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Han T, Zhu T, Lu Y, Wang Q, Bian H, Chen J, Qiao L, He TC, Zheng Q. Collagen type X expression and chondrocyte hypertrophic differentiation during OA and OS development. Am J Cancer Res 2024; 14:1784-1801. [PMID: 38726262 PMCID: PMC11076255 DOI: 10.62347/jwgw7377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 03/15/2024] [Indexed: 05/12/2024] Open
Abstract
Chondrocyte hypertrophy and the expression of its specific marker, the collagen type X gene (COL10A1), constitute key terminal differentiation stages during endochondral ossification in long bone development. Mutations in the COL10A1 gene are known to cause schmid type metaphyseal chondrodysplasia (SMCD) and spondyloepiphyseal dyschondrodysplasia (SMD). Moreover, abnormal COL10A1 expression and aberrant chondrocyte hypertrophy are strongly correlated with skeletal diseases, notably osteoarthritis (OA) and osteosarcoma (OS). Throughout the progression of OA, articular chondrocytes undergo substantial changes in gene expression and phenotype, including a transition to a hypertrophic-like state characterized by the expression of collagen type X, matrix metalloproteinase-13, and alkaline phosphatase. This state is similar to the process of endochondral ossification during cartilage development. OS, the most common pediatric bone cancer, exhibits characteristics of abnormal bone formation alongside the presence of tumor tissue containing cartilaginous components. This observation suggests a potential role for chondrogenesis in the development of OS. A deeper understanding of the shifts in collagen X expression and chondrocyte hypertrophy phenotypes in OA or OS may offer novel insights into their pathogenesis, thereby paving the way for potential therapeutic interventions. This review systematically summarizes the findings from multiple OA models (e.g., transgenic, surgically-induced, mechanically-loaded, and chemically-induced OA models), with a particular focus on their chondrogenic and/or hypertrophic phenotypes and possible signaling pathways. The OS phenotypes and pathogenesis in relation to chondrogenesis, collagen X expression, chondrocyte (hypertrophic) differentiation, and their regulatory mechanisms were also discussed. Together, this review provides novel insights into OA and OS therapeutics, possibly by intervening the process of abnormal endochondral-like pathway with altered collagen type X expression.
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Affiliation(s)
- Tiaotiao Han
- Department of Hematological Laboratory Science, Jiangsu Key Laboratory of Medical Science and Laboratory Medicine, School of Medicine, Jiangsu UniversityZhenjiang 212013, Jiangsu, China
| | - Tianxiang Zhu
- Department of Hematological Laboratory Science, Jiangsu Key Laboratory of Medical Science and Laboratory Medicine, School of Medicine, Jiangsu UniversityZhenjiang 212013, Jiangsu, China
| | - Yaojuan Lu
- Department of Hematological Laboratory Science, Jiangsu Key Laboratory of Medical Science and Laboratory Medicine, School of Medicine, Jiangsu UniversityZhenjiang 212013, Jiangsu, China
- Shenzhen Walgenron Bio-Pharm Co., Ltd.Shenzhen 518118, Guangdong, China
| | - Qian Wang
- Department of Hematological Laboratory Science, Jiangsu Key Laboratory of Medical Science and Laboratory Medicine, School of Medicine, Jiangsu UniversityZhenjiang 212013, Jiangsu, China
- Department of Human Anatomy, School of Medicine, Jiangsu UniversityZhenjiang 212013, Jiangsu, China
| | - Huiqin Bian
- Department of Hematological Laboratory Science, Jiangsu Key Laboratory of Medical Science and Laboratory Medicine, School of Medicine, Jiangsu UniversityZhenjiang 212013, Jiangsu, China
| | - Jinnan Chen
- Department of Hematological Laboratory Science, Jiangsu Key Laboratory of Medical Science and Laboratory Medicine, School of Medicine, Jiangsu UniversityZhenjiang 212013, Jiangsu, China
| | - Longwei Qiao
- The Affiliated Suzhou Hospital of Nanjing Medical UniversitySuzhou 215000, Jiangsu, China
| | - Tong-Chuan He
- The Molecular Oncology Laboratory, Department of Orthopaedic Surgery and Rehabilitation Medicine, The University of Chicago Medical CenterChicago, IL 60637, USA
| | - Qiping Zheng
- Department of Hematological Laboratory Science, Jiangsu Key Laboratory of Medical Science and Laboratory Medicine, School of Medicine, Jiangsu UniversityZhenjiang 212013, Jiangsu, China
- Shenzhen Walgenron Bio-Pharm Co., Ltd.Shenzhen 518118, Guangdong, China
- The Molecular Oncology Laboratory, Department of Orthopaedic Surgery and Rehabilitation Medicine, The University of Chicago Medical CenterChicago, IL 60637, USA
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Davis-Wilson HC, Thoma LM, Franz JR, Blackburn JT, Longobardi L, Schwartz TA, Hackney AC, Pietrosimone B. Physical Activity Associates with T1rho MRI of Femoral Cartilage After Anterior Cruciate Ligament Reconstruction. Med Sci Sports Exerc 2024; 56:411-417. [PMID: 37796166 PMCID: PMC10922225 DOI: 10.1249/mss.0000000000003318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
