• Title, Summary, Keyword: Knee

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Simulation of Three Dimensional Motion of the Knee Joint in Total Knee Arthroplasty (인공 무릎 관절의 3차원 운동 시뮬레이션)

  • Moon, Byung-Young;Son, Kwon;Kim, Ki-Bum;Seo, Jung-Tak
    • Journal of the Korean Society for Precision Engineering
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    • v.21 no.9
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    • pp.188-195
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    • 2004
  • Severe osteoarthrosis of the knee joint often requires total knee arthroplasty(TKA) to yield adequate knee function. The knee joint with TKA is expected ideally to restore the characteristics, however, this is not necessarily 1.ue in the clinical cases. In this study the motion of the intact joint and the joint after. TKA were investigated numerically using computer simulation. For active knee extension from 90 degrees of flexion to full extension, the intact knee joint exhibited anterior tibial translation near the full extension and it showed only rotation at other flexion angles. Physiologic external rotation of the tibia near full extension known as screw home movement was also noted in the analytical model. The analysis of the tibial insert of three different shapes (flat, semicurved, and curved types) demonstrated characteristic rotational and sliding motion as well as different contact forces.

The Correlation Between Foot and Knee Posture Characteristics in Knee Osteoarthritis People (무릎관절 뼈관절염 환자의 발과 무릎관절 자세 특성간의 상관관계)

  • Kim, Seong-Hwan;Kim, Suhn-Yeop;Kim, Ho-Bong
    • Journal of the Korean Society of Physical Medicine
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    • v.7 no.4
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    • pp.433-442
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    • 2012
  • PURPOSE: This study investigated to correlation between foot and knee posture characteristics in knee osteoarthritis patients. METHODS: The subjects of this study were 103 patients with clinically and radiographically-confirmed knee osteoarthritis was investigated using the quadriceps angle (QA), distance of both knee (DBK), ankle dorsiflexion angle (ADA), navicular drop (ND). One-way ANOVA and Pearson's correlation were used to investigate the correlation between foot and knee posture measurements. All of whom agreed to participate in the study. In order to assure the statistical significance of the results, we used for SPSS ver. 18.0 for windows. RESULTS: The results of this study were as follows : 1) There were statistically significant difference in the correlation between QA and DBK. 2) There were statistically significant difference in the correlation between DBK and ADA. CONCLUSION: According the results of this study, patients with osteoarthritis exhibit more genu varus knee posture. Moreover patients with osteoarthritis were not correlation between foot and knee Posture characteristics.

Clinical Characteristics of Hip Joint Rotations and Knee Adduction Moment through 3D Gait Analysis (3차원 보행분석을 통한 무릎 모음 모멘트와 고관절 내외회전의 임상적 특성)

  • Kim, Yongwook;Kang, Seungmook
    • Journal of The Korean Society of Integrative Medicine
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    • v.5 no.4
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    • pp.41-48
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    • 2017
  • Purpose : The purpose of this study was to verify the relationships among the knee adduction moment, hip rotation range, strength of hip rotators, and Foot Posture Index of healthy young adults. Method : Thirty-two healthy adults(24 male, 8 females) participated in this study. Subjects performed 5 walking trials to evaluate the knee adduction moments using a three-dimensional motion analysis system. Hip rotation ranges and hip rotator strengths were measured using a standard goniometer and a handheld dynamometer, respectively. The mean of three trials of clinical tests was used for data analysis. Results : The first peak knee adduction moment was significantly correlated with the hip rotation ranges and hip rotator strengths (P<.05). The second peak knee adduction moment was showed significant correlations with hip external rotation and rotation ratio. There were no correlations between Foot Posture Index and all knee adduction moments (P>.05). Conclusion : This study suggests that imbalances of the range of motion and strength of the internal and external rotation of the hip joint can affect knee adduction moments. The impact may exacerbate musculoskeletal disorders such as osteoarthritis of the knee. Therefore, further studies should be conducted to evaluate the effects of clinical interventions to correct these imbalances on the reduction of the knee adduction moments in patients with knee osteoarthritis.

Isokinetic Test and the Effect of Exercise Therapy of Ipsilateral Knee Osteoarthritis (일측성 슬관절염에 대한 등속성 근기능 평가 및 운동치료의 효과)

  • Kang, Jung-Hoon;Na, Jung-Yub;Jang, Jae-Huyk;Lee, Kyoung-II;Kim, Kweon-Young
    • Korean Journal of Sport Biomechanics
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    • v.20 no.1
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    • pp.75-81
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    • 2010
  • Knee osteoarthritis is one of the most prevalent arthritis that weakens the muscles. This study focused on evaluating muscular functionality of knee osteoarthritis subjects. Muscular strengths of muscles around knee and hip joints of middle-aged female subjects aged over 40 suffering from knee osteoarthritis were evaluated by isokinetic dynanometer. Also, relation between the observed muscle imbalance in knee and hip joints and visual analogue scale was investigated. Subjects performed 8-weeks exercise on weakened muscles - particularly on knee extensors and hip abductors - and had their isokinetic muscular functionalities analyzed again. After the 8-weeks exercise, subjects' thigh circumferences were increased, accompanied with muscular strength improvements and decrease in visual analogue scale. Hence we emphasize the importance of exercise for muscular strength enhancement of knee extensors and hip abductors, in rehabilitation programs for knee osteoarthritis.

