Gupta Dhruv, Donnelly Cyril John, Reinbolt Jeffrey A
Mechanical, Aerospace and Biomedical Engineering, The University of Tennessee, Knoxville, TN 37996, USA.
Rehabilitation Research Institute of Singapore, Nanyang Technological University, Singapore 308232, Singapore.
Life (Basel). 2022 Jul 14;12(7):1050. doi: 10.3390/life12071050.
A high contact force between the medial femoral condyle and the tibial plateau is the primary cause of medial compartment knee osteoarthritis (OA). A high medial contact force (MCF) during gait has been shown to be correlated to both the knee adduction moment (KAM) and knee flexion/extension moment (KFM). In this study, we used OpenSim Moco to find gait kinematics that reduced the peaks of the KAM, without increasing the peaks of the KFM, which could potentially reduce the MCF and, hence, the progression of knee OA. We used gait data from four knee OA participants. Our simulations decreased both peaks of the KAM without increasing either peak of the KFM. We found that increasing the step width was the primary mechanism, followed by simulations of all participants to reduce the frontal plane lever arm of the ground reaction force vector about the knee, in turn reducing the KAM. Importantly, each participant simulation followed different patterns of kinematic changes to achieve this reduction, which highlighted the need for participant-specific gait modifications. Moreover, we were able to simulate emerging gait patterns within 15 min, enhancing the relevance and potential for the application of developed methods in clinical settings.
股骨内侧髁与胫骨平台之间的高接触力是膝关节内侧间室骨关节炎（OA）的主要原因。研究表明，步态期间较高的内侧接触力（MCF）与膝关节内收力矩（KAM）和膝关节屈伸力矩（KFM）均相关。在本研究中，我们使用OpenSim Moco来寻找能降低KAM峰值且不增加KFM峰值的步态运动学，这可能会降低MCF，从而减缓膝关节OA的进展。我们使用了四名膝关节OA参与者的步态数据。我们的模拟降低了KAM的两个峰值，同时没有增加KFM的任何一个峰值。我们发现增加步幅是主要机制，随后对所有参与者进行模拟，以减小地面反作用力矢量在膝关节处的额状面力臂，进而降低KAM。重要的是，每个参与者的模拟都遵循不同的运动学变化模式来实现这种降低，这突出了针对个体的步态调整的必要性。此外，我们能够在15分钟内模拟出新兴的步态模式，提高了所开发方法在临床环境中应用的相关性和潜力。
