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Related Experiment Videos

Joint load considerations in total knee replacement

M S Kuster1, G A Wood, G W Stachowiak

  • 1University of Western Australia, Nedlands.

The Journal of Bone and Joint Surgery. British Volume
|January 1, 1997
PubMed
Summary

Downhill walking significantly increases tibiofemoral compressive forces to 8 times body-weight (BW), potentially exceeding the limits of current total knee replacement designs. Future designs require evaluation under higher joint load conditions.

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Area of Science:

  • Biomechanics
  • Orthopedic Surgery
  • Biomedical Engineering

Background:

  • Understanding knee joint loading is crucial for evaluating the performance and longevity of total knee replacement (TKR) prostheses.
  • Previous studies have estimated knee joint forces during level walking, but data for downhill walking, a more demanding activity, is less comprehensive.

Purpose of the Study:

  • To estimate tibiofemoral joint loadings during level and downhill walking in healthy individuals.
  • To compare calculated joint forces with the load-bearing capacity of current total knee replacement designs.
  • To provide data for future TKR design evaluations.

Main Methods:

  • Kinematic and kinetic data were collected from 12 healthy subjects during level and downhill walking.
  • Musculoskeletal modeling was used to estimate tibiofemoral compressive forces and the contributions of muscle and ground reaction forces.

Related Experiment Videos

  • Calculated forces were compared to the yield point of polyethylene inlays used in typical TKR designs.

    • Main Results:

    • Maximum tibiofemoral compressive forces averaged 3.9 times body-weight (BW) during level walking and 8 times BW during downhill walking.
    • Muscle forces accounted for 70-80% of the maximum bone-on-bone force, with ground reaction forces contributing 20-30%.
    • The contact area in most TKR designs (100-300 mm²) is likely insufficient to withstand the forces experienced during downhill walking.

    Conclusions:

    • Downhill walking imposes significantly higher tibiofemoral joint loads than level walking, potentially leading to premature failure of TKR polyethylene components.
    • Future TKR designs should be evaluated based on higher joint load parameters, specifically 3.5 BW at 20°, 8 BW at 40°, and 6 BW at 60° of knee flexion.
    • These findings highlight the need for improved TKR materials and designs to accommodate the high stresses encountered during activities like downhill walking.