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New Insight into the Biomechanics of Lower Limb: Prevention, Injury, Rehabilitation and Replacements

A special issue of Applied Sciences (ISSN 2076-3417). This special issue belongs to the section "Applied Biosciences and Bioengineering".

Deadline for manuscript submissions: 20 August 2025 | Viewed by 5227

Special Issue Editor

Dr. Gusztáv Fekete

E-Mail Website
Guest Editor
Department of Material Science and Technology, Audi Hungaria Faculty of Vehicle Engineering, Széchenyi István University, H-9026 Győr, Hungary
Interests: biomechanics; biopolymers; tribology; multibody dynamics
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

This Special Issue on "New Insight into the Biomechanics of Lower Limb: Prevention, Injury, Rehabilitation and Replacements" presents detailed studies of significant scientific findings in injury prevention, rehabilitation, and, last but not least, biomedical engineering solutions. This issue covers key topics such as healthcare, biomedical imaging, bioinformatics, machine learning and deep learning, computational biomechanics, and case-control studies.

The focus point of this Special Issue is to build up a chain of articles on the four main subjects, namely prevention, injury, rehabilitation, and replacements.

The Prevention topic expects novel results on avoiding or predicting the possibility of certain lower-limb-related injuries during sports movements.

The objective of the Injury category is to explore the potential mechanism of lower-limb joint injury caused by, e.g., symmetry changes due to acute fatigue or by other factors. It must be emphasized that new findings between implications for injury prevention and motor skill assessment are most welcome.

Rehabilitation is strongly connected to injury problems, where original and even unconventional therapies and their results should be presented for sport injury rehabilitation e.g. cryotherapy or extracorporeal shockwave therapy.

The Replacements section invites authors in the field of hip, knee, and ankle replacements. Since several interesting controversies still exist in the field of lower-limb joint arthroplasty, at least some of them should be addressed to yield approximate results.

In conclusion, this Special Issue aims to provide an academic and in-depth view of how mechanics, informatics, and health science can be further integrated into health care.

Dr. Gusztáv Fekete
Guest Editor

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Applied Sciences is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • sport injury
  • computational biomechanics
  • deep learning
  • machine learning
  • experimental biomechanics
  • physical activity
  • case studies
  • rehabilitation
  • lower limb
  • ankle
  • knee
  • hip

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Published Papers (5 papers)