PURPOSE Less physical activity has been associated with systemic biomarkers of cartilage breakdown after anterior cruciate ligament reconstruction (ACLR). However, previous research lacks analysis of deleterious cartilage compositional changes and objective physical activity after ACLR. The purpose of this study was to determine the association between physical activity quantified via accelerometer-based measures of daily steps and time in moderate-to-vigorous physical activity (MVPA), and T1rho magnetic resonance imaging (MRI) of the femoral articular cartilage, a marker of proteoglycan density in individuals with ACLR. METHODS Daily steps and MVPA were assessed over 7 d using an accelerometer worn on the hip in 26 individuals between 6 and 12 months after primary unilateral ACLR. Resting T1rho MRI was collected bilaterally, and T1rho MRI interlimb ratios (ILR: ACLR limb/contralateral limb) were calculated for lateral and medial femoral condyle regions of interest. We conducted univariate linear regression analyses to determine associations between T1rho MRI ILRs and daily steps and MVPA with and without controlling for sex. RESULTS Greater T1rho MRI ILR of the central lateral femoral condyle, indicative of less proteoglycan density in the ACLR limb, was associated with greater time in MVPA ( R2 = 0.178, P = 0.032). Sex-adjusted models showed significant interaction terms between daily steps and sex in the anterior ( P = 0.025), central ( P = 0.002), and posterior ( P = 0.002) medial femoral condyle. CONCLUSIONS Lesser physical activity may be a risk factor for maintaining cartilage health after ACLR; additionally, the relationship between physical activity and cartilage health may be different between males and females.
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Affiliation(s)
- Hope C. Davis-Wilson
- Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, CO
- VA Eastern Colorado Geriatric Research, Education, and Clinical Center, Rocky Mountain Regional VA Medical Center, Aurora, CO
- MOTION Science Institute, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Louise M. Thoma
- Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Division of Physical Therapy, Department of Allied Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Jason R. Franz
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Chapel Hill, NC
| | - J. Troy Blackburn
- MOTION Science Institute, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Department of Orthopaedics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Lara Longobardi
- Department of Medicine, Division of Rheumatology, Allergy, and Immunology, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Todd A. Schwartz
- Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Department of Biostatistics, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Anthony C. Hackney
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Brian Pietrosimone
- MOTION Science Institute, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Department of Orthopaedics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
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3
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Barati K, Kamyab M, Ebrahimi Takamjani I, Parnianpour M, Hosseini N, Bidari S. Evaluating the effect of equipping an unloading knee orthosis with local muscle vibrators on clinical parameters, muscular activation level, and medial contact force in patients with medial knee osteoarthritis: A randomized trial. Prosthet Orthot Int 2024; 48:46-54. [PMID: 37318271 DOI: 10.1097/pxr.0000000000000243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 03/30/2023] [Indexed: 06/16/2023]
Abstract
BACKGROUND Unloading knee orthosis is prescribed for people with unicompartmental knee osteoarthritis (OA) to unload the damaged compartment. However, despite its benefits, wearing unloading knee orthoses in the long term may decrease knee muscle activity and have a side effect on knee OA progression rate. OBJECTIVES Therefore, this study aimed to determine whether equipping an unloading knee orthosis with local muscle vibrators improves its effectiveness in improving clinical parameters, medial contact force (MCF), and muscular activation levels. METHODS The authors performed a clinical evaluation on 14 participants (7 participants wearing vibratory unloading knee orthoses and 7 participants wearing conventional unloading knee orthoses) with medial knee OA. RESULTS Wearing both orthoses (vibratory and conventional) for 6 weeks significantly improved ( p < 0.05) the MCF, pain, symptoms, function, and quality of life compared with the baseline assessment. Compared with the baseline assessment, the vastus lateralis muscle activation level significantly increased ( p = 0.043) in the vibratory unloading knee orthoses group. The vibratory unloading knee orthoses significantly improved the second peak MCF, vastus medialis activation level, pain, and function compared with conventional unloading knee orthoses ( p < 0.05). CONCLUSIONS Given the potential role of medial compartment loading in the medial knee OA progression rate, both types of unloading knee orthoses (vibratory and conventional) have a potential role in the conservative management of medial knee OA. However, equipping the unloading knee orthoses with local muscle vibrators can improve its effectiveness for clinical and biomechanical parameters and prevent the side effects of its long-term use.
