Application of Computational Lower Extremity Model to Investigate Different Muscle Activities and Joint Force Patterns in Knee Osteoarthritis Patients during Walking
Many experimental and computational studies have reported that osteoarthritis in the knee joint affects knee biomechanics, including joint kinematics, joint contact forces, and muscle activities, due to functional restriction and disability. In this study, differences in muscle activities and joint force patterns between knee osteoarthritis (OA) patients and normal subjects during walking were investigated using the inverse dynamic analysis with a lower extremity musculoskeletal model. Extensor/flexor muscle activations and torque ratios and the joint contact forces were compared between the OA and normal groups. The OA patients had higher extensor muscle forces and lateral component of the knee joint force than normal subjects as well as force and torque ratios of extensor and flexor muscles, while the other parameters had little differences. The results explained that OA patients increased the level of antagonistic cocontraction and the adduction moment on the knee joint. The presented findings and technologies provide insight into biomechanical changes in OA patients and can also be used to evaluate the postoperative functional outcomes of the OA treatments. 1. Introduction Osteoarthritis (OA) is regarded as a degenerative joint disease that results from loss of balance between the biological resistance of the joint and mechanical stress applied to the joint, and it is defined as conditions that lead to joint symptoms and signs associated with defects in the integrity of articular cartilage, in addition to related changes in the underlying bone at the joint margins [1, 2]. The knee is one of the most common joints afflicted by OA with aging: about 33% of people older than 65 have OA in their knee joints [2]. Many experimental and computational studies have reported that OA in the knee joint affects knee biomechanics, including joint kinematics, joint contact forces, and muscle activities, due to functional restriction and disability [3, 4]. Several experimental studies have measured periarticular knee muscle activation of OA patients during walking using electromyography (EMG) systems [5–8] and knee joint contact forces using instrumented knee implants [9–12]. Even though direct measures would be more realistic, direct measures are invasive and require special devices, for example, instrumented implants, fine-wires, or indwelling electrodes. Although surface EMG is not invasive, it generally measures the activity of superficial muscles. In the lower extremity, surface EMG can be used to measure the activation of medial and lateral hamstrings, medial
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