Towards integrating musculo-skeletal analyses into pre-operative planning - The influence of axial alignment on individual knee joint loading

摘要

Objectives: To develop a software module that allows customized musculo-skeletal models of patients with deformities of the lower limb to be created in order to determine their individual loading conditions. In addition, the influence of axial alignment on the individual tibio-femoral contact forces at the knee during dynamic activities is to be evaluated using a previously validated numerical model. Background: High tibial osteotomies attempt to recreate a physiologically normal joint loading environment [1]. Although the changes in loading conditions are considered to have an impact on the long term clinical outcome, there seems to be no consensus on whether a deformity should be corrected to a normal alignment or if an over-correction is required [4]. Whilst it has been shown that there is a considerable inter-individual variability in musculo-skeletal loading conditions [2], there is currently no method available that determines the correction necessary to optimize the musculo-skeletal loading conditions for an individual patient pre-operatively. Previous studies have discussed the influence of mal-alignment on the distribution of static loads to the medial and lateral compartments of the knee [3], but have failed to examine the patient specific changes in musculo-skeletal loading conditions during gait.