Using musculoskeletal modelling to estimate knee joint loading pre and post high tibial osteotomy

Area of Science:

• Orthopedics
• Biomechanics
• Musculoskeletal modeling

Background:

• Medial knee osteoarthritis and varus alignment overload the medial knee compartment.
• High tibial osteotomy (HTO) is a surgical option for varus deformity in knee osteoarthritis patients.
• Understanding knee joint loading is crucial for evaluating surgical outcomes.

Purpose of the Study:

• To evaluate knee loading and contact location before and after high tibial osteotomy (HTO).
• To compare knee loading in osteoarthritis patients and healthy controls.
• To analyze the effects of HTO on medial-lateral condyle load distribution.

Main Methods:

• Musculoskeletal modeling was used to analyze joint kinematics during gait.
• 30 knee osteoarthritis patients (pre- and post-HTO) and 28 healthy adults were studied.
• Patient-specific mechanical tibial femoral angle was incorporated to calculate forces.

Main Results:

• High tibial osteotomy (HTO) significantly reduced medial compartment contact force during stance.
• Medial compartment unloading was observed despite increased post-surgery walking speed.
• Joint contact forces were lateralized post-surgery.

Conclusions:

• The findings support the goal of high tibial osteotomy (HTO) to unload the medial knee compartment.
• The study demonstrates the effectiveness of HTO in altering tibiofemoral contact loading.
• Musculoskeletal modeling provides valuable insights into the biomechanical effects of HTO.