Pressure distribution on articular surfaces: Application to joint stability evaluation

doi:10.1016/0021-9290(90)90316-U

Journal of Biomechanics

Volume 23, Issue 10, 1990, Pages 1013-1020

https://doi.org/10.1016/0021-9290(90)90316-U Get rights and content

Abstract

A generalized method, based on the rigid body spring model, is developed to determine the two-dimensional joint contact pressure of any shape of articular surface and loading condition. The formulation of the model and procedures for the determination of parameters used in the model are presented. The model was used first to analyze the pressure distribution of an ideal hinge joint for comparison with reported results in the literature, and with those using the conventional finite element method. Implications of the results based on the calculated ‘virtual displacement’ to the joint stability are hypothesized and discussed. The problem of joint pressure distribution of the elbow joint is then analyzed, along with the discussion of agonistic and antagonistic muscle activities.

References (9)

T.D. Brown et al.
A contact-coupled finite element analysis of the natural adult hip
J. Biomechanics
(1984)
M. Garcia-Elias et al.
Stability of the transverse carpal arch. An experimental study
J. Hand Surg. (Am.)
(1989)
A.S. Greenwald et al.
The transmission of load through the human hip joint
J. Biomechanics
(1971)
M. Garcia-Elias et al.
Transverse stability of the carpus. An analytic study
J. orthop. Res.
(1989)

There are more references available in the full text version of this article.

Cited by (104)

