步幅对膝关节接触的影响

doi:10.1007/s12204-024-2577-7

摘要/Abstract

摘要： 膝关节的结构复杂，而且影响膝关节运动的因素较多，因此研究步行过程中步幅对膝关节接触的影响对保护膝关节和探究膝关节疾病的产生机理都具有重要意义。本研究中，邀请了一名健康志愿者，通过动作捕捉实验探究了不同步幅下的下肢运动学特性。同时，建立了一个完整精细的膝关节有限元模型，并通过有限元分析研究了步幅对膝关节接触的影响。其中边界条件和载荷是根据动作捕捉实验中获得的符合实际工况的数据设置的。当行走步幅比习惯步幅增加23.08%时，单腿支撑阶段开始时刻的膝关节屈曲角度增加了108.12%，软骨和半月板上的最大von Mises应力值分别从5.888 MPa、5.599MPa增加到16.023 MPa、17.387 MPa，接触面上的高应力区也有显著偏移。当行走步幅比习惯步幅减少12.31%时，单腿支撑阶段结束时刻的膝关节屈曲角度减少了62.22%，软骨和半月板上的最大von Mises应力值分别从5.362 MPa、5.255 MPa减少到2.074 MPa 、1.986 MPa。研究结果表明：通过步行锻炼膝关节和预防、治疗膝关节疾病时，人们应该根据膝关节的健康状况选择合适的步幅进行锻炼，避免过度追求大步幅来提高锻炼效果，而通过较小的步幅进行锻炼则适合大多数人群。

关键词: 膝关节接触, 下肢运动学, 动作捕捉, 有限元法

Abstract: The knee joint is structurally complex and there are numerous factors that influence knee dynamics. Therefore, it is valuable to study the effect of stride length on knee contact during walking. Moreover, it is crucial to study the mechanical properties of the knee joint for the protection of the knee joint and the mechanism of knee diseases. In this study, a healthy volunteer was invited to investigate the kinematics of the lower limb under different stride lengths by conducting motion capture experiments. Then, a complete and detailed finite element model of the knee was established, and the effect of stride length on the knee contact was studied using the finite element method, where the boundary conditions and loads were set up in accordance with the actual working conditions based on the data obtained from the motion capture experiments. When the stride length was increased by 23.08% compared with the habitual stride length, the knee flexion angle at the beginning moment of the single-legged support phase could be increased by 108.12%, the maximum von Mises stress values on the femur cartilage and meniscus were increased from 5.888 to 16.023MPa and from 5.599 to 17.387 MPa, respectively, and the high-stress zone on the contact surface was also significantly shifted. When the stride length was reduced by 12.31% compared to the habitual stride length, the knee flexion angle at the moment of the end of the singlelegged support phase was reduced by 62.22%, and the maximum von Mises stress values on the femur cartilage and meniscus were reduced from 5.362MPa to 2.074MPa and from 5.255MPa to 1.986MPa, respectively. The results of this paper indicate that when exercising and preventing or treating stride knee diseases by walking, people should choose a suitable stride for exercise according to the health condition of the knee and avoid over-pursuing a large stride to improve the exercise effect, while a smaller stride is suitable for most people.

中图分类号:

R318.01

. 步幅对膝关节接触的影响[J]. J Shanghai Jiaotong Univ Sci, 2025, 30(4): 759-767.

Chen Huiran, Fu Rongchang, Yang Xiaozheng, Li Pengju, Wang Kun. Effect of Stride Length on Knee Contact[J]. J Shanghai Jiaotong Univ Sci, 2025, 30(4): 759-767.

