Lower Limb Joint Load Comparison from Subject Specific Musculoskeletal Model Simulation and Direct Measurements on Different Subject with Instrumented Implant During Normal and Abnormal Gait

Abstract

This study presents lower limb joint load comparison from subject specific musculoskeletal model simulation (MSK-MS) and direct measurements from instrumented implants on post-operative (PO) patients. A case study was considered for MSK-MS gait analysis of a 40-year-old healthy male with 70 kg and 1.86 m height. Reflective adhesive markers were applied on skin surface of selected anatomical points at right and left lower limbs. Orthostatic and dynamic acquisition on normal gait (NG), stiff-knee gait (SKG) and slow running (SR) was performed from ground reaction forces with two force plates at 2 kHz and trajectories of skin markers with eight-camera system at 100 Hz. Subject specific MSK-MS was performed using AnyGait and morphed Twente Lower Extremity Model (TLEM), matching the size and joint morphology of the stick-figure model. Over-determinate kinematic analysis was performed, and motion equations solved with hard and soft constraints. Representative MSK-MS gait cycles were selected at NG, SKG and SR lower limb joint vertical force components at the hip, the knee, and the ankle normalized to body weight (JFz/BW). Internal joint direct measurements of four PO patients’, 61–83 years, average weight 808 N and 1.71 m height, with telemetric Hip I (4-channel), Hip II (8-channel) and knee (9-channel) instrumented implants were selected from Orthoload database with comparable gait to NG, SKG and SR. Statistical measurements presented similar mean JFz/BW at right/left hip, knee, ankle MSK-MS and asymmetric peak values with dominant NG, SKG and SR different variances (p < 0.05). Direct JFz/BW measures contrasted NG with similar hip and knee mean and variance from SKG and SR with different mean and variance. Peak JFz/BW direct measurements presented higher hip and knee values on SR and NG than SKG, with higher values at the knee than the hip on NG and SKG, and the opposite on SR. Direct JFz/BW measurements presented at the hip and the knee lower values than their corresponding MSK-MS on NG, SKG and SR.