Role of Dynamic Stabilizers of the Elbow in Radiocapitellar Joint Alignment: A Prospective In Vivo Study
2023, Journal of Hand Surgery
Citation Excerpt :
The dynamic stabilizers of the elbow are believed to contribute to elbow stability via compression across the joint. The basis of this understanding comes from the study by An et al17 describing the theoretical biomechanical joint reactive forces by muscles crossing the joint and from a cadaveric study by An et al18 detailing the muscles that have the most theoretical force across the elbow joint. O’Driscoll et al8 suggest that the triceps, brachialis, and in particular, the anconeus are the main stabilizers of the elbow joint due to compressive forces.
To investigate the effect of dynamic stabilizers of the elbow on radiocapitellar joint alignment, before and after the administration of regional anesthesia.
At a single institution, 14 patients were prospectively enrolled in a study using a within-subjects control design. Before performing a supraclavicular regional block, 10 fluoroscopic images (1 anteroposterior and 9 lateral views) of the elbow were obtained for each patient. The lateral images were obtained with the forearm in maximal supination, neutral rotation, and maximal pronation, and these forearm positions were repeated for 3 elbow positions: (1) full extension; (2) flexion to 90°, with 0° of shoulder internal rotation; and (3) flexion to 90°, with 90° of shoulder internal rotation. After obtaining the 10 initial images, a block was performed to achieve less than 3/5 motor strength of the imaged extremity, followed by obtaining the same 10 images in each patient. Radiocapitellar ratio, defined as the minimal distance between the right bisector of the radial head and the center of the capitellum divided by the diameter of the capitellum, was measured in each image.
The 14 patients had a mean age of 47.8 ± 15.7 years, and 10 (71.4%) patients were women. A difference between radiocapitellar ratios measured before and after the regional block administration was observed for all lateral images (−1.0% ± 7.2% to −2.2% ± 8.0%), although this difference was less than the minimum clinically important difference.
Paralysis of the dynamic stabilizers of the elbow produces a difference in the radiocapitellar joint alignment, but this did not reach the minimum clinically important difference.
Paralysis of the dynamic stabilizers of the elbow via a supraclavicular nerve block produces no clinically relevant effect on the radiocapitellar alignment of uninjured elbows.
Combining advanced computational and imaging techniques as a quantitative tool to estimate patellofemoral joint stress during downhill gait: A feasibility study
2021, Gait and Posture
Citation Excerpt :
These transformations were applied to the femoral and patellar bones, along with their respective cartilage geometry, at each frame measured during downhill gait. Patellofemoral joint contact stress from the DEA model was estimated using a rigid body spring method described previously [19,28–30]. We recently validated this method at the patellofemoral joint [22].
The onset and progression of patellofemoral osteoarthritis (OA) has been linked to alterations in cartilage stress—a potential precursor to pain and subsequent cartilage degradation. A lack in quantitative tools for objectively evaluating patellofemoral joint contact stress limits our understanding of pathomechanics associated with OA.
Could computational modeling and biplane fluoroscopy techniques be used to discriminate in-vivo, subject-specific patellofemoral stress profiles in individuals with and without patellofemoral OA?
The current study employed a discrete element modeling framework driven by in-vivo, subject-specific kinematics during downhill gait to discriminate unique patellofemoral stress profiles in individuals with patellofemoral OA (n = 5) as compared to older individuals without OA (n = 6). All participants underwent biplane fluoroscopy kinematic tracking while walking on a declined instrumented treadmill. Subject-specific kinematics were combined with high resolution geometrical models to estimate patellofemoral joint contact stress during 0%, 25 %, 50 %, 75 % and 100 % of the loading response phase of downhill gait.
Individuals with patellofemoral OA demonstrated earlier increases in patellofemoral stress in the lateral patellofemoral compartment during loading response as compared to OA-free controls (P = 0.021). Overall, both groups exhibited increased patellofemoral contact stress early in the loading response phase of gait as compared to the end of loading response. Results from this study show increased stress profiles in individuals with patellofemoral OA, indicating increasing joint loading in early phases of gait.
This modeling framework—combining arthrokinematics with discrete element models—can objectively estimate changes in patellofemoral joint stress, with potential applications to evaluate outcomes from various treatment programs, including surgical and non-surgical rehabilitation treatments.
Development and validation of a kinematically-driven discrete element model of the patellofemoral joint
2019, Journal of Biomechanics
Citation Excerpt :
This outline was then virtually registered and mapped to the patellar anatomy using measurements of the retropatellar surface recorded using a caliper (height and width). PFJ contact stress from the DEA model was estimated using a rigid body spring method described previously (An et al., 1990; Elias et al., 2004; Genda et al., 2001; Iwasaki et al., 1998). Briefly, springs were generated in the regions of apparent cartilage overlap detected between the femoral and patellar contacting surfaces.
Quantifying the complex loads at the patellofemoral joint (PFJ) is vital to understanding the development of PFJ pain and osteoarthritis. Discrete element analysis (DEA) is a computationally efficient method to estimate cartilage contact stresses with potential application at the PFJ to better understand PFJ mechanics. The current study validated a DEA modeling framework driven by PFJ kinematics to predict experimentally-measured PFJ contact stress distributions. Two cadaveric knee specimens underwent quadriceps muscle [215 N] and joint compression [350 N] forces at ten discrete knee positions representing PFJ positions during early gait while measured PFJ kinematics were used to drive specimen-specific DEA models. DEA-computed contact stress and area were compared to experimentally-measured data. There was good agreement between computed and measured mean and peak stress across the specimens and positions (r = 0.63–0.85). DEA-computed mean stress was within an average of 12% (range: 1–47%) of the experimentally-measured mean stress while DEA-computed peak stress was within an average of 22% (range: 1–40%). Stress magnitudes were within the ranges measured (0.17–1.26 MPa computationally vs 0.12–1.13 MPa experimentally). DEA-computed areas overestimated measured areas (average error = 60%; range: 4–117%) with magnitudes ranging from 139 to 307 mm² computationally vs 74–194 mm² experimentally. DEA estimates of the ratio of lateral to medial patellofemoral stress distribution predicted the experimental data well (mean error = 15%) with minimal measurement bias. These results indicate that kinematically-driven DEA models can provide good estimates of relative changes in PFJ contact stress.
