ABSTRACT
Objective The biomechanical model for the musculoskeletal system of a human knee joint was established using a numerical simulation method.The kinematic and dynamic information captured during jumping motion simulated by the human dynamic model was used as driven data of the knee biomechanical model,followed by further analysis of the stress field distribution characteristics of the meniscus under different thermal-force coupling knee brace conditions.Methods Based on computed tomography and magnetic resonance imaging of the subject,a realistic human knee model,including bone,articular cartilage,meniscus,ligaments and peripheral soft tissues of the knee joint,was constructed.Furthermore,two gaits,namely taking-off and landing-on,of jumping motion with an increased risk of meniscus injuries were selected according to mechanical features in full-cycle jumping motion.Subsequently,the stress field characteristics of the knee meniscus under four different thermal-force coupling knee braces were analyzed,the changes of the peak stress of the meniscus and its stress concentration area were discussed,and the protective efficacy and mechanical basis of meniscal injuries and wearing knee braces were explored.Results The anterior part of the medial knee meniscus was a vulnerable area under concentrated stress.Under the knee brace thermal-force coupling condition,the stress concentration area of the medial meniscus was transferred from its narrow and weak anterior part to its wide and thick middle part,and the peak stress was also significantly reduced.The peak stress on the medial meniscus and that on the lateral meniscus were similar,indicating that the two parts of the meniscus bore the external load evenly,and the meniscus stress concentration area decreased.Conclusions Thermal-force coupling knee braces have good protective effects against knee meniscus injury.The numerical simulation provides theoretical support and technical guidance for the design of multifunctional thermal knee braces.
ABSTRACT
The paper aims to provide a state-of-the-art review of methods for evaluating the effectiveness and effect of unloader knee braces on the knee joint and discuss their limitations and future directions. Unloader braces are prescribed as a non-pharmacological conservative treatment option for patients with medial knee osteoarthritis to provide relief in terms of pain reduction, returning to regular physical activities, and enhancing the quality of life. Methods used to evaluate and monitor the effectiveness of these devices on patients' health are categorized into three broad categories (perception-, biochemical-, and morphology-based), depending upon the process and tools used. The main focus of these methods is on the short-term clinical outcome (pain or unloading efficiency). There is a significant technical, research, and clinical literature gap in understanding the short- and long-term consequences of these braces on the tissues in the knee joint, including the cartilage and ligaments. Future research directions may complement existing methods with advanced quantitative imaging (morphological, biochemical, and molecular) and numerical simulation are discussed as they offer potential in assessing long-term and post-bracing effects on the knee joint.
Subject(s)
Humans , Braces , Cartilage , Complement System Proteins , Joints , Knee Joint , Knee , Ligaments , Methods , Motor Activity , Osteoarthritis, Knee , Quality of Life , Review Literature as TopicABSTRACT
Objective Aiming at reducing the restrictions on lower limbs imposed by traditional knee brace, a design scheme for knee brace complying with internal-external rotation is proposed. Methods By adding the internal-external hinge, the knee brace could help to release the degree of freedom (DOM) of internal-external rotation of the knee. In the experimental group, the subject was required to wear the bilateral unloading knee brace with or without internal-external hinges, respectively, while in the control group, the subject did not wear the knee brace. Then gait experiment and mechanical testing were conducted. Results In gait experiment, the bilateral unloading knee brace with internal-external hinges imposed less restriction on the knee than that from the knee brace without internal-external hinges, and it could also provide some distractive force for the knee joint. Conclusions The internal-external hinge design can help to reduce restrictions on the knee imposed from bilateral unloading knee brace.
ABSTRACT
Background & Objectives: Osteoarthritis is chronic degenerative disorder of joint having many etiological factors. It is estimated to be the fourth leading cause of disability with prevalence of 22% to 39% in India. There is availability of less evidence of physiotherapy treatment for OA. Hence the need of the study is to find the individual and comparative effect of Apos therapy and knee brace in aspect of pain, range of motion and functional disability in patients with O.A. knee. Method: 30 subjects with osteoarthritis of Tibiofemoral joint were selected for the study and randomly divided in to two groups (A&B) of 15 subjects. Group A received Apos therapy and Group B received knee brace. Both groups treated with active exercises plus IFT. Pain was measured by VAS, Range of motion was measured by Goniometer and functional disability was measured by WOMAC scale. Results :Intra-group comparison of VAS , ROM and WOMAC score showed significant improvement in both the group but Apos therapy group showed highly significant (p< 0.001) improvement. Conclusion: In this study both groups have shown significant difference in reducing pain, improving ROM, and improving functional disability but Apos therapy showed more improvement than application of knee brace.
ABSTRACT
PURPOSE: To compare the clinical efficacy after an arthroscopic ACL double-bundle reconstruction with and without functional knee brace. MATERIALS AND METHODS: Between July 2004 and May 2006, fifty patients who underwent an ACL double-bundle reconstruction with and without a functional knee brace for more than a 1-year follow-up were evaluated. The patients were treated with brace (Group 1, 22 cases) or without (Group 2, 28 cases) a brace after surgrey. Stability was assessed by maximal manual testing with a KT-1000 arthrometer, anterior stress radiographs using the Telos device and a lateral pivot shift test. The clinical results were assessed by the OAK (Orthopadische Arbeitsgruppe Knie) score, IKDC (International Knee Documentation Committee) score, mid thigh circumference and the range of motion. RESULTS: More than one year after surgery, average of OAK score, IKDC score, lateral pivot shift test of the stability results and maximal manual testing with the KT-1000 arthrometer, stress radiographs with the Telos device, mid thigh circumference difference, range of motion of the clinical results were similar in both groups. CONCLUSION: An ACL double-bundle reconstruction produces similar stability and clinical results regardlness of whether or not a functional knee brace is used.
Subject(s)
Humans , Braces , Follow-Up Studies , Knee , Range of Motion, Articular , ThighABSTRACT
Results from the first 135 cases of tibial fractures treated with a functional below-the-knee-brace demonstrate uneventful healing while function of the knee and ankle is maintained. Rapid healing of the fracture in most patients suggests that the early resumption of nearly normal physiological conditions in the limb is favorable to timely and uninterrupted osteogenesis.
ABSTRACT
Rotation-plasty provides useful knee function and permits use of what is essentially an end-weight-bearing below-the knee prosthesis. This principle of rotating the foot was first used by Borggreve in 1930(3), in a patient with a short femur secondary to infection. Since then, this procedure has been used in congenital short femurs(4,6,7,), malignant bone tumors of the distal femur(1,5)and compound fracture with wide bone defect around the knee(2) We have performed this procedure in a case of focal femoral deficiency with 14cm shorter than the opposite femur due to long standing persistant chronic osteomyelitis in the mid-shaft femur of a nine-year old Korean boy and gave the good result with a conventional but slightly modified below- the-knee brace. The inverted foot was good to control the brace as a below-knee stump and heel functioned as a patella to support the body weight.