Muscle and external load contribution to knee joint contact loads during normal gait
Muscle and external load contribution to knee joint contact loads during normal gait
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DOI：
10.1016/j.jbiomech.2009.06.019
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发表时间：
2009-10-16
影响因子：
2.4
通讯作者：
Kirk, T. B.
中科院分区：
文献类型：
--
作者：
Winby, C. R.;Lloyd, D. G.;Kirk, T. B.
步态中大的膝关节内收力矩被认为是与胫股骨性关节炎的进展和严重程度有关的力学因素，并被认为增加了膝关节中间室的负荷。然而，如果不考虑肌肉和韧带产生的内力和力矩，就无法验证这一机制，而这些内力和力矩是不容易测量的。以前的肌肉骨骼模型表明，胫股关节的内侧间隙承担了大部分的胫股负荷，站立时外侧间隙有时会卸载。本文利用肌电驱动的模型来估计健康步态下的肌力和膝关节接触力。结果表明，虽然站立时内侧室确实承担了大部分负荷，但肌肉提供了足够的稳定性来对抗外部内收力矩卸载外侧室的趋势。这种稳定性主要是由股四头肌、腿肌和腓肠肌提供的，尽管阔筋膜张肌也有显著的贡献。肌电驱动的模型不能预测侧脑室卸载，这表明肌肉活动模式为估计肌肉和关节接触力提供了有用的输入。(C)2009爱思唯尔有限公司保留所有权利。
Large knee adduction moments during gait have been implicated as a mechanical factor related to the progression and severity of tibiofemoral osteoarthritis and it has been proposed that these moments increase the load on the media) compartment of the knee joint. However, this mechanism cannot be validated without taking into account the internal forces and moments generated by the muscles and ligaments, which cannot be easily measured. Previous musculoskeletal models suggest that the medial compartment of the tibiofemoral joint bears the majority of the tibiofemoral load, with the lateral compartment unloaded at times during stance. Yet these models did not utilise explicitly measured muscle activation patterns and measurements from an instrumented prosthesis which do not portray lateral compartment unloading This paper utilised an EMG-driven model to estimate muscle forces and knee joint contact forces during healthy gait Results indicate that while the medial compartment does bear the majority of the load during stance, muscles provide sufficient stability to counter the tendency of the external adduction moment to unload the lateral compartment. This stability was predominantly provided by the quadriceps, hamstrings, and gastrocnemii Muscles, although the contribution from the tensor fascia latae was also significant. Lateral compartment unloading was not predicted by the EMG-driven model, suggesting that muscle activity patterns provide useful input to estimate muscle and joint contact forces. (C) 2009 Elsevier Ltd All rights reserved.