Finite element analysis of the valgus knee joint of an obese child.
BACKGROUND
Knee valgus and varus morbidity is at the second top place in children lower limb deformity diseases. It may cause abnormal stress distribution. The magnitude and location of contact forces on tibia plateau during gait cycle have been indicated as markers for risk of osteoarthritis. So far, few studies reported the contact stress and force distribution on tibial plateau of valgus knee of children.


METHODS
To estimate the contact stresses and forces on tibial plateau of an 8-year old obese boy with valgus knee and a 7-year old healthy boy, three-dimensional (3D) finite element (FE) models of their left knee joints were developed. The valgus knee model has 36,897 nodes and 1,65,106 elements, and the normal knee model has 78,278 nodes and 1,18,756 elements. Paired t test was used for the comparison between the results from the 3D FE analysis method and the results from traditional kinematic measurement methods.


RESULTS
The p value of paired t test is 0.12. Maximum stresses shifted to lateral plateau in knee valgus children while maximum stresses were on medial plateau in normal knee child at the first peak of vertical GRF of stance phase. The locations of contact centers on medial plateau changed 3.38 mm more than that on lateral plateau, while the locations of contact centers on medial plateau changed 1.22 mm less than that on lateral plateau for healthy child from the first peak to second peak of vertical GRF of stance phase.


CONCLUSIONS
The paired t test result shows that there is no significant difference between the two methods. The results of FE analysis method suggest that knee valgus malalignment could be the reason for abnormal knee load that may cause knee problems in obese children with valgus knee in the long-term. This study may help to understand biomechanical mechanism of valgus knees of obese children.
School of Biomedical Engineering, Capital Medical University, Beijing, 100069, China.|Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, Capital Medical University, Beijing, 100069, China.
Jun
J
Sun
School of Biomedical Engineering, Capital Medical University, Beijing, 100069, China.|Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, Capital Medical University, Beijing, 100069, China.
Songhua
S
Yan
School of Biomedical Engineering, Capital Medical University, Beijing, 100069, China.
Yan
Y
Jiang
Interdisciplinary Division of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, 999077, China.
Duo Wai-Chi
DW
Wong
Interdisciplinary Division of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, 999077, China.
Ming
M
Zhang
Department of Orthopedics, Beijing Luhe Hospital, Capital Medical University, Beijing, 101149, China.
Jizhou
J
Zeng
School of Biomedical Engineering, Capital Medical University, Beijing, 100069, China. kzhang@ccmu.edu.cn.|Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, Capital Medical University, Beijing, 100069, China. kzhang@ccmu.edu.cn.
Kuan
K
Zhang
D000465:Algorithms; D001696:Biomechanical Phenomena; D015992:Body Mass Index; D002648:Child; D020342:Finite Element Analysis; D005684:Gait; D006801:Humans; D021621:Imaging, Three-Dimensional; D007717:Knee / Q000502:physiology*; D007719:Knee Joint / Q000503:physiopathology*; D008297:Male; D008953:Models, Anatomic; D009038:Motion; D009765:Obesity / Q000503:physiopathology*; D010003:Osteoarthritis / Q000503:physiopathology; D011312:Pressure; D013314:Stress, Mechanical; D013977:Tibia / Q000503:physiopathology
Contact force; Finite element; Kinematics; Knee valgus; Obese child