A1 Refereed original research article in a scientific journal

Workflow assessing the effect of gait alterations on stresses in the medial tibial cartilage - combined musculoskeletal modelling and finite element analysis




AuthorsK. S. Halonen, C. M. Dzialo, M. Mannisi, M. S. Venäläinen, M. de Zee, M. S. Andersen

PublisherNATURE PUBLISHING GROUP

Publication year2017

JournalScientific Reports

Journal name in sourceSCIENTIFIC REPORTS

Journal acronymSCI REP-UK

Article number17396

Volume7

Number of pages14

ISSN2045-2322

DOIhttps://doi.org/10.1038/s41598-017-17228-x

Self-archived copy’s web addresshttps://research.utu.fi/converis/portal/Publication/28907560


Abstract
Knee osteoarthritis (KOA) is most common in the medial tibial compartment. We present a novel method to study the effect of gait modifications and lateral wedge insoles (LWIs) on the stresses in the medial tibial cartilage by combining musculoskeletal (MS) modelling with finite element (FE) analysis. Subject's gait was recorded in a gait laboratory, walking normally, with 5 degrees and 10 degrees LWIs, toes inward ('Toe in'), and toes outward ('Toe out wide'). A full lower extremity MRI and a detailed knee MRI were taken. Bones and most soft tissues were segmented from images, and the generic bone architecture of the MS model was morphed into the segmented bones. The output forces from the MS model were then used as an input in the FE model of the subject's knee. During stance, LWIs failed to reduce medial peak pressures apart from Insole 10 degrees during the second peak. Toe in reduced peak pressures by -11% during the first peak but increased them by 12% during the second. Toe out wide reduced peak pressures by -15% during the first and increased them by 7% during the second. The results show that the work flow can assess the effect of interventions on an individual level. In the future, this method can be applied to patients with KOA.

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