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Research

19 pages, 278 KiB  
Article
Prosthesis Embodiment in Lower Extremity Limb Loss: A Narrative Review
by Tuyet Thao Nguyen, Bingjie Wang, Haddy Alas, Quincy Jones, Chase Clark, Sabrina Lazar, Shaddy Malik, Joshua Graham , Yasmeen Talaat, Chris Shin, Jonathon Schofield, Toran Macleod, Laduan Smedley, Clifford Pereira, Wilsaan Joiner, R. Lor Randall, Diana Farmer, Aijun Wang, Dake Hao, Spencer Greene, Ravi Sood, Danielle Brown, Rachel Russo, Kingsley Manoharan, Andrew Simpkins and Andrew Liadd Show full author list remove Hide full author list
Appl. Sci. 2025, 15(9), 4952; https://doi.org/10.3390/app15094952 (registering DOI) - 29 Apr 2025
Abstract
Lower limb prosthesis abandonment is a significant challenge, leading to reliance on walking aids, such as wheelchairs, which frequently do not match the patient’s needs and lead to increased morbidity. Prosthesis abandonment is driven by a lack of embodiment, the latter defined as [...] Read more.
Lower limb prosthesis abandonment is a significant challenge, leading to reliance on walking aids, such as wheelchairs, which frequently do not match the patient’s needs and lead to increased morbidity. Prosthesis abandonment is driven by a lack of embodiment, the latter defined as the integration of a prosthetic device into one’s body schema. This review evaluates interventions enhancing embodiment through three dimensions: ownership, agency, and co-location. The aim of this narrative review is to ask what interventions are available to improve embodiment, and what dimensions of embodiment should be included in the standard of care for lower-limb amputation surgery and componentry development. This narrative is constructed through a thorough literature search on how the aforementioned dimensions of embodiment can be optimized. In the studies reviewed, standardization of embodiment metrics and longitudinal data are lacking, hindering clinical translation. Future work must prioritize patient-centered design, integrate multidimensional assessments, and address practical issues to expand eligibility for advanced interventions. Full article
(This article belongs to the Special Issue New Insight into the Biomechanics of Lower Limb: Prevention, Injury, Rehabilitation and Replacements)
14 pages, 1692 KiB  
Article
Influence of Quadriceps Femoris Muscle and Tendon Morphology on Mechanical Efficiency During Stretch–Shortening Cycles
by Örs Sebestyén, Bálint Kovács, Leonidas Petridis, István Kóbor, Yang Song, Yaodong Gu and József Tihanyi
Appl. Sci. 2025, 15(6), 3047; https://doi.org/10.3390/app15063047 - 11 Mar 2025
Viewed by 587
Abstract
Currently, limited information is available on the influence of quadriceps femoris muscle–tendon unit morphological parameters on mechanical efficiency; therefore, the aim of this study was to investigate the interaction between these variables. The morphological characteristics of the quadriceps femoris muscle–tendon unit of nine [...] Read more.
Currently, limited information is available on the influence of quadriceps femoris muscle–tendon unit morphological parameters on mechanical efficiency; therefore, the aim of this study was to investigate the interaction between these variables. The morphological characteristics of the quadriceps femoris muscle–tendon unit of nine healthy females (22 ± 0.9 years) were assessed using magnetic resonance imaging. The mechanical efficiency was assessed using a dynamometer. During contractions, the electromyographic activity of the vastus lateralis and rectus femoris was recorded. The highest mechanical efficiency was achieved with moderate pretension and a 20 J stretch load, resulting in an efficiency of 54.14 ± 2.24%. A large correlation was found between the patella tendon cross-sectional area and mechanical efficiency (r = 0.93; p < 0.01). No correlation was observed between the muscle-to-tendon cross-sectional ratio and mechanical efficiency. The association between the patella tendon cross-sectional area and mechanical efficiency aligns with previous research, suggesting that a larger cross-sectional area can reduce tendon stress under a given force, potentially lowering the risk of strain injuries. The lack of association between the muscle-to-tendon cross-sectional ratio and mechanical efficiency indicates that the relative cross-sectional dimensions of muscle and tendon do not influence muscle–tendon dynamics. Full article
(This article belongs to the Special Issue New Insight into the Biomechanics of Lower Limb: Prevention, Injury, Rehabilitation and Replacements)
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18 pages, 5955 KiB  
Article
Mathematical Modeling and Biomechanical Analysis of a Derotation Plate for Treating Complex Hip Dysplasia
by Durdana Oktyabrova, Kairat Ashimov, Berk Guclu, Mukhtar Abilmazhinov, Boris Gorbunov, Ramazanov Zhanatay, Timur Baidalin, Bekzhan Suleimenov, Askar Beknazarov, Bagdat Azamatov and Nail Beisekenov
Appl. Sci. 2025, 15(6), 2991; https://doi.org/10.3390/app15062991 - 10 Mar 2025
Viewed by 541
Abstract
Developmental dysplasia of the hip, particularly Crowe type IV, presents significant challenges in orthopedic surgery due to severe anatomical deformities and biomechanical instability. This study focuses on evaluating the biomechanical performance of a prosthesis–femur–derotation plate system designed to address these challenges. Using FEA, [...] Read more.
Developmental dysplasia of the hip, particularly Crowe type IV, presents significant challenges in orthopedic surgery due to severe anatomical deformities and biomechanical instability. This study focuses on evaluating the biomechanical performance of a prosthesis–femur–derotation plate system designed to address these challenges. Using FEA, a comprehensive assessment of stress distribution, displacement, and safety factors was conducted under physiological loading conditions. The derotation plate was specifically engineered to stabilize the femur and restore the anatomical and biomechanical axis of the limb. Results demonstrated that the derotation plate effectively eliminated rotational and axial displacement, with a peak displacement of 0.08 mm, and maintained sufficient strength reserves, with a minimum safety factor of 3.63. The maximum von Mises stress in the plate was 76 MPa, significantly below the yield strength of the titanium alloy, ensuring long-term durability and reliability. The system as a whole exhibited favorable biomechanical properties, confirming its ability to manage high stress loads without the risk of material failure or instability. These findings underscore the potential of this novel system to improve surgical outcomes in complex cases of hip dysplasia. Future clinical trials will further validate its practical utility, providing valuable insights for advancing orthopedic implant design and patient care. Full article