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Affiliation(s)
- Kourosh Barati
- Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Orthotics and Prosthetics, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mojtaba Kamyab
- Department of Orthotics and Prosthetics, California State University Dominguez Hills, Carson, CA, USA
| | - Ismail Ebrahimi Takamjani
- Rehabilitation Research Centre, Department Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mohamad Parnianpour
- Department of Mechanical Engineering, Sharif University of Technology, Tehran, Iran
| | - Nesa Hosseini
- Department of Mechanical Engineering, Sharif University of Technology, Tehran, Iran
| | - Shahrbanoo Bidari
- Department of Orthotics and Prosthetics, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
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Suzuki Y, Ohkoshi Y, Kawakami K, Shimizu K, Chida S, Ukishiro K, Onodera T, Iwasaki K, Maeda T, Suzuki S, Kondo E, Iwasaki N. Assessing knee joint biomechanics and trunk posture according to medial osteoarthritis severity. Sci Rep 2023; 13:19186. [PMID: 37932370 PMCID: PMC10628121 DOI: 10.1038/s41598-023-46486-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 11/01/2023] [Indexed: 11/08/2023] Open
Abstract
During progression of knee osteoarthritis (OA), gait biomechanics changes three-dimensionally; however, its characteristics and trunk posture according to OA severity remain unknown. The present study investigated three-dimensional knee joint biomechanics and trunk posture according to knee OA severity. Overall, 75 patients (93 knees) with medial knee OA [Kellgren-Lawrence grade ≥ 2, grade 2: 20 patients with 24 knees (mean 60.0 years old); grade 3: 25 with 28 knees (mean 62.0 years old); grade 4: 30 with 41 knees (mean 67.9 years old)] and 14 healthy controls (23 knees, mean 63.6 years old) underwent gait analysis using an optical motion capture system and point cluster technique. In grade 2 knee OA, the relative contribution of the knee adduction moment (KAM) increased significantly (P < 0.05), and that of the knee flexion moment decreased (P < 0.05) prior to significant progression of varus knee deformity. Grade 3 knee OA showed significant exacerbation of varus knee deformity (P < 0.01) and KAM increase (P < 0.001). The maximum knee extension angle decreased (P < 0.05) and trunk flexion increased during gait in grade 4 knee OA (P < 0.001). Our study clarified the kinematics and kinetics of medial knee OA with trunk flexion according to severity. Kinetic conversion occurred in grade 2 knees prior to progression of varus deformities, knee flexion contractures, and sagittal imbalance during gait in patients with severe knee OA.
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Affiliation(s)
- Yuki Suzuki
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15 jo, Nishi 7 chome, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan.
- Department of Orthopedic Surgery, Hakodate Orthopedic Clinic, Ishikawa-cho2-115, Hakodate, Hokkaido, 041-0802, Japan.
| | - Yasumitsu Ohkoshi
- Department of Orthopedic Surgery, Hakodate Orthopedic Clinic, Ishikawa-cho2-115, Hakodate, Hokkaido, 041-0802, Japan
| | - Kensaku Kawakami
- Department of Production Systems Eng., National Institute of Technology, Hakodate College, Tokura-cho 14-1, Hakodate, Hokkaido, 042-8501, Japan
| | - Kenta Shimizu
- Department of Rehabilitation, Hakodate Orthopedic Clinic, Ishikawa-cho2-115, Hakodate, Hokkaido, 041-0802, Japan
| | - Shuya Chida
- Department of Rehabilitation, Hakodate Orthopedic Clinic, Ishikawa-cho2-115, Hakodate, Hokkaido, 041-0802, Japan
| | - Kengo Ukishiro
- Department of Rehabilitation, Hakodate Orthopedic Clinic, Ishikawa-cho2-115, Hakodate, Hokkaido, 041-0802, Japan
| | - Tomohiro Onodera
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15 jo, Nishi 7 chome, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Koji Iwasaki
- Department of Functional Reconstruction for the Knee Joint, Graduate School of Medicine, Hokkaido University, Kita 15 jo, Nishi 7 chome, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Tatsunori Maeda
- Department of Orthopedic Surgery, Hakodate Orthopedic Clinic, Ishikawa-cho2-115, Hakodate, Hokkaido, 041-0802, Japan
| | - Sho'ji Suzuki
- Department of Complex and Intelligent Systems, Future University Hakodate, Kamedanakano-cho 116-2, Hakodate, Hokkaido, 041-8655, Japan
| | - Eiji Kondo
- Centre for Sports Medicine, Hokkaido University Hospital, Kita 14 jo Nishi 5 chome, Kita-ku, Sapporo, Hokkaido, 060-8648, Japan
| | - Norimasa Iwasaki
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15 jo, Nishi 7 chome, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan
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5
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Lee YR, Briggs MT, Kuliwaba JS, Jagiello J, Anderson PH, Hoffmann P. High-Resolution N-Glycan MALDI Mass Spectrometry Imaging of Subchondral Bone Tissue Microarrays in Patients with Knee Osteoarthritis. Anal Chem 2023; 95:12640-12647. [PMID: 37583288 PMCID: PMC10470451 DOI: 10.1021/acs.analchem.3c00348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 07/12/2023] [Indexed: 08/17/2023]
Abstract
N-glycan alterations contribute to the progression of several joint diseases, including knee osteoarthritis (KOA). However, molecular changes in KOA subchondral trabecular bone, when exposed to different joint loading forces, are still unknown. The aim of this study was, therefore, to demonstrate the feasibility to differentiate N-glycan changes in subchondral trabecular bone from four different joint loading forces of the tibial plateau regions (i.e., Lateral Anterior (L-A), Lateral Posterior (L-P), Medial Anterior (M-A), and Medial Posterior (M-P)) in KOA patients (n = 10) using matrix-assisted laser desorption/ionization mass spectrometry imaging (MALDI-MSI) at 20 μm spatial resolution. The degree of cartilage degeneration was evaluated histologically, and the subchondral bone tissue microarrays (TMAs) were subsequently manually constructed from formalin-fixed paraffin-embedded (FFPE) KOA osteochondral (i.e., cartilage-subchondral bone) tissues. Overall, the Osteoarthritis Research Society International (OARSI) histological grade was significantly higher and the size of chondrocytes in the superficial zone was much larger for both M-A and M-P compared to L-A and L-P of cartilage (p = 0.006, p = 0.030, p = 0.028, and p = 0.010; respectively). Among the 65 putative N-glycans observed by MALDI-MSI, 2 core fucosylated bi-antennary N-glycans, m/z 1809.64; (Hex)5(HexNAc)4(Fuc)1 and 2100.73; (NeuAc)1(Hex)5(HexNAc)4(Fuc)1, were significantly higher in intensity in M-A compared to L-A of the trabecular bone (p = 0.027, and p = 0.038, respectively). These N-glycans were then further structurally characterized by in situ MS/MS fragmentation post-MALDI-MSI. Our results demonstrate, for the first time, N-glycan alterations can occur at different joint loading forces in the KOA tibial plateau and the feasibility of subchondral bone TMA construction for N-glycan MALDI-MSI.
