Clinical Biomechanics最新文献

{"title":"Reactive stepping behavior during dual tasking is related to falls in community-dwelling older adults: A cross-sectional study","authors":"Hideyuki Tashiro ,&nbsp;Sota Hirosaki ,&nbsp;Yui Sato ,&nbsp;Hikaru Ihira ,&nbsp;Megumi Toki ,&nbsp;Naoki Kozuka","doi":"10.1016/j.clinbiomech.2025.106536","DOIUrl":"10.1016/j.clinbiomech.2025.106536","url":null,"abstract":"<div><h3>Background</h3><div>We investigated whether reactive stepping during dual tasking is associated with falls in community-dwelling older adults.</div></div><div><h3>Methods</h3><div>In 78 healthy community-dwelling older adults, we evaluated quiet standing stability, limits of stability, and reactive stepping performance during single and dual tasking. Participants were suspended in a forward-leaning position using a lean control cable with a load of 12 % of their body weight and were instructed to regain balance upon release by taking steps forward. Reactive stepping was induced under two conditions: (1) simple front-fixed gaze (single-task condition) and (2) reading color names written in different colors (dual-task condition). Reactive stepping performance was measured using the onset latency of the medial gastrocnemius of the stepping limb and the number of steps required to recover balance after forward balance loss. Participants were classified as fallers or non-fallers based on fall history during the past 12 months.</div></div><div><h3>Findings</h3><div>Twenty-two participants were classified as fallers. Both fallers and non-fallers exhibited a significantly increased number of steps during dual-tasking compared to the single-task condition. An interaction between group and condition was observed. The increased number of steps to balance recovery from forward balance loss during dual-tasking was significantly associated with falls after controlling for age, sex, body mass, cognitive function, and concerns about falling.</div></div><div><h3>Interpretation</h3><div>The number of steps taken to recover balance during dual-tasking was independently related to fall history in community-dwelling older adults. Fall prevention strategies for older adults should include measuring and improving their response to balance loss while dual tasking.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"125 ","pages":"Article 106536"},"PeriodicalIF":1.4,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143877091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biomechanical comparison of screw position in variable angle locking plate in intra-articular calcaneal fractures: Cadaveric and radiologic study","authors":"Vit Baba ,&nbsp;Lukas Capek ,&nbsp;Lubomir Kopp ,&nbsp;Vaclav Bittner","doi":"10.1016/j.clinbiomech.2025.106534","DOIUrl":"10.1016/j.clinbiomech.2025.106534","url":null,"abstract":"<div><h3>Background</h3><div>Lateral plating of calcaneal fractures using variable-angle locking plates is still the golden standard for severely comminuted cases. The aim of this study is to explore the possibilities of improving stability of osteosynthesis by changing screw directions. It provides an assessment and comparison of cadaveric biomechanical experiment with retrospective radiologic data analysis.</div></div><div><h3>Methods</h3><div>In the cadaveric study 8 intact calcaneus-talus specimens were obtained from 4 deceased donors. Fracture type 2b according to Sanders' classification was created in each specimen and fixed with variable-angle locking plate. The specimens were divided in 2 groups differing in orientation of anterior screws and fixed in PMMA base. A push-in test was performed by a two-column testing machine until gross failure.</div><div>Retrospective cohort study was performed, reviewing data of 74 patients which underwent surgical treatment of calcaneal fractures with the same construct. Evaluation was performed at scheduled CT and X-Ray controls. Direction of inserted screws and implant failure were noted.</div></div><div><h3>Findings</h3><div>The cadaveric study proved that there is no significant difference in mean failure force between two abovementioned screw configurations in Sanders 2b fracture. A significant difference was observed in initial stiffness. The radiologic retrospective study showed that difference in screw position within all fracture types but type 2b is significant.</div></div><div><h3>Interpretation</h3><div>Screw configuration in the anterior part of variable-angle locking plate appears to affect primary stiffness and stability of the construct. Particularly in more comminuted fractures, screw inserted in the direction of sustentaculum improves the stability and lowers risk of implant failure.