Model analysis of factors influencing the prediction of muscle forces at the knee.

A three-dimensional stochastic mathematical muscle model of the knee joint has been developed and applied to a study in which the influence of both mechanical and physiological factors were examined in relation to the prediction of muscular forces about the joint. The model includes a representation of the proximal portion of the tibia and distal portion of the femur along with a mathematical expression of the patellar mechanism and 13 muscles crossing the knee joint. The model accounts for the rolling and gliding movement of the tibial-femoral articulation. The computational technique involves equilibrating three components of external moments at the knee joint to the internal moments generated by muscular forces and soft tissue. The variables contained in the moment equilibrium equation are randomly chosen based on the choice of the tibial-femoral contact point. The randomness of the variables, reflected in the final solution, defines a stochastic process in the context of the present model. Studies with the model indicated that a very important mechanical aspect of the model was the capability to simulate the moving contact point between the tibia and femur. The moving contact point increased the mechanical advantage of the quadriceps muscles by 50%, which corresponded to in vivo EMG measurements. Muscle force predictions during normal gait have shown the capability of the model to determine the presence of synergistic and antagonistic muscle action.