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Affiliation(s)
- Yea-Rin Lee
- Clinical
and Health Sciences, Health and Biomedical Innovation, University of South Australia, Adelaide, SA 5000, Australia
- Clinical
and Health Sciences, University of South
Australia, Adelaide, SA 5000, Australia
- Discipline
of Orthopaedics and Trauma, Adelaide Medical School, The University of Adelaide, Adelaide, SA 5000, Australia
| | - Matthew T. Briggs
- Clinical
and Health Sciences, University of South
Australia, Adelaide, SA 5000, Australia
| | - Julia S. Kuliwaba
- Discipline
of Orthopaedics and Trauma, Adelaide Medical School, The University of Adelaide, Adelaide, SA 5000, Australia
| | - Jakub Jagiello
- Department
of Orthopaedics and Trauma Surgery, Royal
Adelaide Hospital, Adelaide, SA 5000, Australia
| | - Paul H. Anderson
- Clinical
and Health Sciences, Health and Biomedical Innovation, University of South Australia, Adelaide, SA 5000, Australia
| | - Peter Hoffmann
- Clinical
and Health Sciences, University of South
Australia, Adelaide, SA 5000, Australia
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Mohout I, Elahi SA, Esrafilian A, Killen BA, Korhonen RK, Verschueren S, Jonkers I. Signatures of disease progression in knee osteoarthritis: insights from an integrated multi-scale modeling approach, a proof of concept. Front Bioeng Biotechnol 2023; 11:1214693. [PMID: 37576991 PMCID: PMC10413555 DOI: 10.3389/fbioe.2023.1214693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 07/13/2023] [Indexed: 08/15/2023] Open
Abstract
Introduction: Knee osteoarthritis (KOA) is characterized by articular cartilage degeneration. It has been widely accepted that the mechanical joint environment plays a significant role in the onset and progression of this disease. In silico models have been used to study the interplay between mechanical loading and cartilage degeneration, hereby relying mainly on two key mechanoregulatory factors indicative of collagen degradation and proteoglycans depletion. These factors are the strain in collagen fibril direction (SFD) and maximum shear strain (MSS) respectively. Methods: In this study, a multi-scale in silico modeling approach was used based on a synergy between musculoskeletal and finite element modeling to evaluate the SFD and MSS. These strains were evaluated during gait based on subject-specific gait analysis data collected at baseline (before a 2-year follow-up) for a healthy and progressive early-stage KOA subject with similar demographics. Results: The results show that both SFD and MSS factors allowed distinguishing between a healthy subject and a KOA subject, showing progression at 2 years follow-up, at the instance of peak contact force as well as during the stance phase of the gait cycle. At the peak of the stance phase, the SFD were found to be more elevated in the KOA patient with the median being 0.82% higher in the lateral and 0.4% higher in the medial compartment of the tibial cartilage compared to the healthy subject. Similarly, for the MSS, the median strains were found to be 3.6% higher in the lateral and 0.7% higher in the medial tibial compartment of the KOA patient compared to the healthy subject. Based on these intersubject SFD and MSS differences, we were additionally able to identify that the tibial compartment of the KOA subject at risk of progression. Conclusion/discussion: We confirmed the mechanoregulatory factors as potential biomarkers to discriminate patients at risk of disease progression. Future studies should evaluate the sensitivity of the mechanoregulatory factors calculated based on this multi-scale modeling workflow in larger patient and control cohorts.
