Understanding, analysing and reducing knee joint loading

G. Bergmann, Charité- Universitätsmedizin Berlin

Abstract: Osteoarthritis of the knee joint is influenced by the internal joint contact forces. Their magnitudes and medio-lateral distribution are co-factors for cartilage degradation, mostly starting at the medial compartment. A deceleration of osteoarthritis progression and a reduction of pain could be achieved if joint forces are reduced or shifted more to the lateral side.

A direct relation between external knee adduction moment (EKAM) and medial-side knee contact force (MKCF) is a widely accepted opinion. Several studies assessed the effect of wedged shoes, valgus braces, osteotomies and other methods by analyzing changes of the EKAM. However, no verified facts about the correlation EKAM   MKCF exist. Our own data showed that a reduced EKAM is not a reliable predictor for a load reduction.

As one of only two groups worldwide, we can measure the tibio-femoral contact forces and their distribution in the joint by instrumented implants with telemetric data transmission. Synchronous gait analyses allow detailed investigations of the relations between external and internal loads.
We plan to

• Review the concept that the maximum EKAM is a reliable measure for the maximum medial knee load.
• Investigate the biomechanical mechanisms of gait modifications in detail.
• Analyze the efficiency of various methods for reducing the MKCF. Some may become obsolete, effective ones could be optimized.
• Provide partner groups with detailed data about loading of the knee joint including gait and anatomical data of our telemetric patients. This allows verifying loads determined by analytical and stresses/strains calculated by FE models. These loads could cause increased movements in the knee and thereby influence the progress of osteoarthritis


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