Effect of frontal plane tibiofemoral angle on the stress and strain at the knee cartilage during the stance phase of gait.

Subject-specific three-dimensional finite element models of the knee joint were created and used to study the effect of the frontal plane tibiofemoral angle on the stress and strain distribution in the knee cartilage during the stance phase of the gait cycle. Knee models of three subjects with different tibiofemoral angle and body weight were created based on magnetic resonance imaging of the knee. Loading and boundary conditions were determined from motion analysis and force platform data, in conjunction with the muscle-force reduction method. During the stance phase of walking, all subjects exhibited a valgus-varus-valgus knee moment pattern with the maximum compressive load and varus knee moment occurring at approximately 25% of the stance phase of the gait cycle. Our results demonstrated that the subject with varus alignment had the largest stresses at the medial compartment of the knee compared to the subjects with normal alignment and valgus alignment, suggesting that this subject might be most susceptible to developing medial compartment osteoarthritis (OA). In addition, the magnitude of stress and strain on the lateral cartilage of the subject with valgus alignment were found to be larger compared to subjects with normal alignment and varus alignment, suggesting that this subject might be most susceptible to developing lateral compartment knee OA.

The effect of the frontal plane tibiofemoral angle and varus knee moment on the contact stress and strain at the knee cartilage.

Subject-specific models were developed and finite element analysis was performed to observe the effect of the frontal plane tibiofemoral angle on the normal stress, Tresca shear stress and normal strain at the surface of the knee cartilage. Finite element models were created for three subjects with different tibiofemoral angle and physiological loading conditions were defined from motion analysis and muscle force mathematical models to simulate static single-leg stance. The results showed that the greatest magnitude of the normal stress, Tresca shear stress and normal strain at the medial compartment was for the varus aligned individual. Considering the lateral knee compartment, the individual with valgus alignment had the largest stress and strain at the cartilage. The present investigation is the first known attempt to analyze the effects of tibiofemoral alignment during single-leg support on the contact variables of the cartilage at the knee joint. The method could be potentially used to help identify individuals most susceptible to osteoarthritis and to prescribe preventive measures.