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Affiliation(s)
- Ikram Mohout
- Department of Movement Science, Human Movement Biomechanics Research Group, Leuven, Belgium
| | - Seyed Ali Elahi
- Department of Movement Science, Human Movement Biomechanics Research Group, Leuven, Belgium
- Mechanical Engineering Department, Soft Tissue Biomechanics Group, Leuven, Belgium
| | - Amir Esrafilian
- Department of Technical Physics, Biophysics of Bone and Cartilage Research Group, University of Eastern Finland, Kuopio, Finland
| | - Bryce A. Killen
- Department of Movement Science, Human Movement Biomechanics Research Group, Leuven, Belgium
| | - Rami K. Korhonen
- Department of Technical Physics, Biophysics of Bone and Cartilage Research Group, University of Eastern Finland, Kuopio, Finland
| | - Sabine Verschueren
- Department of Rehabilitation Science, Research Group for Musculoskeletal Rehabilitation, Leuven, Belgium
| | - Ilse Jonkers
- Department of Movement Science, Human Movement Biomechanics Research Group, Leuven, Belgium
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Di Raimondo G, Willems M, Killen BA, Havashinezhadian S, Turcot K, Vanwanseele B, Jonkers I. Peak Tibiofemoral Contact Forces Estimated Using IMU-Based Approaches Are Not Significantly Different from Motion Capture-Based Estimations in Patients with Knee Osteoarthritis. SENSORS (BASEL, SWITZERLAND) 2023; 23:s23094484. [PMID: 37177688 PMCID: PMC10181595 DOI: 10.3390/s23094484] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 05/01/2023] [Accepted: 05/03/2023] [Indexed: 05/15/2023]
Abstract
Altered tibiofemoral contact forces represent a risk factor for osteoarthritis onset and progression, making optimization of the knee force distribution a target of treatment strategies. Musculoskeletal model-based simulations are a state-of-the-art method to estimate joint contact forces, but they typically require laboratory-based input and skilled operators. To overcome these limitations, ambulatory methods, relying on inertial measurement units, have been proposed to estimated ground reaction forces and, consequently, knee contact forces out-of-the-lab. This study proposes the use of a full inertial-capture-based musculoskeletal modelling workflow with an underlying probabilistic principal component analysis model trained on 1787 gait cycles in patients with knee osteoarthritis. As validation, five patients with knee osteoarthritis were instrumented with 17 inertial measurement units and 76 opto-reflective markers. Participants performed multiple overground walking trials while motion and inertial capture methods were synchronously recorded. Moderate to strong correlations were found for the inertial capture-based knee contact forces compared to motion capture with root mean square error between 0.15 and 0.40 of body weight. The results show that our workflow can inform and potentially assist clinical practitioners to monitor knee joint loading in physical therapy sessions and eventually assess long-term therapeutic effects in a clinical context.
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Affiliation(s)
- Giacomo Di Raimondo
- Department of Movement Sciences, Katholieke Universiteit Leuven, 3001 Heverlee, Belgium
| | - Miel Willems
- Department of Movement Sciences, Katholieke Universiteit Leuven, 3001 Heverlee, Belgium
| | - Bryce Adrian Killen
- Department of Movement Sciences, Katholieke Universiteit Leuven, 3001 Heverlee, Belgium
| | | | - Katia Turcot
- Department of Kinesiology, Université Laval, Québec, QC G1V 0A6, Canada
| | - Benedicte Vanwanseele
- Department of Movement Sciences, Katholieke Universiteit Leuven, 3001 Heverlee, Belgium
| | - Ilse Jonkers
- Department of Movement Sciences, Katholieke Universiteit Leuven, 3001 Heverlee, Belgium
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8
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The biomechanical fingerprint of hip and knee osteoarthritis patients during activities of daily living. Clin Biomech (Bristol, Avon) 2023; 101:105858. [PMID: 36525720 DOI: 10.1016/j.clinbiomech.2022.105858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 12/07/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Osteoarthritis is a highly prevalent disease affecting the hip and knee joint and is characterized by load-mediated pain and decreased quality of life. Dependent on involved joint, patients present antalgic movement compensations, aiming to decrease loading on the involved joint. However, the associated alterations in mechanical loading of the ipsi- and contra-lateral lower limb joints, are less documented. Here, we documented the biomechanical fingerprint of end-stage hip and knee osteoarthritis patients in terms of ipsilateral and contralateral hip and knee loading during walking and stair ambulation. METHODS Three-dimensional motion-analysis was performed in 20 hip, 18 knee osteoarthritis patients and 12 controls during level walking and stair ambulation. Joint contact forces were calculated using a standard musculoskeletal modelling workflow in Opensim. Involved and contralateral hip and knee joint loading was compared against healthy controls using independent t-tests (p < 0.05). FINDINGS Both hip and knee cohorts significantly decreased loading of the involved joint during gait and stair ambulation. Hip osteoarthritis patients presented no signs of ipsilateral knee nor contralateral leg overloading, during walking and stair ascending. However, knee osteoarthritis patients significantly increased loading at the ipsilateral hip, and contralateral hip and knee joints during stair ambulation compared to controls. INTERPRETATION The biomechanical fingerprint in knee and hip osteoarthritis patients confirmed antalgic movement strategies to unload the involved leg during gait. Only during stair ambulation in knee osteoarthritis patients, movement adaptations were confirmed that induced unbalanced intra- and inter-limb loading conditions, which are known risk factors for secondary osteoarthritis.
