Combining advanced computational and imaging techniques as a quantitative tool to estimate patellofemoral joint stress during downhill gait: A feasibility study.
Combining advanced computational and imaging techniques as a quantitative tool to estimate patellofemoral joint stress during downhill gait: A feasibility study.
复制标题
结合先进的计算和成像技术作为定量工具，以估计髌股关节应力下坡步态：可行性研究。
DOI：
10.1016/j.gaitpost.2020.11.016
复制
发表时间：
2021-03
期刊：
影响因子：
2.4
通讯作者：
Farrokhi S
中科院分区：
文献类型：
--
作者：
Gustafson JA;Elias JJ;Fitzgerald GK;Tashman S;Debski RE;Farrokhi S
髌股关节骨关节炎（OA）的发病和进展与软骨应力的改变有关——这是疼痛和后续软骨退变的一个潜在先兆。缺乏用于客观评估髌股关节接触应力的定量工具限制了我们对与OA相关的病理力学的理解。
计算建模和双平面透视技术能否用于区分患有和未患有髌股关节OA的个体体内特定受试者的髌股应力分布情况呢？
当前的研究采用了一个离散元建模框架，该框架由下坡步态期间体内特定受试者的运动学驱动，以区分髌股关节OA患者（n = 5）与无OA的老年人（n = 6）体内独特的髌股应力分布情况。所有参与者在倾斜的仪器化跑步机上行走时都接受了双平面透视运动学跟踪。将特定受试者的运动学与高分辨率几何模型相结合，以估计下坡步态加载响应阶段的0%、25%、50%、75%和100%时的髌股关节接触应力。
与无OA的对照组相比，髌股关节OA患者在加载响应期间髌股外侧间室的髌股应力增加得更早（P = 0.021）。总体而言，与加载响应结束时相比，两组在步态加载响应阶段早期都表现出髌股关节接触应力增加。这项研究的结果显示，髌股关节OA患者的应力分布增加，表明在步态早期阶段关节负荷增加。
这种将关节运动学与离散元模型相结合的建模框架能够客观地估计髌股关节应力的变化，有可能应用于评估各种治疗方案的效果，包括手术和非手术康复治疗。
The onset and progression of patellofemoral osteoarthritis (OA) has been linked to alterations in cartilage stress—a potential precursor to pain and subsequent cartilage degradation. A lack in quantitative tools for objectively evaluating patellofemoral joint contact stress limits our understanding of pathomechanics associated with OA. Could computational modeling and biplane fluoroscopy techniques be used to discriminate in-vivo, subject-specific patellofemoral stress profiles in individuals with and without patellofemoral OA? The current study employed a discrete element modeling framework driven by in-vivo, subject-specific kinematics during downhill gait to discriminate unique patellofemoral stress profiles in individuals with patellofemoral OA (n=5) as compared to older individuals without OA (n=6). All participants underwent biplane fluoroscopy kinematic tracking while walking on a declined instrumented treadmill. Subject-specific kinematics were combined with high resolution geometrical models to estimate patellofemoral joint contact stress during 0%, 25%, 50%, 75% and 100% of the loading response phase of downhill gait. Individuals with patellofemoral OA demonstrated earlier increases in patellofemoral stress in the lateral patellofemoral compartment during loading response as compared to OA-free controls (P=0.021). Overall, both groups exhibited increased patellofemoral contact stress early in the loading response phase of gait as compared to the end of loading response. Results from this study show increased stress profiles in individuals with patellofemoral OA, indicating increasing joint loading in early phases of gait. This modeling framework—combining arthrokinematics with discrete element models—can objectively estimate changes in patellofemoral joint stress, with potential applications to evaluate outcomes from various treatment programs, including surgical and non-surgical rehabilitation treatments.
登录
查看更多内容
影响因子：
2.4
作者：
Farrokhi S;Meholic B;Chuang WN;Gustafson JA;Fitzgerald GK;Tashman S
通讯作者：
Tashman S
影响因子：
2.4
作者：
BLANKEVOORT, L;KUIPER, JH;GROOTENBOER, HJ
通讯作者：
GROOTENBOER, HJ
影响因子：
2.2
作者：
Bei, YH;Fregly, BJ
通讯作者：
Fregly, BJ
影响因子：
2.4
作者：
Genda, E;Iwasaki, N;Chao, EYS
通讯作者：
Chao, EYS
影响因子：
2.8
作者：
Fregly, Benjamin J.;Banks, Scott A.;Colwell, Clifford W., Jr.
通讯作者：
Colwell, Clifford W., Jr.