Influence of Hip Fracture on Knee Pain During Postoperative Rehabilitation

  • Kim, Hee-Ju;Lee, Seong Jae;Hyun, Jung Keun;Kim, Seo-Young;Kim, Tae Uk
    • Annals of Rehabilitation Medicine
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    • v.42 no.5
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    • pp.682-689
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    • 2018
  • Objective To investigate whether fracture type, surgical procedure, or fracture grade affect knee pain during postoperative rehabilitation after a hip fracture. Methods We conducted a retrospective case-controlled study of 139 patients during postoperative rehabilitation after surgery for hip fractures. Patients were divided into two groups: patients experiencing knee pain during the first week of postoperative rehabilitation, and patients without knee pain. We compared the types of fracture, surgical procedure, and fracture grade between the two groups. Results We enrolled 52 patients (37.4%) with knee pain during the first weeks of postoperative rehabilitation. For type of fracture, knee pain was more common with intertrochanteric fracture than with femur neck fracture (48.8% vs. 21.1%, respectively; p=0.001). For the surgical procedure, there was no significant difference between the groups. For the fracture grade, the grades classified as unstable fractures were more common in the group of intertrochanteric fracture patients with knee pain than in those without knee pain (74.1% vs. 36.4%, respectively; p=0.002). Conclusion Intertrochanteric fracture affected knee pain after hip fracture surgery more than did femur neck fracture, particularly in unstable fractures. Furthermore, there was no difference in each fracture type according to the surgical procedure. Careful examination and management for knee pain is needed in patients with hip fracture surgery.

Comparison of Muscle Activity of Vastus Lateralis and Medialis Oblique among Knee Extension Angles at 90°, 135°, 180° in Sitting Position

  • Jeon, InCheol
    • The Journal of Korean Physical Therapy
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    • v.32 no.1
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    • pp.52-57
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    • 2020
  • Purpose: This study compared the muscle activities of the Vastus medialis oblique (VMO) and the Vastus lateralis (VL) at three different knee extension angles: 90°, 135°, and 180° in the sitting position. Methods: Twenty subjects between 20 and 30 years of age participated in the study. A mobile phone application called the Clinometer was used to measure the knee joint angle. Electromyography (EMG) was performed to measure the muscle activities of the VMO and VL muscles during knee isometric extension exercises. The pulling sensor was used to maintain 70% of the maximum strength of the knee extensor continuously in the sitting position. After attaching the EMG sensor, the subjects were asked to perform isometric knee extension exercises randomly among three knee extension angles (90°, 135°, or 180°) in the sitting position. One-way repeated measures analysis of the variance and a Bonferroni post hoc test was used to identify the VMO and VL muscle activity during knee extension angles among 90°, 135°, and 180°. Results: The VMO and VL muscle activities increased with increasing knee extension angle in the sitting position (p<0.01). Conclusions: Knee extension exercise at a 180° angle in the sitting position can be recommended to increase the muscle activity of the VMO and VL muscle activities efficiently.

The Effects of Sit-to-Stand Training with Visual Feedback on the Strength and Balance Ability Patients with Total Knee Replacement (시각적 되먹임의 제공에 따른 일어서기 훈련이 무릎관절 전치환술 환자의 다리 근력과 균형 능력에 미치는 영향)

  • Park, Jin;Park, Han-Kyu
    • PNF and Movement
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    • v.19 no.1
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    • pp.9-17
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    • 2021
  • Purpose: This study aims to verify the effectiveness of sit-to-stand training with visual feedback to improve balance ability and knee extensor strength of total knee replacement patients. Methods: In this study, 15 patients with total knee replacement participated in this study. Subjects were assigned to two groups: a feedback group (experimental group)(n = 8) and a control group (n = 7). They all received 30 min of continuous passive motion (CPM) and sit-to-stand training for 15 min five times per week for two weeks. Knee extensor and balance ability were measured. Knee extensor was measured by Biodex system 3; balance ability was measured by Balancia software. Results: After the intervention, there was a significant difference in the strengthening of the knee extensor muscles in the feedback group, area 95%, weight distribution of the affected side, and the sit-to-stand test repeated five times (p < 0.05). Conclusion: The results of this study showed that sit-to-stand training with visual feedback was more effective in increasing knee extensor muscle strength and balance ability than the sit-to-stand training without visual feedback. Therefore, in order to improve the knee extensor muscle and the balance of total knee replacement patients, it is necessary to consider providing visual feedback during sit-to-stand training.