(This article belongs to the Special Issue New Insight into the Biomechanics of Lower Limb: Prevention, Injury, Rehabilitation and Replacements)
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15 pages, 8660 KiB  
Article
The Effects of Skill Level on Lower-Limb Injury Risk During the Serve Landing Phase in Male Tennis Players
by Jianqi Pan, Dong Sun, Fengping Li, Zhanyi Zhou, Yucheng Wang, Xuanzhen Cen, Yang Song and Gusztáv Fekete
Appl. Sci. 2025, 15(5), 2681; https://doi.org/10.3390/app15052681 - 3 Mar 2025
Viewed by 724
Abstract
The kinematic and kinetic performance of tennis players differs across skill levels, with joint range of motion (ROM), moments, and stiffness being strongly linked to injury risk. Focusing on the biomechanical characteristics of lower-limb joints throughout the landing stage, especially among athletes of [...] Read more.
The kinematic and kinetic performance of tennis players differs across skill levels, with joint range of motion (ROM), moments, and stiffness being strongly linked to injury risk. Focusing on the biomechanical characteristics of lower-limb joints throughout the landing stage, especially among athletes of different skill levels, aids in understanding the link between injury risk and performance level. This study recruited 15 male campus tennis enthusiasts and 15 male professional tennis players. The kinematic and kinetic differences between amateur and professional players during the landing phase of the tennis serve were analyzed using SPM1D 0.4.11 and SPSS 27.0.1, with independent-sample t-tests applied in both cases. Throughout the tennis serve’s landing stage, the professional group exhibited significantly greater sagittal plane hip-joint stiffness (p < 0.001), horizontal plane moment (59~91%; p = 0.036), and a significantly higher peak moment (p = 0.029) in comparison with the amateur group. For the knee joint, the professional group exhibited significantly larger ROM in flexion–extension (0~82%; p = 0.003); along with greater ROM (0~29%; p = 0.042), moment (12~100%; p < 0.001), peak moment (p < 0.001) in adduction-abduction; and internal–external rotational moments (19~100%; p < 0.001) were markedly higher. The professional group showed significantly higher ankle joint ROM (p < 0.001) and moments (6~74%; p = 0.004) in the sagittal plane, as well as greater horizontal-plane ROM (27~67%; p = 0.041) and peak moments (p < 0.001). Compared with amateur tennis players, professional tennis players exhibit greater ROM, joint moments, and stiffness in specific planes, potentially increasing their risk of injury during the landing phase. Full article
(This article belongs to the Special Issue New Insight into the Biomechanics of Lower Limb: Prevention, Injury, Rehabilitation and Replacements)
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19 pages, 6533 KiB  
Article
Personalised High Tibial Osteotomy Surgery Is Accurate: An Assessment Using 3D Distance Mapping
by Andrea Varaschin, Harinderjit Singh Gill, Stefano Zaffagnini, Alberto Leardini, Maurizio Ortolani, Fabio Norvillo, Alisdair MacLeod, Giacomo Dal Fabbro, Giorgio Cassiolas, Alberto Grassi and Claudio Belvedere
Appl. Sci. 2024, 14(19), 9033; https://doi.org/10.3390/app14199033 - 6 Oct 2024
Viewed by 2155
Abstract
Early-stage knee osteoarthritis is often suitable for treatment with high tibial osteotomy (HTO). This is an effective joint-preserving treatment, resulting in good postoperative outcomes. To overcome the limitations of traditional HTO, the surgical technique and correction accuracy can be enhanced by personalised procedures [...] Read more.
Early-stage knee osteoarthritis is often suitable for treatment with high tibial osteotomy (HTO). This is an effective joint-preserving treatment, resulting in good postoperative outcomes. To overcome the limitations of traditional HTO, the surgical technique and correction accuracy can be enhanced by personalised procedures using three-dimensional digital planning and metal additive manufacturing, The purpose of this clinical trial study was to evaluate the three-dimensional accuracy of a new personalised HTO procedure, using modern imaging techniques, 3D modelling, and distance map analysis (DMA). Twenty-five patients were treated with the personalised HTO procedure. Before surgery and after 6 months, they underwent clinical evaluation scoring, radiographic imaging, and computed-tomography scanning to generate morphological models. Specifically, preoperative tibia models were used to plan the tibia correction and the design and position of the fixation plate. Preoperative, planned, and postoperative models were imported in computer-aided and designing software (Geomagic ControlTM 2014, 3D Systems, Rock Hill, SC, USA) for DMA implementation to assess geometrical differences between model surfaces. A very good reproduction of the planned tibia morphology was achieved postoperatively (average differences between −0.9 mm and 1.4 mm). DMA values associated with fixation-plate deformation were less than 1 mm, similar to those for plate-to-tibia surface-contour matching. Overall, personalised digitally planned HTO utilising three-dimensional printed surgical guides and plates enables accurate planned correction and plate placement. Full article
(This article belongs to the Special Issue New Insight into the Biomechanics of Lower Limb: Prevention, Injury, Rehabilitation and Replacements)
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