Biomechanics of the shoulder and elbow
2017, Orthopaedics and Trauma
Citation Excerpt :
It was also found that the force through the humero-ulnar joint can be as high as one to three times body weight during heavy lifting.14 An et al.13 evaluated the contact stresses on elbow cartilage during the normal range of movement. They found that the highest contact stresses occurred when the direction of force was centred at the margins of the articular surface, and that the force distribution was more uneven.
The shoulder and elbow are complex joints with inherent biomechanical features that allow for a wide range of motion, yet stability at the extremes of movement. The shoulder girdle is composed of three bones and five joints, with multiple muscle attachments. It is predisposed to develop a wide range of pathologies if injury or dysfunction disturbs the biomechanical balance. It is the synergistic effect of static and dynamic stabilizers of the shoulder that work to maintain the congruence of what is inherently an unstable joint. The elbow links the shoulder and the hand, and functions as a fulcrum for the forearm lever. It helps position the hand in space, thus allowing the hand to perform activities of daily living. The elbow must be robust enough to allow it to function as a weight-bearing joint, and therefore complex joint biomechanics are required to maintain its stability and function. Many conditions affect the bony and soft tissue structures of the upper limb. This often results in reduced movement and function, necessitating replacement or restoration of normal anatomy. A comprehensive understanding of shoulder and elbow biomechanics is essential to plan and treat upper limb conditions.
Arthroscopic Management of Elbow Osteoarthritis
2017, Journal of Hand Surgery
Citation Excerpt :
These forces can reach 3 times body weight with heavy lifting and can exceed 6 times body weight with dynamic loading.1 The surface area of contact is relatively small, resulting in substantial compressive force on the hyaline cartilage during load application, especially with axial loading in extension.5 Repetitive supraphysiological loading leads to wear and cartilage fragmentation, which can produce intra-articular loose bodies and result in the formation of peripheral osteophytes.6
The incidence of osteoarthritis in the general population is low, but it can be seen in manual laborers, throwing athletes, and people dependent on crutches and wheelchairs. Patients often complain of pain at the terminal extents of motion, and imaging shows osteophyte formation at the tips of the coronoid and olecranon processes as well as thickening of the bone between the coronoid and the olecranon fossae. Recent advances in arthroscopic instrumentation and techniques have led to a growing interest in the arthroscopic treatment of elbow osteoarthritis. This article provides a review of basic arthroscopic elbow anatomy and the most common procedures, including diagnostic arthroscopy, loose body removal, and arthroscopic osteocapsular and ulnohumeral arthroplasty. As techniques advance, there might be interest in further procedures including arthroscopic-assisted interpositional arthroplasty. Although complications such as persistent drainage and nerve injury are frequently mentioned with elbow arthroscopy, the actual incidence of such complications remains low.
Optimizing the rehabilitation of elbow lateral collateral ligament injuries: a biomechanical study
2017, Journal of Shoulder and Elbow Surgery
Citation Excerpt :
With the forearm pronated and the arm overhead, the ulnohumeral kinematics of an elbow with a combined LCL/CEO injury are comparable to those of an intact elbow during both active and passive ROM. This is likely because of the gravitational mass of the forearm and hand leading to elbow joint compression in this position, increasing bone congruency and thus joint stability.2,37 During active motion with the arm overhead and forearm supinated, there was no difference in ulnohumeral stability based on extent of lateral soft tissue injury, perhaps because of the positive effects of gravity and the force through the activated triceps negating the destabilizing moment caused by forearm supination.
Elbow lateral collateral ligament (LCL) injury may arise after trauma or lateral surgical approaches. The optimal method of rehabilitating the LCL-insufficient elbow is unclear. Therapists often prescribe active motion exercises with the forearm pronated. Recently, overhead exercises have become popular as they may enable gravity to compress the elbow joint, improving stability, although this has not been proved biomechanically. This investigation aimed to quantify the effects of several variables used in LCL injury rehabilitation on elbow stability.
Seven cadaveric specimens were tested in a custom elbow motion simulator in 3 arm positions (overhead, dependent, and varus) and 2 forearm positions (pronation and supination) during passive and simulated active elbow extension. Three injury patterns were studied (intact, LCL injury, and LCL with common extensor origin injury). An electromagnetic tracking device measured ulnohumeral kinematics.
Following combined LCL and common extensor origin injury, overhead positioning enhanced elbow stability relative to the other arm positions (P < .01 in pronation; P = .04 in supination). Active motion stabilized the LCL-deficient elbow in the dependent (P = .02) and varus (P < .01) positions. Pronation improved stability in the overhead (P = .05), dependent (P = .06), and varus (P < .01) positions.
Rehabilitation with the arm overhead improves elbow stability after LCL injury. Initiating earlier range of motion in this “safe position” might decrease elbow stiffness and allow optimal ligament healing. If exercises are done in the dependent position, active motion with forearm pronation should be encouraged. Varus arm positioning should be avoided.

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Pressure distribution on articular surfaces: Application to joint stability evaluation

Abstract

J. Biomechanics

J. Hand Surg. (Am.)

J. Biomechanics

Transverse stability of the carpus. An analytic study

J. orthop. Res.