoon, J. R., and Chae, S.-W., “Assessment of Stresses at the Lower Extremity Joints Wearing Laterally Wedged Insoles,” International Journal of Precision Engineering and Manufacturing, vol. 18, no. 3, pp. 325–331, 2017.

    Article  Google Scholar 

  34. Hurwitz, D. E., Ryals, A. B., Case, J. P., Block, J. A., and Andriacchi, T. P., “The Knee Adduction Moment during Gait in Subjects with Knee Osteoarthritis is More Closely Correlated with Static Alignment than Radiographic Disease Severity, Toe out Angle and Pain,” Journal of Orthopaedic Research, vol. 20, no. 1, pp. 101–107, 2002.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Soo-Won Chae.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yoon, J., Ha, S., Lee, S. et al. Analysis of Contact Pressure at Knee Cartilage during Gait with Respect to Foot Progression Angle. Int. J. Precis. Eng. Manuf. 19, 761–766 (2018). https://doi.org/10.1007/s12541-018-0091-2

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12541-018-0091-2

Keywords

Navigation