Quantifying knee joint mechanical exposures and tissue response in high knee flexion

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Floor-level postures (eg. kneeling, squatting) are essential for many daily activities (household chores, home maintenance, religious practices) and occupations (mining, childcare, floor installation, masonry, landscaping), yet knee joint mechanics and the corresponding joint tissue behaviours in these high knee flexion (knee bending) postures are not well understood. While some research has estimated high knee joint loads in these postures (beyond levels that healthy tissue can withstand), there is scientific evidence to support the idea that healthy joint tissues can adapt to withstand high joint loads. In healthy individuals, changes have been observed in how people move after prolonged kneeling, which may play a role in this adaptation. My research program aims to:******1. Advance the novel, computational knee joint model, developed in my lab, to best represent knee joint movements and loading throughout the full range of knee joint motion.******2. Create a non-invasive, wearable system to measure the frequency and duration of floor-level tasks in activities of daily living. Modeled joint loads (from 1, above) and measurements from this system will be used to determine a “total load.” The proposed work will determine if healthy, living knee joint cartilage exhibits different strain (deformation) behaviour depending on the total load to which it is typically exposed.******3. Test whether the changes in movement strategies observed after kneeling could be a result of changes in the ligaments.******My research program will contribute innovative approaches to anatomically-based computational knee modeling. It will deliver the first validated full-flexion knee model and exposure measurement system. My proposed research will make Canada a leader in this area by clarifying mechanisms for cartilage conditioning, characterizing the loads associated with these postures, and providing simple tools to measure how often, and for how long, these postures are assumed, using wearable technology.******This work has high potential for impact beyond the scope of this proposal. The identified mechanisms for adaptation related to floor-level activities of daily living can be used in future prevention efforts to reduce the risk of tissue damage that has been indirectly linked to kneeling and squatting. Some countries designate knee osteoarthritis associated with deep knee bending at work as an occupational disease. Preventing this type of osteoarthritis becomes more pressing to Canadians as the workforce ages. ******Trainees in my research program will apply state-of-the-art modeling, motion tracking, and imaging approaches to achieve these timely objectives. They will gain leadership, technical, and scientific skills that will enable them to make a strong impact in the fields of engineering, science, and medicine in Canada.**