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"125 ","pages":"Article 106534"},"PeriodicalIF":1.4,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143874206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Variable gait training to improve gait stability in ankle-foot orthosis users with neuromuscular disorders: A pilot study","authors":"Elza van Duijnhoven ,&nbsp;Bart Raijmakers ,&nbsp;Fieke Sophia Koopman ,&nbsp;Frans Nollet ,&nbsp;Merel-Anne Brehm ,&nbsp;Katinka van der Kooij ,&nbsp;Niels Waterval","doi":"10.1016/j.clinbiomech.2025.106533","DOIUrl":"10.1016/j.clinbiomech.2025.106533","url":null,"abstract":"<div><h3>Background</h3><div>Ankle-foot orthoses aim to improve walking in people with neuromuscular disorders with lower leg muscle weakness. However, clinical experience indicates that some ankle-foot orthosis users report limited gait stability improvements, suggesting suboptimal adaptation. Variable gait training may improve adaptation, and thereby gait stability. We aimed to investigate whether variable gait training improves gait stability in individuals with neuromuscular disorders who initially experienced stability problems when using ankle-foot orthoses.</div></div><div><h3>Methods</h3><div>Three stiffness-optimized dorsal leaf ankle-foot orthosis users received three variable gait training sessions on an interactive treadmill with one session per week. Gait stability (variability in step time, step length, and step width), target-stepping accuracy (variable stepping error), balance performance, balance confidence, fear of falling, and perceived walking ability were assessed pre-training and one week post-training. Training experiences were also inventoried.</div></div><div><h3>Findings</h3><div>Post-training, the variability in step time, step length, and step width decreased on average by 38 %, 26 %, and 22 % respectively. Anteroposterior target-stepping accuracy increased post-training by 24 % and mediolateral accuracy by 3 %. No clear differences in balance and fear of falling were observed. All participants perceived improvements in some aspects of walking ability and appreciated the training.</div></div><div><h3>Interpretation</h3><div>Variable gait training may enhance gait stability and target-stepping accuracy in ankle-foot orthosis users who initially perceived little benefits. No improvements on balance outcomes and mixed outcomes on perceived walking ability were found. A larger study is needed to determine whether variable gait training following orthosis provision could lead to meaningful changes in gait stability, balance, and daily functioning.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"125 ","pages":"Article 106533"},"PeriodicalIF":1.4,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143879211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dynamic response of soft tissue can be disregarded during femoral stem impaction","authors":"Peter J. Schlieker ,&nbsp;Frank Lampe ,&nbsp;Johann Zwirner ,&nbsp;Benjamin Ondruschka ,&nbsp;Michael M. Morlock ,&nbsp;Gerd Huber","doi":"10.1016/j.clinbiomech.2025.106530","DOIUrl":"10.1016/j.clinbiomech.2025.106530","url":null,"abstract":"<div><h3>Background</h3><div>In cementless total hip arthroplasty stems are inserted into the bone by mallet blows. Surgeons are not instructed to adjust the force of their blows to differences among patients especially with regard to weight. Whether this is linked to complications is yet unknown. This study investigated factors that could affect the mechanical behavior of the femur-tissue system.</div></div><div><h3>Methods</h3><div>Four cadavers were subject to two total hip arthroplasties by the same surgeon – one side via a lateral approach and the contralateral side via a direct anterior approach. A mass-spring-damper model was used to replicate the mechanical response of the femur-tissue system of the cadavers and make them comparable.</div></div><div><h3>Findings</h3><div>The mechanical response in terms of mass-spring-damper parameters differed between the approaches (lateral: 16.5 kg, 29.7 N/mm, 467.1 Ns/m; direct anterior: 11.5 kg, 41.7 N/mm, 553.0 Ns/m).</div></div><div><h3>Interpretation</h3><div>Common metal-on-metal mallet blows in surgery are very short and mostly excite high frequencies that are clearly above the natural frequency of the femur-tissue system. Those overcritical force impulses make the stem slide into the femur before the bone can even start moving. Hence, the individual mechanical behavior of the femur-tissue system can be disregarded provided that the force is applied with very short blows. This needs to be considered for any attempt to replace the mallet in the operation theater (e.g. automated surgical impaction tools) or to modify the mallet (e.g. alternative tip material). Furthermore, it may provide guidance on the fixation of femurs in in vitro testing to mimic surgical reality.