So, as I mentioned in another thread, using my generated default weights file broke some things, including the eyes no longer moving with the head and clothes no longer moving with the body. I thought I was just changing the weights around specific joints and that everything else would stay the same but it appears not. I don't see why the connection between the eye and the head should be affected by changing the knee weights so clearly there is something else going on, quite likely the issue of painting helpers that was raised earlier.
I had a moment of clarity while looking at my (own physical) knee this morning. Movement of the skin surface is only indirectly related to the movement of the bones involved. What really determines surface movement is the muscles attached to the bones that the skin then sits on top of. In the case of the knee, the thigh muscles attach to the lower leg bone below the joint so when the knee is bent the inside (back corner) where creasing occurs is sitting on the muscle a good distance from the joint, and more importantly, at the surface so the crease is very shallow. For weight painting purposes there ought to be another "bone" that represents the muscle and its attachment, and that is what the skin should be weighted to. To complicate matters of course muscles change length so you would need drivers that adjust the bone length as the knee bent.
The skeleton model of surface position and movement is fundamentally wrong, and fiddling with the weights will never produce anything realistic, just a tad less unrealistic. I could create a new armature that incorporates "muscle bones", but MakeHuman always uses its own default skeleton internally so it won't work within MakeHuman.
So a fundamental rethink is needed.
Edit:
I think this is a more accurate model of at least the back of the knee. I'm not sure of the implementation of the armatures so I'm not sure whether the two muscle "bones" need to adjust length and/or have a joint between them. The main point here is that the distance between the intersecting skin segments and the intersection of the bones determines the depth of the crease that is formed. In real life the crease is only skin deep.