On the biomechanical relationship between applied hip, knee and ankle joint moments and the internal knee compressive forces

Mechanical devices are common treating methods for knee osteoarthritis. It has the purpose of reducing the internal joint forces and unloading the damaged structure. The reduction is often achieved by alterations in the frontal plan, shifting the contact force from one compartment to the other, leaving the total compressive force unchanged. The aim of this study was to investigate how internal knee joint forces depend on applied external moments during gait. Musculoskeletal models of the gait of 10 healthy subjects were developed in the AnyBody Modelling System and used to simulate applied joint moments about different axes (load cases), each with the magnitude to compensate the net moment about the respective axis by a specified percentage. For each load case, the total, medial and lateral knee compressive force were computed and compared with a baseline case with no external moments applied. Among the investigated moments, hip flexion-extension, knee flexion-extension and ankle plantarflexion-dorsiflexion moment compensations have the most positive impact on the total knee joint compressive force, and combining the 3, each with a 40% compensation of the muscle moments, reduced the first peak by 23.6%, the second by 30.6% and the impulse by 28.6% with respect to no applied moments.