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"125 ","pages":"Article 106530"},"PeriodicalIF":1.4,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143874208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing return-to-work decisions following anterior cruciate ligament reconstruction: A 12-week evaluation of objective functional assessment and rehabilitation outcomes in patients with occupational injuries","authors":"Raquel S. Salinas Gonzalez ,&nbsp;Javier Pérez-de la Torre ,&nbsp;Cristina Herrera Ligero","doi":"10.1016/j.clinbiomech.2025.106532","DOIUrl":"10.1016/j.clinbiomech.2025.106532","url":null,"abstract":"<div><h3>Background</h3><div>Anterior cruciate ligament (ACL) injuries are common, yet there is a critical knowledge gap regarding rehabilitation in non-athlete occupational populations. This lack of research translates to insufficient objective criteria to guide effective clinical decision-making in these patients. This research aimed to assess the impact of a 12-week rehabilitation program with specialized tools on the recovery and return-to-work potential of patients with occupational ACL injuries.</div></div><div><h3>Methods</h3><div>A prospective, observational single-center study evaluated rehabilitation outcomes in patients after ACL reconstruction. Twenty patients undergoing ACL reconstruction participated in a 12-week clinical-functional follow-up program. Rehabilitation treatment was assessed through biomechanical gait analysis (dynamometric platform and NedAMH/IBV® software), isokinetic dynamometry ((Biodex 3™), and the Lysholm scale to assess patient-reported function. Statistical analysis included normality testing (Kolmogorov-Smirnov and Shapiro-Wilk tests) and appropriate tests for parametric (one-way ANOVA with repeated measures) or non-parametric data (Friedman test with Wilcoxon signed-rank post-hoc tests).</div></div><div><h3>Findings</h3><div>Rehabilitation improved gait mechanics (reduced stance time, improved ground reaction forces by the ninth week) and muscle strength (decreased deficit, improved peak torque by 8th–12th week) as measured by biomechanical analysis and isokinetic dynamometry. Patient-reported function (Lysholm scale) also showed significant improvements from the sixth week onwards.</div></div><div><h3>Interpretation</h3><div>Our findings indicate that rehabilitation following ACL reconstruction significantly enhances patient function in work-related injuries, as demonstrated by improvements in gait, strength, and self-reported outcomes. These objective assessments play a significant role in facilitating safe return-to-work decisions. Further research is necessary to explore job-specific rehabilitation strategies.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"125 ","pages":"Article 106532"},"PeriodicalIF":1.4,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143864944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stepping into a safer movement: The relationship between foot progression angle and lower extremity biomechanics during a 45-degree run-cut maneuver","authors":"Josh Riesenberg ,&nbsp;Lauren Butler ,&nbsp;Hannah Olander ,&nbsp;Ashley L. Erdman ,&nbsp;Sophia Ulman","doi":"10.1016/j.clinbiomech.2025.106529","DOIUrl":"10.1016/j.clinbiomech.2025.106529","url":null,"abstract":"<div><h3>Background</h3><div>Anterior cruciate ligament injury rates are high and often associated with change-of-direction movements. Analysis of youth movement patterns is critical for avoiding injury and foot progression angle affects lower extremity kinematics during cutting movements. Knee abduction and hip adduction are known predictors of anterior cruciate ligament injury. The relationship between foot progression angle and lower extremity biomechanics lacks exploration in youth athletes following anterior cruciate ligament reconstruction. This study aimed to assess the relationship between foot progression angle at max knee flexion, and mechanics predictive of anterior cruciate ligament injury during a change-of-direction task in youth athletes following anterior cruciate ligament reconstruction.</div></div><div><h3>Methods</h3><div>Thirty-four participants (12 m, 15.0 ± 2.5 years) who previously underwent anterior cruciate ligament reconstruction participated in the study. Participants performed a 45-degree run cut task on both affected and unaffected limbs. Trunk and lower extremity biomechanics were collected using 3D motion capture and force plates.</div></div><div><h3>Findings</h3><div>Moderate correlations were observed on the affected limb for trunk, pelvis, hip, knee, and ankle angles, as well as ankle moments (<em>r</em> = −0.34-0.52). On the unaffected limb, moderate correlations were seen in pelvis, hip, and ankle angles (<em>r</em> = 0.41–0.44). Significant differences exist between limbs for pelvis, hip and knee angles, as well as knee moments (<em>p</em> ≤ 0.038).</div></div><div><h3>Interpretation</h3><div>Youth athletes appear to exhibit cutting movement patterns following anterior cruciate ligament reconstruction that may increase their risk of anterior cruciate ligament reinjury. Foot progression angle is a potential component of cutting tasks that clinicians and coaches can use to reduce an athlete's injury risk.