Impact of Osteotomy Surgery on Lower-limb Contact Mechanics

Osteoarthritis (OA) of the knee is defined as a mechanically induced degenerative joint disorder. Lower-limb deformity is one of the main causes of disease development as load is one-sidedly shifted and unequally redistributed over the articular surface. Knee joint replacement surgery is frequently performed, however postoperative patient dissatisfaction is present in one fifth of patients. Therefore, the aim of this proposal is to deepen the understanding of joint-preserving procedures to ameliorate the native joint by addressing two important clinical obstacles: the static two-dimensional pre-operative planning and adverse effects on the adjacent ankle joint. Development of a discrete element analysis (DEA) model of the knee joint will be based on three-dimensional geometric morphometric data obtained from our in-house available, largest present multi statistic shape model (SSM). For dynamic assessment, data will be extrapolated out of parameterized gait analysis. The generated knee joint DEA model will be integrated with our DEA models of the hip and ankle to provide an entire lower-limb model. K-fold cross validation will be used for evaluation in terms of in-model accuracy, specificity and generalizability. Translation of the developed and validated lower-limb model from engineering science to the clinical field will enable preoperative planning to allow an optimal correction of the contact mechanics of the knee as well as the adjacent joints.