Date of Award

2006

Degree Type

Thesis

Degree Name

Master of Engineering Science

Program

Biomedical Engineering

Supervisor

Dr. Thomas Jenkyn, Ph.D, P.Eng.

Abstract

Osteoarthritis (OA) is a degenerative joint disease that commonly affects the knee. There is currently no pharmacological or therapeutic method to alleviate or halt the progression of OA. Previous studies have shown that there is a correlation between Brete varus alignment of the knee (which inherently produces an abnormally large external knee adduction moment) and osteoarthritis in the medial compartment of the tibial plateau. A high tibial osteotomy (HTO) is a corrective surgical procedure that uses a % wedge-prosthesis to re-align the mechanical axis of the knee to alleviate the aggravating loading conditions that propagate OA. A three-dimensional, six degree- of-freedom, internal knee model was designed to be used in conjunction with gait analysis data of medial compartment OA patients (n=30) who subsequently underwent HTO surgery. The model was designed to determine the loads in the muscles, ligaments and bones of the knee using inverse dynamics and static optimization, in vivo. This study also created a novel measure of tibial plateau load balance; the medial-to-lateral compartment load ratio is a normalized measure that enables a comparison of tibial plateau loading between subjects. The model produced medial-to-lateral compartment load ratio values that showed significant (p < 0.001) decrease between pre-surgery and 6-month post-surgery conditions. These results were fairly correlated (R2 = 0.4566) with the external knee adduction moment, which is a proxy of loading conditions on the medial compartment. These results provide further understanding of the loading changes brought on by HTO surgery.

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