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"125 ","pages":"Article 106529"},"PeriodicalIF":1.4,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143844533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of sagittal plane axis shifts in hinged ankle-foot orthoses on gait mechanics and shaft-to-leg relative motion","authors":"Harald Böhm ,&nbsp;Markus Müller ,&nbsp;Markus Hildebrandt-Ahlborn ,&nbsp;Thomas Schmalz ,&nbsp;Malte Bellmann","doi":"10.1016/j.clinbiomech.2025.106527","DOIUrl":"10.1016/j.clinbiomech.2025.106527","url":null,"abstract":"<div><h3>Background</h3><div>The alignment of the axis in ankle-foot orthoses is essential for ensuring optimal biomechanical function and comfort for the user. Correct alignment reduces orthosis displacement, minimizes skin irritation and joint stress, and improves overall performance. This study explores the effects of varying joint axis positions on ankle-foot orthoses functionality and shaft-to-leg movement.</div></div><div><h3>Methods</h3><div>Six healthy adult males (mean age: 35 ± 12 years) participated, walking with bilateral ankle foot orthoses configured in five joint axis positions and a shod condition. A 3D motion analysis system captured kinematic and kinetic data, examining the effects of anterior, posterior, proximal, and distal axis shifts on range of motion, joint moments, energy, and shaft-to-leg relative movement (pistoning).</div></div><div><h3>Findings</h3><div>Anterior-posterior axis shifts significantly affected joint mechanics. Anterior alignment produced the highest dorsiflexion moments and reduced pistoning during dorsiflexion. Range of motion was reduced in all orthotic conditions compared to the shod condition. Proximal-distal shifts had minimal biomechanical impact but increased pistoning. Contrary to expectations, neutral alignment due to the recommendations of the manufacturer did not consistently minimize pistoning or preserve motion.</div></div><div><h3>Interpretation</h3><div>This study underscores the importance of anterior-posterior alignment in optimizing ankle joint function with orthotics. Specifically, anterior alignment reduced pistoning more effectively than the manufacturer-recommended neutral position, particularly during dorsiflexion. These findings highlight the clinical relevance of aligning the orthotic axis with natural joint mechanics, which can reduce motion restrictions, improve gait efficiency, and prevent harmful pressures that may cause discomfort, bruising, and inflammation around the ankle.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"125 ","pages":"Article 106527"},"PeriodicalIF":1.4,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143838327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantification of gait impairment using the gait profile and variable score in children with cerebral palsy","authors":"C. Boulard ,&nbsp;S. Tavoosi ,&nbsp;A. Ravel ,&nbsp;B. Dohin","doi":"10.1016/j.clinbiomech.2025.106528","DOIUrl":"10.1016/j.clinbiomech.2025.106528","url":null,"abstract":"<div><h3>Background</h3><div>gait kinematic parameters of children with unilateral and bilateral cerebral palsy must be characterized separately by a statistical index with promising psychometric properties. The objective of this study was to compare both forms of cerebral palsy using the gait profile score and gait variable score.</div></div><div><h3>Methods</h3><div>Gait profile score of 47 children with cerebral palsy classified with a Gross Motor Function Classification System level I-III were retrospectively calculated from gait analysis. Statistical analysis were used to compare (1) gait profile score between level I and II, (2) gait profile and variable score between children with unilateral (<em>n</em> = 28) and bilateral (<em>n</em> = 16) forms as well as their difference between both limbs for each subgroup (significance level of 0.05).</div></div><div><h3>Findings</h3><div>The gait profile score was significantly different between level I and II (<em>p</em> ≤ 0.021). No significant difference was found for gait profile score between both subgroups (<em>p</em> = 0.72) or between both limbs of children with bilateral form (<em>p</em> = 0.85). The gait profile score was significantly higher for the paretic compared to the non-paretic limb of children with unilateral form (<em>p</em> &lt; 0.005). Significant differences were found for some gait variable score between subgroups (<em>p</em> &lt; 0.05).</div></div><div><h3>Interpretation</h3><div>The gait profile score can distinguish altered kinematic gait parameters in paretic from non-paretic limb in children with unilateral form. The gait variable score helps to localize the largest kinematic impairment.