A developed multibody knee model for unloading knee with cartilage penetration depth control

Proc Inst Mech Eng H. 2022 Oct;236(10):1528-1540. doi: 10.1177/09544119221122067. Epub 2022 Sep 10.

Abstract

Unloader knee braces could relieve pain by decreasing the medial knee loading. Particularly for knee osteoarthritis (KOA) patients, this study investigates the relevance of the knee model after identifying the most influential parameter. Since KOA causes the cartilage in a joint to lose its elasticity and thickness, the lack of normal bone-to-bone separation can be painful. We believe that cartilage penetration depth control is an impactful strategy in this research. Moreover, the knee contact force in KOA is fewer than in healthy knees, confirming that the contact force control cannot be a straight factor. Therefore, a biomechanical human knee model is developed, and a generic procedure for dynamic analysis of contact problems in combination with the musculoskeletal model is introduced. The developed model includes the geometric expression of collision curves and an algorithm for determining collision points. This presentation addresses cartilage penetration depth and contact force calculation through nonlinear discontinuous contact law. In view of this, femur and tibia's relative motion is analyzed through the combined collision reactions of cartilage and bone in the knee. In the simulation, maximum penetration depth in a healthy knee is reported to be 0.795 mm, while in a 75% KOA is 0.521 mm, including 0.5 mm cartilage-cartilage contact and 0.021 mm bone-bone contact. The top unloading 852 N is achieved, reducing penetration depth to 0.45 mm, avoiding bone-bone contact. This proposed procedure with low computation gives us a suitable analysis method for designing knee assistive devices.

Keywords: Knee joint; cartilage penetration depth; contact force; forward dynamics; knee osteoarthritis; musculoskeletal modeling; nonlinear discontinuity.

MeSH terms

  • Biomechanical Phenomena
  • Cartilage, Articular*
  • Humans
  • Knee
  • Knee Joint
  • Osteoarthritis, Knee*