In vivo knee joint loading and kinematics – the interplay between movement and loading at the patello-femoral and tibio-femoral joints.

体内膝关节载荷和运动学 – 髌股关节和胫股关节运动和载荷之间的相互作用。

• 批准号: 417498832
• 负责人: Dr. Adam Trepczynski
• 金额: --
• 依托单位: Julius Wolff Institut für Biomechanik und Muskuloskeletale Regeneration (CVK)
• 依托单位国家: 德国
• 项目类别: Research Grants
• 财政年份: 2019
• 资助国家: 德国
• 起止时间: 2018-12-31 至 2022-12-31
• 项目状态: 已结题
• 来源: https://gepris.dfg.de/gepris/projekt/417498832?language=en
• 关键词: vivo; knee; joint; loading; kinematics

While total knee arthroplasty is a generally very successful treatment for knee osteoarthritis, about 20% of patients later turn out to be not satisfied with their functional post-operative outcome. A substantial patient population suffers from not yet fully understood post-operative symptoms, such as anterior knee pain. Progress towards solving the remaining problems of knee joint replacement requires a better understanding of the mechanical interaction between the patello-femoral and tibio-femoral joints. However, measuring the precise internal loading and kinematics of the knee during dynamic activities is extremely challenging; as a result no appropriate data is available so far. Over the last few years, a tight collaboration between the Charité-Berlin and the ETH-Zürich allowed us to capture a worldwide unique dataset of synchronized in vivo tibio-femoral loads and internal joint kinematics. The simultaneous measurement of these two key parameters, along with whole body motion, ground reaction forces and muscle activity, now provides the basis for the present application, which aims to gain an understanding of the underlying knee mechanics in a replaced joint. Concurrently, we will quantify the patient-specific patello-femoral loads, how they relate to the dynamic movements within the patello-femoral and tibio-femoral joints, and how antagonist muscle co-contraction affects the total joint forces and the pressure distributions at the articulating surfaces. In particular, we will develop a technology platform that enables us to identify adverse combinations of implantation parameters, that may lead to excessive loading of the joint structures. After validation against in vivo knee load measurements and muscle activation from EMG, the musculoskeletal loading determined through advanced subject specific models will serve as input to detailed contact analyses with the goal to unravel the loading distribution at the articulating surfaces. Although this specific dataset of in vivo forces and kinematics is limited to a patient cohort of six, it is globally the largest available dataset, and within this project we aim at establishing it as a benchmark for later analyses of other implants or patient kinematic data. In doing so, we will also lay the technological foundation to evaluate other implant designs and implantation methods, beyond the validated instrumented implants used here.

虽然全膝关节置换术通常是膝关节骨关节炎的一种非常成功的治疗方法，但约20%的患者后来对其术后功能结果不满意。大量患者患有尚未完全理解的术后症状，例如膝前疼痛。要解决膝关节置换术的剩余问题，需要更好地了解髌股关节和胫股关节之间的机械相互作用。然而，在动态活动期间测量膝关节的精确内部载荷和运动学是极其具有挑战性的;因此，迄今为止没有适当的数据可用。在过去的几年里，Charité-柏林和ETH-Zürich之间的密切合作使我们能够捕获全球唯一的同步体内胫股载荷和内部关节运动学数据集。沿着这两个关键参数以及全身运动、地面反作用力和肌肉活动的同时测量现在为本申请提供了基础，本申请旨在获得对置换关节中的潜在膝关节力学的理解。同时，我们将量化患者特定的髌股载荷，它们如何与髌股和胫股关节内的动态运动相关，以及拮抗肌共同收缩如何影响关节面的总关节力和压力分布。特别是，我们将开发一个技术平台，使我们能够识别植入参数的不利组合，这可能导致关节结构的过度负荷。根据体内膝关节载荷测量和EMG肌肉激活进行确认后，通过高级受试者特定模型确定的肌肉骨骼载荷将作为详细接触分析的输入，目的是揭示关节面的载荷分布。虽然体内力和运动学的特定数据集仅限于6名患者队列，但它是全球最大的可用数据集，在本项目中，我们的目标是将其作为其他植入物或患者运动学数据后续分析的基准。在此过程中，我们还将为评价其他植入物设计和植入方法奠定技术基础，而不仅仅是在此使用的经确认的内固定植入物。