参考文献

[1] SAFIRI S, KOLAHI A A, SMITH E, et al. Global, regional and national burden of osteoarthritis 1990-2017: A systematic analysis of the Global Burden of Disease Study 2017 [J]. Annals of the Rheumatic Diseases, 2020, 79(6): 819-828.
[2] BIEDERT R M, SANCHIS-ALFONSO V. Sources of anterior knee pain [J]. Clinics in Sports Medicine, 2002, 21(3): 335-347.
[3] BENNELL K L, HINMAN R S. A review of the clinical evidence for exercise in osteoarthritis of the hip and knee [J]. Journal of Science and Medicine in Sport, 2011, 14(1): 4-9.
[4] NA A, BUCHANAN T S. Self-reported walking difficulty influences gait characteristics in patients with medial compartment knee osteoarthritis [J]. Clinical Biomechanics, 2022, 100: 105805.
[5] LO G H, VINOD S, RICHARD M J, et al. Association between walking for exercise and symptomatic and structural progression in individuals with knee osteoarthritis: Data from the osteoarthritis initiative cohort [J]. Arthritis & Rheumatology, 2022, 74(10): 1660-1667.
[6] MILLS K, HÜBSCHER M, O’LEARY H, et al. Current concepts in joint pain in knee osteoarthritis [J]. Schmerz, 2019, 33(1): 22-29.
[7] SAKAMOTO J, MIYAHARA S, MOTOKAWA S, et al. Regular walking exercise prior to knee osteoarthritis reduces joint pain in an animal model [J]. PLoS One, 2023, 18(8): e0289765.
[8] KAUFMAN K R, HUGHES C, MORREY B F, et al. Gait characteristics of patients with knee osteoarthritis [J]. Journal of Biomechanics, 2001, 34(7): 907-915.
[9] WANG X, MA Y, HOU B Y, et al. Influence of gait speeds on contact forces of lower limbs [J]. Journal of Healthcare Engineering, 2017, 2017: 6375976.
[10] WARD S R, POWERS C M. The influence of patella Alta on patellofemoral joint stress during normal and fast walking [J]. Clinical Biomechanics, 2004, 19(10): 1040-1047.
[11] MAGALHÃES C M B, RESENDE R A, KIRKWOOD R N. Increased hip internal abduction moment and reduced speed are the gait strategies used by women with knee osteoarthritis [J]. Journal of Electromyography and Kinesiology, 2013, 23(5): 1243-1249.
[12] EDD S N, BENNOUR S, ULRICH B, et al. Modifying stride length in isolation and in combination with foot progression angle and step width can improve knee kinetics related to osteoarthritis; A preliminary study in healthy subjects [J]. Journal of Biomechanical Engineering, 2020, 142(7): 074505.
[13] FAVRE J, ERHART-HLEDIK J C, CHEHAB E F, et al. General scheme to reduce the knee adduction moment by modifying a combination of gait variables [J]. Journal of Orthopaedic Research, 2016, 34(9): 1547-1556.
[14] MILNER C E, MEARDON S A, HAWKINS J L, et al. Walking velocity and step length adjustments affect knee joint contact forces in healthy weight and obese adults [J]. Journal of Orthopaedic Research, 2018, 36(10): 2679-2686.
[15] ULRICH B, PEREIRA L C, JOLLES B M, et al. Walking with shorter stride length could improve knee kinetics of patients with medial knee osteoarthritis [J]. Journal of Biomechanics, 2023, 147: 111449.
[16] ATMACA H, ÖZKAN A, MUTLU İ, et al. The effect of proximal tibial corrective osteotomy on menisci, tibia and tarsal bones: A finite element model study of tibia vara [J]. The International Journal of Medical Robotics and Computer Assisted Surgery, 2014, 10(1): 93-97.
[17] GUESS T M, THIAGARAJAN G, KIA M, et al. A subject specific multibody model of the knee with menisci [J]. Medical Engineering & Physics, 2010, 32(5): 505-515.
[18] LI G, LOPEZ O, RUBASH H. Variability of a three-dimensional finite element model constructed using magnetic resonance images of a knee for joint contact stress analysis [J]. Journal of Biomechanical Engineering, 2001, 123(4): 341-346.
[19] LI Z X, LIU L, GAO L L, et al. Establishment and validation of precise finite element model of human total knee joint [J]. Biomedical Engineering and Clinical Medicine, 2020, 24(5), 501-507 (in Chinese).
[20] SHU L M, YAMAMOTO K, YOSHIZAKI R, et al. Multiscale finite element musculoskeletal model for intact knee dynamics [J]. Computers in Biology and Medicine, 2022, 141: 105023.
[21] DASZKIEWICZ K, ŁUCZKIEWICZ P. Biomechanics of the medial meniscus in the osteoarthritic knee joint [J]. PeerJ, 2021, 9: e12509.
[22] DONG Y F, HU G H, ZHANG L L, et al. Accurate 3D reconstruction of subject-specific knee finite element model to simulate the articular cartilage defects [J]. Journal of Shanghai Jiao Tong University (Science), 2011, 16(5): 620-627.
[23] FARROKHI S, KEYAK J H, POWERS C M. Individuals with patellofemoral pain exhibit greater patellofemoral joint stress: A finite element analysis study [J]. Osteoarthritis and Cartilage, 2011, 19(3): 287-294.
[24] FURUMATSU T, OKAZAKI Y, OKAZAKI Y, et al. Injury patterns of medial meniscus posterior root tears [J]. Orthopaedics & Traumatology: Surgery & Research, 2019, 105(1): 107-111.