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9
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Eskelinen ASA, Florea C, Tanska P, Hung HK, Frank EH, Mikkonen S, Nieminen P, Julkunen P, Grodzinsky AJ, Korhonen RK. Cyclic loading regime considered beneficial does not protect injured and interleukin-1-inflamed cartilage from post-traumatic osteoarthritis. J Biomech 2022; 141:111181. [DOI: 10.1016/j.jbiomech.2022.111181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 06/06/2022] [Accepted: 06/07/2022] [Indexed: 11/25/2022]
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10
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Alvarado-Rivera D, Niño-Suárez PA, Corona-Ramírez LG. Semiactive Knee Orthotic Using a MR Damper and a Smart Insole to Control the Damping Force Sensing the Plantar Pressure. Front Neurorobot 2022; 16:790020. [PMID: 35711282 PMCID: PMC9197162 DOI: 10.3389/fnbot.2022.790020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 03/14/2022] [Indexed: 11/28/2022] Open
Abstract
This work presents the development of semiactive knee orthosis prototype that focus to absorb the forces and impacts in this joint during the human gait. This prototype consists of three subsystems: the first is a wireless and portable system capable of measuring the ground reaction forces in the stance phase of the gait cycle, by means of an instrumented insole with force sensing resistors strategically placed on the sole of the foot, an electronic device allows processing and transmit this information via Bluetooth to the control system. The second is a semiactive actuator, which has inside a magnetorheological fluid, highlighting its ability to modify its damping force depending on the intensity of the magnetic field that circulates through the MR fluid. It is regulated by a Proportional Derivative (PD) controller system according to the values of plantar pressure measured by the insole. The third component is a mechanical structure manufactured by 3D printing, which adapts to the morphology of the human leg. This exoskeleton is designed to support the forces on the knee controlling the action of the magnetorheological actuator by ground reaction forces. The purpose of this assistance system is to reduce the forces applied to the knee during the gait cycle, providing support and stability to this joint. The obtained experimental results indicate that the device fulfills the function by reducing 12 % of the impact forces on the user's knee.
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Affiliation(s)
- David Alvarado-Rivera
- Instituto Politécnico Nacional, Escuela Superior de Ingeniería Mecánica y Eléctrica, México City, Mexico
| | - Paola A. Niño-Suárez
- Instituto Politécnico Nacional, Escuela Superior de Ingeniería Mecánica y Eléctrica, México City, Mexico
- *Correspondence: Paola A. Niño-Suárez
| | - Leonel G. Corona-Ramírez
- Instituto Politécnico Nacional, Unidad Profesional Interdisciplinaria en Ingeniería y Tecnologías Avanzadas, México City, Mexico
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11
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Shimizu H, Shimoura K, Iijima H, Suzuki Y, Aoyama T. Functional manifestations of early knee osteoarthritis: a systematic review and meta-analysis. Clin Rheumatol 2022; 41:2625-2634. [PMID: 35554743 DOI: 10.1007/s10067-022-06150-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 03/21/2022] [Accepted: 03/24/2022] [Indexed: 11/26/2022]
Abstract
Early detection of knee osteoarthritis (KOA) can improve treatment outcomes and prevent its progression. The aim of this systematic review was to identify the functional changes in early KOA. Electronic journal databases and platforms, including PubMed, the Physiotherapy Evidence Database, the Cochrane Central Register of Controlled Trials, and Scopus were searched. The inclusion criteria were as follows: (1) studies comparing patients with early KOA with an age-matched control group and (2) studies with objectively measured functional changes as outcomes. Studies that included individuals with Kellgren and Lawrence (K/L) grades > 2- were excluded. A random-effects model was constructed to calculate pooled standardized mean differences (SMDs). A total of nine articles were included in this systematic review. Seven studies used classification criteria to define early KOA, including knee pain; a K/L grade of 0, 1, or 2- (osteophytes only) for the medial compartment; and the presence of two out of four MRI criteria. The remaining two studies included K/L grade 1 confirmed by radiography. Early KOA participants had a significantly longer timed up-and-go test (TUG) time (pooled SMD: 0.57; 95% confidence interval: 0.15, 0.98). The two groups had similar knee extension muscle strength at 90° knee flexion. The quality of evidence for each measured outcome was "very low." In this review, longer TUG was identified as a functional manifestation of early KOA. Further studies involving functional assessments are needed to develop a screening method to detect early KOA. Key Points • There is a need for diagnostic criteria that include functional changes in patients with early knee osteoarthritis, since radiographic facilities are not available everywhere. • In this review, a long timed up-and-go test time was identified as a functional manifestation of early knee osteoarthritis. • If the findings of this study can be replicated, measurement of TUG may allow for earlier detection of knee osteoarthritis outside the hospital and in routine clinical practice without the use of MRI or X-rays.
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Affiliation(s)
- Hiroki Shimizu
- Department of Physical Therapy, Graduate School of Medicine, Human Health Sciences, Kyoto University, 53 Kawahara-choSakyo-ku, Kyoto-shi Kyoto, Shogoin, 606-8507, Japan
| | - Kanako Shimoura
- Department of Physical Therapy, Graduate School of Medicine, Human Health Sciences, Kyoto University, 53 Kawahara-choSakyo-ku, Kyoto-shi Kyoto, Shogoin, 606-8507, Japan.