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"125 ","pages":"Article 106528"},"PeriodicalIF":1.4,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143850592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The functional popliteal angle test can detect features of hamstring spasticity","authors":"Mahdieh Hajibozorgi ,&nbsp;Juha M. Hijmans ,&nbsp;Christian Greve","doi":"10.1016/j.clinbiomech.2025.106523","DOIUrl":"10.1016/j.clinbiomech.2025.106523","url":null,"abstract":"<div><h3>Background</h3><div>Hamstring spasticity is a common impairment in patients with central neurological lesions, and accurate diagnostics is crucial for effective treatment of associated gait abnormalities, such as crouch gait. Current diagnostics, including 3D clinical gait analysis during normal and fast walking, have limitations that may lead to misdiagnosis, possibly explaining the current poor treatment outcomes. To address these limitations, we introduced the functional popliteal angle test—a knee-extension motion with flexed-hip performed while standing on one leg at both slow and fast speeds. This study aimed to assess this test's construct validity, showing its capacity to detect features of hamstring spasticity.</div></div><div><h3>Methods</h3><div>Kinematics and hamstring EMG data from patients with central neurological lesions and healthy participants were retrospectively extracted. Two criteria—<em>EMG-Velocity</em> and <em>Peak Muscle Length</em> ratios—were defined to capture key spasticity components: a disproportionately large increase in muscle activity with higher muscle-tendon lengthening velocities and a shorter maximum muscle length during fast vs. slow lengthening. Ratios were calculated individually for patients' and healthy participants' limbs, with values above <em>one</em> indicating spasticity.</div></div><div><h3>Findings</h3><div>Eight out of nine healthy limbs scored below <em>one</em> on both criteria. Among 35 patient limbs (age: 16 ± 12 years), 18 scored below <em>one</em> on both criteria (categorized as non-spastic), while 14 scored above <em>one</em> on both criteria (categorized as spastic). Discrepancies arose in three limbs.</div></div><div><h3>Interpretation</h3><div>The results suggest that the functional popliteal angle test can detect features of hamstring spasticity and holds potential for enhancing clinical diagnostics of hamstring spasticity.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"125 ","pages":"Article 106523"},"PeriodicalIF":1.4,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143838326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of a posterior-stabilized prosthesis on knee ligament loads during walking: A musculoskeletal modelling study","authors":"Lucia Donno,&nbsp;Christian Dubbini,&nbsp;Carlo Albino Frigo","doi":"10.1016/j.clinbiomech.2025.106526","DOIUrl":"10.1016/j.clinbiomech.2025.106526","url":null,"abstract":"<div><h3>Background</h3><div>The correct balancing of the knee joint ligaments in case of total knee arthroplasty is fundamental for the functional outcome. Hence, it could be of interest for surgeons to understand how the ligaments' tension and intraarticular forces change after the implantation of a knee prosthesis, not only in clinical tests but particularly during functional activities. Many studies have compared the effects of different implant designs but without any reference to changes compared to the natural knee.</div></div><div><h3>Methods</h3><div>In this study, a posterior-stabilized prosthesis was virtually implanted in a three-dimensional musculoskeletal model of the knee joint. Through a dynamic simulation of the gait cycle, the knee kinematics, ligaments' tension and tibial-femoral contact force were quantified and compared with those obtained by the intact knee model.</div></div><div><h3>Findings</h3><div>In the presence of the prosthesis, the tibia preserved the two peaks of anterior displacement in correspondence with the peaks of knee flexion, even if reduced in relation to the intact knee. The superficial and deep Medial Collateral Ligaments supported the highest load, compensating for the absence of the cruciate ligaments. After the introduction of the prosthesis, the tibial-femoral contact force showed the same trend obtained in the natural knee model, however it appeared reduced compared to the intact knee condition and approached the experimental data recorded by an instrumented prosthesis.</div></div><div><h3>Interpretation</h3><div>This study quantified the changes induced by the posterior-stabilized implant in terms of kinematics, ligament tensions and intraarticular forces during walking, demonstrating how musculoskeletal models can support gaining insight into complex biomechanical systems.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"125 ","pages":"Article 106526"},"PeriodicalIF":1.4,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143844680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}