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Journal of Orthopaedic Research

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Volume 25, Issue 6 , Pages 789 - 797

Published Online: 7 Mar 2007

Copyright © 2007 Orthopaedic Research Society

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 Research Article
Correlation between the knee adduction torque and medial contact force for a variety of gait patterns
Dong Zhao 1, Scott A. Banks 1 2 3 4, Kim H. Mitchell 4, Darryl D. D'Lima 5, Clifford W. Colwell Jr. 5, Benjamin J. Fregly 1 2 3 *
1Department of Mechanical & Aerospace Engineering, University of Florida, Gainesville, Florida
2Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, Florida
3Department of Biomedical Engineering, University of Florida, Gainesville, Florida
4The Biomotion Foundation, Palm Beach, Florida
5Shiley Center for Orthopaedic Research & Education at Scripps Clinic, La Jolla, California
email: Benjamin J. Fregly (fregly@ufl.edu)

*Correspondence to Benjamin J. Fregly, Department of Mechanical & Aerospace Engineering, University of Florida, Gainesville, Florida. Telephone: 352-392-8157; Fax: 352-392-7303

Keywords
knee joint adduction moment gait in vivo knee loads total knee arthroplasty instrumented knee implant

Abstract
The external knee adduction torque has been proposed as a surrogate measure for medial compartment load during gait. However, a direct link between these two quantities has not been demonstrated using in vivo measurement of medial compartment load. This study uses in vivo data collected from a single subject with an instrumented knee implant to evaluate this link. The subject performed five different overground gait motions (normal, fast, slow, wide, and toe-out) with simultaneous collection of instrumented implant, video motion, and ground reaction data. For each trial, the knee adduction torque was measured externally while the total axial force applied to the tibial insert was measured internally. Based on data collected from the same subject performing treadmill gait under fluoroscopic motion analysis, a regression equation was developed to calculate medial contact force from the implant load cell measurements. Correlation analyses were performed for the stance phase and entire gait cycle to quantify the relationship between the knee adduction torque and both the medial contact force and the medial to total contact force ratio. When the entire gait cycle was analyzed, R2 for medial contact force was 0.77 when all gait trials were analyzed together and between 0.69 and 0.93 when each gait trial was analyzed separately (p < 0.001 in all cases). For medial to total force ratio, R2 was 0.69 for all trials together and between 0.54 and 0.90 for each trial separately (p < 0.001 in all cases). When only the stance phase was analyzed, R2 values were slightly lower. These results support the hypothesis that the knee adduction torque is highly correlated with medial compartment contact force and medial to total force ratio during gait. © 2007 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 25: 789-797, 2007

Received: 5 May 2006; Accepted: 6 December 2006

Digital Object Identifier (DOI)

10.1002/jor.20379  About DOI

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