- Japan Society for the Promotion of Science, Tokyo, 102-0083, Japan.
| | - Hirotaka Iijima
- Department of Physical Therapy, Graduate School of Medicine, Human Health Sciences, Kyoto University, 53 Kawahara-choSakyo-ku, Kyoto-shi Kyoto, Shogoin, 606-8507, Japan.
- Department of System Design Engineering, Faculty of Science and Technology, Keio University, 3-14-1 Hiyoshi, Kohoku-ku, Yokohama, 223-8522, Japan.
| | - Yusuke Suzuki
- Department of Physical Therapy, Faculty of Rehabilitation, Niigata University of Health and Welfare, Niigata, 950-3198, Japan
| | - Tomoki Aoyama
- Department of Physical Therapy, Graduate School of Medicine, Human Health Sciences, Kyoto University, 53 Kawahara-choSakyo-ku, Kyoto-shi Kyoto, Shogoin, 606-8507, Japan
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12
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Mixon A, Bahar-Moni AS, Faisal TR. Mechanical characterization of articular cartilage degraded combinedly with MMP-1 and MMP-9. J Mech Behav Biomed Mater 2022; 129:105131. [DOI: 10.1016/j.jmbbm.2022.105131] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 08/24/2021] [Accepted: 02/11/2022] [Indexed: 11/29/2022]
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13
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Buehler C, Koller W, De Comtes F, Kainz H. Quantifying Muscle Forces and Joint Loading During Hip Exercises Performed With and Without an Elastic Resistance Band. Front Sports Act Living 2021; 3:695383. [PMID: 34497999 PMCID: PMC8419330 DOI: 10.3389/fspor.2021.695383] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 07/21/2021] [Indexed: 01/13/2023] Open
Abstract
An increase in hip joint contact forces (HJCFs) is one of the main contributing mechanical causes of hip joint pathologies, such as hip osteoarthritis, and its progression. The strengthening of the surrounding muscles of the joint is a way to increase joint stability, which results in the reduction of HJCF. Most of the exercise recommendations are based on expert opinions instead of evidence-based facts. This study aimed to quantify muscle forces and joint loading during rehabilitative exercises using an elastic resistance band (ERB). Hip exercise movements of 16 healthy volunteers were recorded using a three-dimensional motion capture system and two force plates. All exercises were performed without and with an ERB and two execution velocities. Hip joint kinematics, kinetics, muscle forces, and HJCF were calculated based on the musculoskeletal simulations in OpenSim. Time-normalized waveforms of the different exercise modalities were compared with each other and with reference values found during walking. The results showed that training with an ERB increases both target muscle forces and HJCF. Furthermore, the ERB reduced the hip joint range of motion during the exercises. The type of ERB used (soft vs. stiff ERB) and the execution velocity of the exercise had a minor impact on the peak muscle forces and HJCF. The velocity of exercise execution, however, had an influence on the total required muscle force. Performing hip exercises without an ERB resulted in similar or lower peak HJCF and lower muscle forces than those found during walking. Adding an ERB during hip exercises increased the peak muscle and HJCF but the values remained below those found during walking. Our workflow and findings can be used in conjunction with future studies to support exercise design.
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Affiliation(s)
- Callum Buehler
- Neuromechanics Research Group, Department of Biomechanics, Kinesiology and Computer Science in Sport, Centre for Sport Science and University Sports, University of Vienna, Vienna, Austria
| | - Willi Koller
- Neuromechanics Research Group, Department of Biomechanics, Kinesiology and Computer Science in Sport, Centre for Sport Science and University Sports, University of Vienna, Vienna, Austria
| | - Florentina De Comtes
- Neuromechanics Research Group, Department of Biomechanics, Kinesiology and Computer Science in Sport, Centre for Sport Science and University Sports, University of Vienna, Vienna, Austria
| | - Hans Kainz
- Neuromechanics Research Group, Department of Biomechanics, Kinesiology and Computer Science in Sport, Centre for Sport Science and University Sports, University of Vienna, Vienna, Austria
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14
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Mixon A, Savage A, Bahar-Moni AS, Adouni M, Faisal T. An in vitro investigation to understand the synergistic role of MMPs-1 and 9 on articular cartilage biomechanical properties. Sci Rep 2021; 11:14409. [PMID: 34257325 PMCID: PMC8277889 DOI: 10.1038/s41598-021-93744-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 06/30/2021] [Indexed: 11/09/2022] Open
Abstract
Matrix metalloproteinases (MMPs) play a crucial role in enzymatically digesting cartilage extracellular matrix (ECM) components, resulting in degraded cartilage with altered mechanical loading capacity. Overexpression of MMPs is often caused by trauma, physiologic conditions and by disease. To understand the synergistic impact MMPs have on cartilage biomechanical properties, MMPs from two subfamilies: collagenase (MMP-1) and gelatinase (MMP-9) were investigated in this study. Three different ratios of MMP-1 (c) and MMP-9 (g), c1:g1, c3:g1 and c1:g3 were considered to develop a degradation model. Thirty samples, harvested from bovine femoral condyles, were treated in groups of 10 with one concentration of enzyme mixture. Each sample was tested in a healthy state prior to introducing degradative enzymes to establish a baseline. Samples were subjected to indentation loading up to 20% bulk strain. Both control and treated samples were mechanically and histologically assessed to determine the impact of degradation. Young's modulus and peak load of the tissue under indentation were compared between the control and degraded cartilage explants. Cartilage degraded with the c3:g1 enzyme concentration resulted in maximum 33% reduction in stiffness and peak load compared to the other two concentrations. The abundance of collagenase is more responsible for cartilage degradation and reduced mechanical integrity.
