McGibbon Chris A, Brandon Scott, Bishop Emily L, Cowper-Smith Chris, Biden Edmund N
Faculty of Kinesiology and Institute of Biomedical Engineering, University of New Brunswick, Fredericton, NB, Canada.
School of Engineering, University of Guelph, Guelph, ON, Canada.
Front Bioeng Biotechnol. 2021 Jan 28;8:604860. doi: 10.3389/fbioe.2020.604860. eCollection 2020.
Off-loader knee braces have traditionally focused on redistributing loads away from either the medial or lateral tibiofemoral (TF) compartments. In this article, we study the potential of a novel "tricompartment unloader" (TCU) knee brace intended to simultaneously unload both the patellofemoral (PF) and TF joints during knee flexion. Three different models of the TCU brace are evaluated for their potential to unload the knee joint. A sagittal plane model of the knee was used to compute PF and TF contact forces, patellar and quadriceps tendon forces, and forces in the anterior and posterior cruciate ligaments during a deep knee bend (DKB) test using motion analysis data from eight participants. Forces were computed for the observed (no brace) and simulated braced conditions. A sensitivity and validity analysis was conducted to determine the valid output range for the model, and Statistical Parameter Mapping was used to quantify the effectual region of the different TCU brace models. PF and TF joint force calculations were valid between 0 and 100 degrees of flexion. All three simulated brace models significantly ( < 0.001) reduced predicted knee joint loads (by 30-50%) across all structures, at knee flexion angles >30 degrees during DKB. The TCU brace is predicted to reduce PF and TF knee joint contact loads during weight-bearing activity requiring knee flexion angles between 30 and 100 degrees; this effect may be clinically beneficial for pain reduction or rehabilitation from common knee injuries or joint disorders. Future work is needed to assess the range of possible clinical and prophylactic benefits of the TCU brace.
卸载式膝关节支具传统上主要致力于将负荷从内侧或外侧胫股（TF）关节腔重新分配出去。在本文中，我们研究了一种新型“三关节腔卸载器”（TCU）膝关节支具在膝关节屈曲过程中同时卸载髌股（PF）和TF关节的潜力。对三种不同型号的TCU支具卸载膝关节的潜力进行了评估。利用八名参与者的运动分析数据，在屈膝深蹲（DKB）测试中，使用膝关节矢状面模型来计算PF和TF接触力、髌腱和股四头肌肌腱力以及前后交叉韧带中的力。针对观察到的（不佩戴支具）和模拟佩戴支具的情况计算了力。进行了敏感性和有效性分析以确定模型的有效输出范围，并使用统计参数映射来量化不同TCU支具模型的有效区域。PF和TF关节力计算在约0至100度屈曲之间是有效的。在DKB过程中，当膝关节屈曲角度>~30度时，所有三种模拟支具模型均显著（<0.001）降低了所有结构的预测膝关节负荷（降低了30 - 50%）。预计TCU支具在需要膝关节屈曲角度在30至100度之间的负重活动中可降低PF和TF膝关节接触负荷；这种效果对于减轻常见膝关节损伤或关节疾病的疼痛或康复可能具有临床益处。需要进一步开展工作来评估TCU支具可能的临床和预防益处的范围。
