In vivo knee joint loading and kinematics – the interplay between movement and loading at the patello-femoral and tibio-femoral joints.

• Applicant: Dr. Adam Trepczynski
• Subject Area: Orthopaedics, Traumatology, Reconstructive Surgery
• Term: from 2019 to 2023
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 417498832

• Final Report Year: 2023

Final Report Abstract

While total knee arthroplasty is a generally very successful treatment for knee osteoarthritis, about 20% of patients later turn out to be dissatisfied with their functional post-operative outcome. A substantial patient population suffers from not yet fully understood post-operative symptoms, such as anterior knee pain. Progress towards solving the remaining problems of knee joint replacement requires a better understanding of the mechanical interaction between the patello-femoral and tibio-femoral joints. A tight collaboration between the Charité-Berlin and the ETH-Zürich allowed us to capture a worldwide unique dataset of synchronized in vivo tibio-femoral loads and internal joint kinematics. The simultaneous measurement of these two key parameters, along with whole body motion, ground reaction forces and muscle activity, provided the basis for the project, which aimed to gain an understanding of the underlying knee mechanics in a replaced joint. In this project we have quantified the patient-specific patellofemoral loads, and how they relate to the dynamic movements within the patello-femoral and tibio-femoral joints. The musculoskeletal loading determined through advanced subject specific models serve as a benchmark for later analyses of other implants or patient kinematic data, and form the technological foundation to evaluate other implant designs and implantation methods, beyond the validated instrumented implants used here.

Publications

• Weight Bearing Activities change the Pivot Position after Total Knee Arthroplasty. Scientific Reports, 9(1).
  Moewis, Philippe; Hommel, Hagen; Trepczynski, Adam; Krahl, Leonie; von Roth, Philipp & Duda, Georg N.
  
• Evaluation and validation of 2D biomechanical models of the knee for radiograph-based preoperative planning in total knee arthroplasty. PLOS ONE, 15(1), e0227272.
  Asseln, Malte; Eschweiler, Jörg; Trepczynski, Adam; Damm, Philipp & Radermacher, Klaus
  
• Knieendoprothetik: Biomechanik des Kniegelenks. Springer Reference Medizin, 1-18. Springer Berlin Heidelberg.
  Duda, Georg N.; Moewis, Philippe; Hommel, Hagen; Heller, Markus O.; Taylor, William R.; Bergmann, Georg & Trepczynski, Adam
  
• Length-Change Patterns of the Collateral Ligaments During Functional Activities After Total Knee Arthroplasty. Annals of Biomedical Engineering, 48(4), 1396-1406.
  Hosseini, Nasab S. H.; Smith, C. R.; Schütz, P.; Damm, P.; Trepczynski, A.; List, R. & Taylor, W. R.
  
• Retention of Posterior Cruciate Ligament Alone May Not Achieve Physiological Knee Joint Kinematics After Total Knee Arthroplasty. Journal of Bone and Joint Surgery, 103(2), 146-154.
  Moewis, Philippe; Duda, Georg N.; Trepczynski, Adam; Krahl, Leonie; Boese, Christoph K. & Hommel, Hagen
  
• The Capacity of Generic Musculoskeletal Simulations to Predict Knee Joint Loading Using the CAMS-Knee Datasets. Annals of Biomedical Engineering, 48(4), 1430-1440.
  Imani, Nejad Zohreh; Khalili, Khalil; Hosseini, Nasab Seyyed Hamed; Schütz, Pascal; Damm, Philipp; Trepczynski, Adam; Taylor, William R. & Smith, Colin R.
  
• Dynamic Knee Joint Line Orientation Is Not Predictive of Tibio-Femoral Load Distribution During Walking. Frontiers in Bioengineering and Biotechnology, 9.
  Trepczynski, Adam; Moewis, Philippe; Damm, Philipp; Schütz, Pascal; Dymke, Jörn; Hommel, Hagen; Taylor, William R. & Duda, Georg N.
  