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Affiliation(s)
- Allison Mixon
- Department of Mechanical Engineering, University of Louisiana at Lafayette, Lafayette, LA, 70503, USA
| | - Andrew Savage
- Department of Biology, University of Louisiana at Lafayette, Lafayette, LA, 70503, USA
| | - Ahmed Suparno Bahar-Moni
- Department of Orthopaedics, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Bertam, 13200, Kepala Batas, Penang, Malaysia
| | - Malek Adouni
- Department of Mechanical Engineering, Australian College of Kuwait, P.O. Box 1411, East Meshrif, Kuwait
| | - Tanvir Faisal
- Department of Mechanical Engineering, University of Louisiana at Lafayette, Lafayette, LA, 70503, USA.
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15
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Knee loading in OA subjects is correlated to flexion and adduction moments and to contact point locations. Sci Rep 2021; 11:8594. [PMID: 33883591 PMCID: PMC8060429 DOI: 10.1038/s41598-021-87978-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 03/29/2021] [Indexed: 11/29/2022] Open
Abstract
This study evaluated the association of contact point locations with the knee medial and lateral contact force (Fmed, Flat) alterations in OA and healthy subjects. A musculoskeletal model of the lower limb with subject-specific tibiofemoral contact point trajectories was used to estimate the Fmed and Flat in ten healthy and twelve OA subjects during treadmill gait. Regression analyses were performed to evaluate the correlation of the contact point locations, knee adduction moment (KAM), knee flexion moment (KFM), frontal plane alignment, and gait speed with the Fmed and Flat. Medial contact point locations in the medial–lateral direction showed a poor correlation with the Fmed in OA (R2 = 0.13, p = 0.01) and healthy (R2 = 0.24, p = 0.001) subjects. Anterior–posterior location of the contact points also showed a poor correlation with the Fmed of OA subjects (R2 = 0.32, p < 0.001). Across all subjects, KAM and KFM remained the best predictors of the Fmed and Flat, respectively (R2 between 0.62 and 0.69). Results suggest different mechanisms of contact force distribution in OA joints. The variations in the location of the contact points participate partially to explains the Fmed variations in OA subjects together with the KFM and KAM.
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16
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Lawrence EA, Aggleton J, van Loon J, Godivier J, Harniman R, Pei J, Nowlan N, Hammond C. Exposure to hypergravity during zebrafish development alters cartilage material properties and strain distribution. Bone Joint Res 2021; 10:137-148. [PMID: 33560137 DOI: 10.1302/2046-3758.102.bjr-2020-0239.r1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
AIMS Vertebrates have adapted to life on Earth and its constant gravitational field, which exerts load on the body and influences the structure and function of tissues. While the effects of microgravity on muscle and bone homeostasis are well described, with sarcopenia and osteoporosis observed in astronauts returning from space, the effects of shorter exposures to increased gravitational fields are less well characterized. We aimed to test how hypergravity affects early cartilage and skeletal development in a zebrafish model. METHODS We exposed zebrafish to 3 g and 6 g hypergravity from three to five days post-fertilization, when key events in jaw cartilage morphogenesis occur. Following this exposure, we performed immunostaining along with a range of histological stains and transmission electron microscopy (TEM) to examine cartilage morphology and structure, atomic force microscopy (AFM) and nanoindentation experiments to investigate the cartilage material properties, and finite element modelling to map the pattern of strain and stress in the skeletal rudiments. RESULTS We did not observe changes to larval growth, or morphology of cartilage or muscle. However, we observed altered mechanical properties of jaw cartilages, and in these regions we saw changes to chondrocyte morphology and extracellular matrix (ECM) composition. These areas also correspond to places where strain and stress distribution are predicted to be most different following hypergravity exposure. CONCLUSION Our results suggest that altered mechanical loading, through hypergravity exposure, affects chondrocyte maturation and ECM components, ultimately leading to changes to cartilage structure and function. Cite this article: Bone Joint Res 2021;10(2):137-148.
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Affiliation(s)
| | - Jessye Aggleton
- School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, UK.,School of Anthropology and Archaeology, University of Bristol, Bristol, UK
| | - Jack van Loon
- European Space Agency (ESA) Technology Center (ESTEC), TEC-MMG, Noordwijk, The Netherlands.,Department Oral & Maxillofacial Surgery/Pathology, Amsterdam Movement Sciences & Amsterdam Bone Center (ABC), Amsterdam University Medical Center Location VUmc & