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Knee joint loading in knee osteoarthritis

Janie L Astephen Wilson, William D Stanish, Cheryl L Hubley-Kozey
There is an established discordance between the structural joint damage and clinical symptoms of knee osteoarthritis; however, there has been little investigation into the differences in joint level biomechanics and muscle activation patterns during gait between symptomatic and asymptomatic individuals with the same radiographic evidence of osteoarthritis. The objective of this study was to examine three-dimensional knee joint biomechanics and muscle activation differences during gait between asymptomatic and symptomatic individuals with radiographic knee osteoarthritis...
October 24, 2016: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Gerrit Bode, Ferdinand Kloos, Matthias J Feucht, Benjamin Fleischer, Norbert Südkamp, Philipp Niemeyer, Christoph Becher
PURPOSE: The unloading effect of an extra-articular absorber system on the knee joint medial compartment was compared with high tibial osteotomy (HTO) under physiological conditions in vitro. METHODS: Seven fresh-frozen cadaveric knees were used to test isokinetic flexion-extension motions under physiological loading using a biomechanical knee simulator. Tibiofemoral area contact and peak contact pressures were measured using pressure-sensitive film in the untreated medial compartment...
October 19, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Elizabeth Wellsandt, Ashutosh Khandha, Kurt Manal, Michael J Axe, Thomas S Buchanan, Lynn Snyder-Mackler
Anterior cruciate ligament (ACL) injury results in altered knee joint mechanics which frequently continue even after ACL reconstruction. The persistence of altered mechanical loading of the knee is of concern due to its likely role in the development of post-traumatic osteoarthritis (OA). Joint contact forces are associated with post-traumatic OA development, but evaluation of factors influencing the magnitude of contact forces after ACL injury is needed to advance current strategies aimed at preventing post-traumatic OA...
October 17, 2016: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Alison H Chang, Joan S Chmiel, Orit Almagor, Ali Guermazi, Pottumarthi V Prasad, Kirsten C Moisio, Laura Belisle, Yunhui Zhang, Karen Hayes, Leena Sharma
OBJECTIVE: Knee sagittal dynamic joint stiffness (DJS) describes the biomechanical interaction between change in external knee flexion moment and flexion angular excursion during gait. In theory, greater DJS may particularly stress the patellofemoral (PF) compartment and thereby contribute to PF osteoarthritis (OA) worsening. We hypothesized that greater baseline knee sagittal DJS is associated with PF cartilage damage worsening 2 years later. METHODS: Participants all had OA in at least one knee...
October 8, 2016: Osteoarthritis and Cartilage
Ssu-Yu Chang, Yi-Jia Lin, Wei-Chun Hsu, Lin-Fen Hsieh, Yuan-Hsiang Lin, Chao-Chin Chang, You-Cai Chou, Li-Fei Chen
Six female patients with bilateral medial knee OA and 6 healthy controls were recruited. Patients with knee OA received a 6-week physiotherapist-supervised and home-based exercise program. Outcome measures, including the Western Ontario and McMaster Universities Arthritis Index and Short Form-36 Health Survey as well as objective biomechanical indices were obtained at baseline and follow-up. After treatment, no significant difference was observed in the knee abductor moment (KAM), lever arm, and ground reaction force...
2016: BioMed Research International
Mehmet E Tezcan, Berna Goker, Roy Lidtke, Joel A Block
BACKGROUND: Lateral wedge insoles have been used for the treatment of medial knee osteoarthritis (OA) and have been shown to reduce loading of the medial compartment of the knee. However, as the entire lower extremity acts as a single kinetic chain, altering the biomechanics of the knee may also have significant effects at the ankles or hips. We aimed to evaluate the effects of lateral wedge orthotics on ankle and hip joints, compared to neutral orthotics, by assessing the changes in joint space width (JSW) during 36 months of continuous use...
September 21, 2016: Gait & Posture
Sai Krishna Prabhala, Stanley Chien, Hiroki Yokota, Sohel Anwar
This paper presents the design of an innovative device that applies dynamic mechanical load to human knee joints. Dynamic loading is employed by applying cyclic and periodic force on a target area. The repeated force loading was considered to be an effective modality for repair and rehabilitation of long bones that are subject to ailments like fractures, osteoporosis, osteoarthritis, etc. The proposed device design builds on the knowledge gained in previous animal and mechanical studies. It employs a modified slider-crank linkage mechanism actuated by a brushless Direct Current (DC) motor and provides uniform and cyclic force...
2016: Sensors
Gregory M Freisinger, Laura C Schmitt, Andrea B Wanamaker, Robert A Siston, Ajit M W Chaudhari
The purpose of this study was to systematically review and synthesize the literature measuring varus-valgus laxity in individuals with tibiofemoral osteoarthritis (OA). Specifically, we aimed to identify varus-valgus laxity differences between persons with OA and controls, by radiographic disease severity, by frontal plane knee alignment, and by sex. We also aimed to identify if there was a relationship between varus-valgus laxity and clinical performance and self-reported function. We systematically searched for peer-reviewed original research articles in PubMed, Scopus, and CINAHL to identify all existing literature regarding knee OA and objective measurement of varus-valgus laxity in vivo...
September 28, 2016: Journal of Knee Surgery
Boris Dousteyssier, Jérôme Molimard, Chafiaa Hamitouche, Woo Suck Han, Eric Stindel
OBJECTIVE: With cartilage physiopathology, knee stability and therefore the subsequent loadings on ligaments have a strong impact in the development of knee osteoarthritis. To understand this phenomenon, authors are proposing different knee models. Most of them are without any flexion, some have been introduced by controlling actively muscular groups. In this case, the forces used to achieve the flexion may not be physiological, and the pressure on the articulation can be questioned. We propose a mixed approach, both using medical imaging (MRI, EOS X-ray system) and force platform in conjunction with a finite element model...
September 2016: Annals of Physical and Rehabilitation Medicine
Rebecca L Krupenevich, Alison L Pruziner, Ross H Miller
: Increased or abnormal loading on the intact limb is thought to contribute to the relatively high risk of knee osteoarthritis (OA) in this limb for individuals with unilateral lower limb loss. This theory has been assessed previously by studying walking, but knee joint loading during walking is often similar between individuals with limb loss and individuals without limb loss, prompting assessment of other movements that may place unusual loads on the knee. One such movement, hopping, is a form of locomotion that individuals with unilateral lower limb loss may situationally use instead of walking, but the mechanical effects of hopping on the intact limb are unknown...
September 16, 2016: Medicine and Science in Sports and Exercise
André Schmidt, Andrea Meurer, Katharina Lenarz, Lutz Vogt, Dara Froemel, Frederick Lutz, John Barker, Felix Stief
In order to reduce pain caused by the affected hip joint, unilateral hip osteoarthritis patients (HOAP) adopt characteristic gait patterns. However, it is unknown if the knee and hip joint loading in the non-affected (limbnon-affected ) and the affected (limbaffected ) limb differ from healthy controls (HC) and which gait parameters correlate with potential abnormal joint loading. Instrumented 3D-gait analysis was performed on 18 HOAP and 18 sex, age, and height matched HC. The limbnon-affected showed greater first and second peak external hip adduction moments (first HAM: +15%, p = 0...
September 24, 2016: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Christopher V Nagelli, James L Cook, Kei Kuroki, Chantelle Bozynski, Richard Ma, Timothy E Hewett
Complications following anterior cruciate ligament (ACL) injury and reconstruction that include chronic dysfunction, second ACL injury, and posttraumatic osteoarthritis (OA) may be interrelated and stem from the inability to fully restore native ACL integrity and function. The loss of ACL sensory input following injury may significantly contribute to joint dysfunction. We developed a novel preclinical animal model to assess the contributions of ACL sensory afferents to knee joint function and health. We hypothesized that ACL sensory denervation would manifest in knee joint dysfunction and development of early OA...
September 20, 2016: Journal of Knee Surgery
M Hall, K L Bennell, T V Wrigley, B R Metcalf, P K Campbell, J Kasza, K L Paterson, D J Hunter, R S Hinman
OBJECTIVE: To investigate relationships between external knee adduction moment parameters (KAM) and osteoarthritis (OA) symptoms according to disease severity. DESIGN: 164 participants with symptomatic medial knee OA were included. Radiographic severity was graded by (1) Kellgren & Lawrence (KL) scale (Grade 2, n = 49; Grade, n = 52; Grade 4, n = 63) and; (2) medial tibiofemoral joint space narrowing (JSN) (Grade 1, n = 47; Grade 2, n = 50; Grade 3, n = 67)...