• Patient‐specific resurfacing implant knee surgery in subjects with early osteoarthritis results in medial pivot and lateral femoral rollback during flexion: a retrospective pilot study. Knee Surgery, Sports Traumatology, Arthroscopy, 31(4), 1247-1266.
  Moewis, Philippe; Kaiser, René; Trepczynski, Adam; von Tycowicz, Christoph; Krahl, Leonie; Ilg, Ansgar; Holz, Johannes & Duda, Georg N.
  
• Towards planning of osteotomy around the knee with quantitative inclusion of the adduction moment: a biomechanical approach. Journal of Experimental Orthopaedics, 8(1).
  Biehl, Margit; Damm, Philipp; Trepczynski, Adam; Preiss, Stefan & Salzmann, Gian Max
  
• Dynamic knee joint line orientation is not a reliable predictor of contact load dynamics in vivo; 27th Congress of the European Society of Biomechanics (ESB), Porto, Portugal, 2022.
  Trepczynski A, Moewis P, Damm P, Schütz P, Dymke J, Hommel H, Taylor WR & Duda GN
  
• European Society of Biomechanics S.M. Perren Award 2022: Standardized tibio-femoral implant loads and kinematics. Journal of Biomechanics, 141, 111171.
  Dreyer, Michael J.; Trepczynski, Adam; Hosseini, Nasab Seyyed Hamed; Kutzner, Ines; Schütz, Pascal; Weisse, Bernhard; Dymke, Jörn; Postolka, Barbara; Moewis, Philippe; Bergmann, Georg; Duda, Georg N.; Taylor, William R.; Damm, Philipp & Smith, Colin R.
  
• Loading of the Knee Joint After Total Knee Arthroplasty. Basics in Primary Knee Arthroplasty, 65-76. Springer International Publishing.
  Moewis, P.; Trepczynski, A.; Bender, A.; Duda, G. N. & Damm, P.
  
• Patellar tendon loading and stiffness derived from in vivo loads and kinematics; 27th Congress of the European Society of Biomechanics (ESB), Porto, Portugal, 2022 (podium presentation).
  Kneifel P., Moewis P., Damm P., Schütz P., Dymke J., Taylor W.R., Duda G.N. & Trepczynski A.
  
• Uncertainty in Muscle–Tendon Parameters can Greatly Influence the Accuracy of Knee Contact Force Estimates of Musculoskeletal Models. Frontiers in Bioengineering and Biotechnology, 10.
  Hosseini, Nasab Seyyed Hamed; Smith, Colin R.; Maas, Allan; Vollenweider, Alexandra; Dymke, Jörn; Schütz, Pascal; Damm, Philipp; Trepczynski, Adam & Taylor, William R.
  
• A novel method to accurately recreate in vivo loads and kinematics in computational models of the knee. Computer Methods in Biomechanics and Biomedical Engineering, 27(7), 860-866.
  Dreyer, Michael J.; Kneifel, Paul; Hosseini, Nasab Seyyed Hamed; Weisse, Bernhard & Taylor, William R.
  
• Externes Knie-Flexionsmoment als Indikator für patello-femorale Belastung; Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU), Berlin, Germany, 2023.
  Trepczynski A, Kneifel P, Moewis P, Damm P, Schütz P, Dymke J, Taylor WR & Duda GN
  
• Patellar tendon elastic properties derived from in vivo loading and kinematics. Journal of Biomechanics, 151, 111549.
  Kneifel, Paul; Moewis, Philippe; Damm, Philipp; Schütz, Pascal; Dymke, Jörn; Taylor, William R.; Duda, Georg N. & Trepczynski, Adam
  
• Periarticular muscle status affects in vivo tibio-femoral joint loads after total knee arthroplasty. Frontiers in Bioengineering and Biotechnology, 11.
  Winkler, Tobias; Bell, Louisa; Bender, Alwina; Trepczynski, Adam; Duda, Georg N.; Baur, Alexander J. D. & Damm, Philipp
  
• Impact of the external knee flexion moment on patello-femoral loading derived from in vivo loads and kinematics. Frontiers in Bioengineering and Biotechnology, 12.
  Trepczynski, Adam; Kneifel, Paul; Heyland, Mark; Leskovar, Marko; Moewis, Philippe; Damm, Philipp; Taylor, William R.; Zachow, Stefan & Duda, Georg N.