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Biomechanics of the hip and
knee joints
Dr. Sairamakrishnan S
Biomechanics of the Hip
• BIOMECHANICS – Science that deals with the
study of forces (internal or external ) acting on
the living body
• Hip is a first order lever with fulcrum (hip
joint) located between the load and the effort
(body wt and abductor tension)
• To maintain stable
hip, torques produced
by the body weight is
countered by
abductor muscles
pull.
• Forces acting across hip joint
– Body weight
– Abductor muscles force
– Joint reaction force
• Weight X Weight arm = Abductor pull X Abductor arm
Joint reaction force
• Defined as force generated within a joint in
response to forces acting on the joint
• In the hip, it is the result of the need to balance
the moment arms of the body weight and
abductor tension
• Joint reaction force
– 2W during SLR
– 3W in single leg stance
– 5W in walking
– 10W while running
Two leg stance
• Lower limbs constitute 2/6 (1/6 + 1/6), and
U.L & trunk constitute 4/6 the total body wt
• Little or no muscular forces required to
maintain equilibrium in 2 leg stance
• Body wt is equally distributed across both hips
• Each hip carries 1/3rd body weight
– (4/6 = 2/3 = 1/3 + 1/3)
Single leg stance
• Rt lower limb supports the body wt & also the
Lt lower limb’s weight i.e. 5/6th total body wt.
• Effective Centre of gravity shifts to the non-
supportive leg (L) & produces downward force
to tilt pelvis
• Rt abductors must exert a downward counter
balancing force with right hip joint acting as a
fulcrum
Coxa vara and Coxa valga
• Coxa vara the abductor arm is increased and
hence lesser force is needed to keep the pelvis
level
• Coxa valga the abductor arm is decreased and
hence higher force is needed to keep the
pelvis level
• Use of a cane on the contralateral side
transfers some amount of weight and hence
reduces the amount of abductor force needed
Biomechanics of THR
• Centralization of femoral head by deepening
of Acetabulum - decreases body wt lever arm
• Increase in neck length and Lateral
reattachment of trochanter - lengthens
abductor lever arm
• This decreases abductor force, hence joint
reaction force, & so the wear of the implants.
• If weight arm is equal to the abductor arm
joint reaction force reduces by 30%
Biomechanics of the knee
• Much more complex
than simple flexion and
extension.
• Knee motion during gait
occurs in flexion and
extension, abduction and
adduction, and rotation
around the long axis of
the limb
• Knee flexion, which
occurs around a varying
transverse axis is a
function of the articular
geometry of the knee and
the ligamentous
restraints.
• Flexion axis as varying in a
helical fashion (J)
• Dennis et al. described the flexion axis as
varying in a helical fashion in a normal knee,
with an average of 2 mm of posterior
translation of the medial femoral condyle on
the tibia during flexion compared with 21 mm
of translation of the lateral femoral condyle.
• Rotations
– Flexion / extension-0 to 135
– varus / valgus - 6-8
– Internal / external rotation - 25 – 30
• Translations
– AP 5-10mm
– Compression / distration 2-5mm
– medio-lateral 1-2mm
Femoral roll back
• Allows for increased knee flexion by avoiding
impingement
Screw home mechanism
• The external rotation of the tibia on the femur
during extension and internal rotation of the
tibia during knee flexion.
• Cause
– medial tibial plateau articular surface is longer
than lateral tibial plateau.
• Relevance
– "locks" knee decreasing the work performed by
the quadriceps while standing
• In kinematic studies of the knee during
selected activities of daily living, normal gait
required 67 degrees of flexion during the
swing phase, 83 degrees for stair climbing, 90
degrees for descending stairs, and 93 degrees
to rise from a chair.
Patello femoral joint
• “Sliding" articulation
• Patella moves 7cm caudally during full flexion
• Maximum contact between femur and patella is
at 45 degrees of flexion
• The primary function of the patella is to increase
the lever arm of the extensor mechanism around
the knee, improving the efficiency of quadriceps
mechanism
• Extensor lever arm is greatest at 20 degrees of
flexion
Joint reaction force of tibiofemoral joint
• 1W when standing on both feet
• 2Wwhen standing on one foot
• 4W during stance phase
• 1/2W during swing phase
• 6W during Jogging
Joint reaction force of patellofemoral joint
• 1/3W during walking
• 2.5W during Ascending Stairs
• 3.5W during Descending Stairs
• 7W during Squatting

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Biomechanics of the hip and knee joint

  • 1. Biomechanics of the hip and knee joints Dr. Sairamakrishnan S
  • 3. • BIOMECHANICS – Science that deals with the study of forces (internal or external ) acting on the living body
  • 4. • Hip is a first order lever with fulcrum (hip joint) located between the load and the effort (body wt and abductor tension)
  • 5. • To maintain stable hip, torques produced by the body weight is countered by abductor muscles pull.
  • 6. • Forces acting across hip joint – Body weight – Abductor muscles force – Joint reaction force • Weight X Weight arm = Abductor pull X Abductor arm
  • 7. Joint reaction force • Defined as force generated within a joint in response to forces acting on the joint • In the hip, it is the result of the need to balance the moment arms of the body weight and abductor tension • Joint reaction force – 2W during SLR – 3W in single leg stance – 5W in walking – 10W while running
  • 8. Two leg stance • Lower limbs constitute 2/6 (1/6 + 1/6), and U.L & trunk constitute 4/6 the total body wt • Little or no muscular forces required to maintain equilibrium in 2 leg stance • Body wt is equally distributed across both hips • Each hip carries 1/3rd body weight – (4/6 = 2/3 = 1/3 + 1/3)
  • 9. Single leg stance • Rt lower limb supports the body wt & also the Lt lower limb’s weight i.e. 5/6th total body wt. • Effective Centre of gravity shifts to the non- supportive leg (L) & produces downward force to tilt pelvis • Rt abductors must exert a downward counter balancing force with right hip joint acting as a fulcrum
  • 10. Coxa vara and Coxa valga • Coxa vara the abductor arm is increased and hence lesser force is needed to keep the pelvis level • Coxa valga the abductor arm is decreased and hence higher force is needed to keep the pelvis level
  • 11. • Use of a cane on the contralateral side transfers some amount of weight and hence reduces the amount of abductor force needed
  • 12. Biomechanics of THR • Centralization of femoral head by deepening of Acetabulum - decreases body wt lever arm • Increase in neck length and Lateral reattachment of trochanter - lengthens abductor lever arm • This decreases abductor force, hence joint reaction force, & so the wear of the implants.
  • 13. • If weight arm is equal to the abductor arm joint reaction force reduces by 30%
  • 15. • Much more complex than simple flexion and extension. • Knee motion during gait occurs in flexion and extension, abduction and adduction, and rotation around the long axis of the limb
  • 16. • Knee flexion, which occurs around a varying transverse axis is a function of the articular geometry of the knee and the ligamentous restraints. • Flexion axis as varying in a helical fashion (J)
  • 17. • Dennis et al. described the flexion axis as varying in a helical fashion in a normal knee, with an average of 2 mm of posterior translation of the medial femoral condyle on the tibia during flexion compared with 21 mm of translation of the lateral femoral condyle.
  • 18. • Rotations – Flexion / extension-0 to 135 – varus / valgus - 6-8 – Internal / external rotation - 25 – 30 • Translations – AP 5-10mm – Compression / distration 2-5mm – medio-lateral 1-2mm
  • 19. Femoral roll back • Allows for increased knee flexion by avoiding impingement
  • 20. Screw home mechanism • The external rotation of the tibia on the femur during extension and internal rotation of the tibia during knee flexion. • Cause – medial tibial plateau articular surface is longer than lateral tibial plateau. • Relevance – "locks" knee decreasing the work performed by the quadriceps while standing
  • 21.
  • 22. • In kinematic studies of the knee during selected activities of daily living, normal gait required 67 degrees of flexion during the swing phase, 83 degrees for stair climbing, 90 degrees for descending stairs, and 93 degrees to rise from a chair.
  • 23. Patello femoral joint • “Sliding" articulation • Patella moves 7cm caudally during full flexion • Maximum contact between femur and patella is at 45 degrees of flexion • The primary function of the patella is to increase the lever arm of the extensor mechanism around the knee, improving the efficiency of quadriceps mechanism • Extensor lever arm is greatest at 20 degrees of flexion
  • 24.
  • 25. Joint reaction force of tibiofemoral joint • 1W when standing on both feet • 2Wwhen standing on one foot • 4W during stance phase • 1/2W during swing phase • 6W during Jogging
  • 26. Joint reaction force of patellofemoral joint • 1/3W during walking • 2.5W during Ascending Stairs • 3.5W during Descending Stairs • 7W during Squatting