September 9, 2016: Osteoarthritis and Cartilage
Yoshinori Asou, Munetaka Iwata, Hiroki Ochi, Maierhaba Ailixiding, Zulipiya Aibibula, Jinying Piao, Guangwen Jin, Yasushi Hara, Atsushi Okawa
Obesity is a risk factor for osteoarthritis (OA). To investigate the roles of increased mechanical loading in the onset of obesity-induced OA, knee joints were histologically analyzed after applying a tail suspension (TS) model to a high-fat diet (HFD)-induced OA model. Mice were divided into four groups: normal diet (ND) with normal loading (NL) group; HFD with NL group; ND with TS group; and HFD with TS group. Whole knee joints were evaluated by immunohistological analysis. The infrapatellar fat pad (IPFP) was excised and mRNA expression profiles were compared by qPCR analysis...
2016: PloS One
Marco Corgiat Loia, Stefania Vanni, Federica Rosso, Davide Edoardo Bonasia, Matteo Bruzzone, Federico Dettoni, Roberto Rossi
Opening wedge high tibial osteotomy (OWHTO) is a surgical procedure that aims to correct the weight-bearing axis of the knee, moving the loads laterally from the medial compartment. Conventional indications for OWHTO are medial compartment osteoarthritis and varus malalignment of the knee; recently OWHTO has been used successfully in the treatment of double and triple varus. OWHTO, in contrast to closing wedge high tibial osteotomy, does not require fibular osteotomy or peroneal nerve dissection, or lead to disruption of the proximal tibiofibular joint and bone stock loss...
April 2016: Joints
Carina L Blaker, Christopher B Little, Elizabeth C Clarke
Anterior cruciate ligament (ACL) tears are a common knee injury with a known but poorly understood association with secondary joint injuries and post-traumatic osteoarthritis (OA). Female sex and age are known risk factors for ACL injury but these variables are rarely explored in mouse models of injury. This study aimed to further characterise a non-surgical ACL injury model to determine its clinical relevance across a wider range of mouse specifications. Cadaveric and anaesthetised C57BL/6 mice (9-52 weeks of age) underwent joint loading to investigate the effects of age, sex and body mass on ACL injury mechanisms...
September 7, 2016: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Stephen J Preece, Richard K Jones, Christopher A Brown, Timothy W Cacciatore, Anthony K P Jones
BACKGROUND: Both increased knee muscle co-contraction and alterations in central pain processing have been suggested to play a role in knee osteoarthritis pain. However, current interventions do not target either of these mechanisms. The Alexander Technique provides neuromuscular re-education and may also influence anticipation of pain. This study therefore sought to investigate the potential clinical effectiveness of the AT intervention in the management of knee osteoarthritis and also to identify a possible mechanism of action...
2016: BMC Musculoskeletal Disorders
François Fraysse, John Arnold, Dominic Thewlis
Estimation of joint reaction forces (JRF) is critical for the understanding of load-related pathologies, such as osteoarthritis (OA). Typically, singular components at discrete time-points are presented without knowledge of their orientation over time. The aim of this study was to develop and demonstrate the utility of a method for the concise and intuitive representation of JRF orientation. A scaled musculoskeletal model of the lower limbs was informed by walking gait data from adults with knee OA (n=10) and healthy controls (C) (n=10)...
October 3, 2016: Journal of Biomechanics
Shawn M Robbins, Anthony Teoli, Richard A Preuss
Lateral trunk lean (LTL) is a proposed intervention for knee osteoarthritis but increased muscular demands have not been considered. The objective was to compare lower extremity and trunk muscle activation and joint mechanics between normal and increased LTL gait in healthy adults. Participants (n=20, mean age 22 years) were examined under two gait conditions: normal and increased LTL. A motion capture system and force plates sampled at 100 and 2000Hz respectively were used to determine joint angles and external moments including LTL angle and external knee adduction moment (KAM)...
September 2016: Gait & Posture
Bilge Yılmaz, Serdar Kesikburun, Ozlem Köroğlu, Evren Yaşar, Ahmet Salim Göktepe, Kamil Yazıcıoğlu
OBJECTIVE: The aim of this study is to assess the effect of 5 and 10° lateral-wedge insoles on unilateral lower extremity load carrying line in patients with medial knee osteoarthritis using the L.A.S.A.R. posture alignment system. PATIENTS AND METHODS: Twenty subjects (10 females and 10 males, mean age 67.7 ± 5.4 years (range: 58-78) with bilateral medial knee osteoarthritis were included in the study. The laser line projected on the person by the L.A.S.A.R...
August 2016: Acta Orthopaedica et Traumatologica Turcica
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