Tibio-femoral loading during human gait and stair-climbing

Taylor, William R., Heller, Markus O., Bergmann, Georg and Duda, Georg N. (2004) Tibio-femoral loading during human gait and stair-climbing. Journal of Orthopaedic Research, 22 (3), 625-632. (doi:10.1016/j.orthres.2003.09.003).

Abstract

Surgical intervention of the knee joint routinely endeavours to recreate a physiologically normal joint loading environment. The loading conditions resulting from osteotomies, fracture treatment, ligament replacements and arthroplasties of the knee are considered to have an impact on the long term clinical outcome; however knowledge regarding the in vivo loading conditions in the knee is limited. Using a previously validated musculo-skeletal model of the human lower limb, this study has focused on predicting the tibio-femoral joint contact forces that occur in the human knee during the common daily activities of walking and stair-climbing.

The average resultant peak tibio-femoral contact force during walking was 3.1 times body weight (BW) across four THA patients. Inter-individual variations proved larger than the variation of forces for each patient repeating the same task. Forces through the knee were considerably larger during stair climbing than during walking: the average maximum resultant force during stair climbing was 5.4 BW although peaks of up to 6.2 BW were calculated for one particular patient. Average anterior-posterior peak shear components of 0.6 BW were determined during walking and 1.3 BW during stair climbing.

These results confirm both the joint contact forces reported in the literature and the importance of muscular activity in creating high forces across the joint. The magnitudes of these forces, specifically in shear, have implications for all forms of surgical intervention of the knee. The data demonstrate that high contact and shear forces are generated during weight bearing combined with knee flexion angles greater than approximately 15 degrees. Clinically, the conditions that produce these larger contact forces in the knee should be avoided during post-operative rehabilitation.

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Contributors

Author: Markus O. Heller

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