In Vivo Kinematics of a Mobile-bearing Total Knee Prosthesis (이동베어링형 인공무릎전치환관절의 생체내의 운동)

  • Lee, Yeon-Soo;Park, Sang-Jin;Song, Eun-Kyoo
    • Proceedings of the KSME Conference
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    • pp.1473-1474
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    • 2008
  • In the total knee arthroplasty (TKA), kinematic benefic of a mobile-bearing total knee prosthesis is still arguing. Main reasons for implant failure are loosening and polyethylene wear and should be solved with new designs with mob ile bearings. The kinematics of the knee prosthesis also affects the implant failure. Recently, a second generation of p rostheses with a mobile-bearing was developed. The current study aimed to assess the kinematic path of the 2nd generation mobile knee prosthesis compared to the normal knees. Using 3D/2D registration method, CT-derived 3D knee models were fitted to sequential 2D X-ray images during knee flexion. 3D kinematics of the femur and the tibia were analyzed. The 2nd generation mobile-bearing TKA prosthesis (e.motion, Aesculap, Germany) knees showed less external rotation and knee flexion range compared to the normal knee, but the trend of external rotation was similar each other.

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Characteristics of the Compensation for Gait of the Induced Knee Stiffness in Normal Subjects (정상인 보행에서 무릎관절의 유도된 강직에 따른 신체 보상 특성)

  • Woo, Byung-Hoon
    • Korean Journal of Sport Biomechanics
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    • v.23 no.4
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    • pp.357-367
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    • 2013
  • The purposes of this study were investigated physical compensation for gait on induced knee stiffness in normal subjects. Ten subjects were participated in the experiment(age: $26.0{\pm}6.3$ yrs, height: $175.5{\pm}5.3$ cm, weight: $69.1{\pm}6.1$ kg). The study method adopted 3D analysis with five cameras and ground reaction force with two force-plate. Induced knee stiffness level were classified as gait pattern on ROM of knee(free level, $30^{\circ}$ restriction level, fix level). The results were as follows; In angular displacement of hip joint, left hip joint was the more extended in mid-stance on induced right knee stiffness. In angular displacement of knee joint, there was no physical compensation on induced right knee stiffness, but free knee level gait was more flexed in swing phase of right knee joint. In angular displacement of ankle joint, right ankle joint was the more dorsiflexed on induced right knee stiffness, and $30^{\circ}$ restriction level and fix level gait were less plantarflexed in TO2. In trunk tilt, free and $30^{\circ}$ restriction level gait was more backward tilt on induced right knee stiffness. In ROM of each joint, right knee joint was more larger and trunk tilt was more lower on induced right knee stiffness. In GRF, Fx was more bigger lateral force in free and $30^{\circ}$ restriction level gait, and was more bigger medial force in fix level gait. Fy was more bigger propulsion force in free level gait, and was was more bigger braking force in $30^{\circ}$ restriction level gait. Left braking force in $30^{\circ}$ restriction level gait was more bigger. Fz was no significant.

Influence of Walking With High-Heeled Shoes on the Knee Joint of Obese Women (하이힐 보행이 비만여성의 슬관절에 미치는 영향)

  • Chang, Yun-Hee;Lee, Wan-Hee
    • Physical Therapy Korea
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    • v.14 no.3
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    • pp.23-31
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    • 2007
  • The purpose of this study was to determine the influence of high-heeled shoes on walking of obese women as it was already proven an extrinsic factor of knee osteoarthritis in women with normal weight. In this study the aimed therefore in particular was to utilize high-heeled shoes in proving it's causal influence on knee osteoarthritis by measuring the angle and torque of the knee joint. Fifteen obese women (BMI>25 $kg/m^2$) were measured in their twenties. Each angle and torque of their knee joints during walking on 6.5 cm high-heeled shoes and with a bare feet, were compared with each other and analyzed with a 3D motion analysis system. There was no significant difference in walking speed, cadence and stride length between the two conditions. However, there was a significant increase in a double limb support time and the stance phase when walking on high-heeled shoes as when walking with bare feet. The peak knee flexion angle and peak knee varus torque was higher when walking on high-heeled shoes than with bare feet. On the contrary, the peak knee flexion angle in the swing phase was not statistically different. The prolongation of peak knee varus torque was also proven. There was a significant increase in peak knee varus torque in the initial and last stance phases during walking on high-heeled shoes as compared to walking on bare feet. Through the above results, it was proven that when obese women walked on high-heeled shoes, rather than with bare feet, peak knee flexor and varus torque increased along with the changes of the in knee joint angle. Therefore, the influence of high-heeled shoes might be a significant intrinsic factor in knee osteoarthritis of obese women.

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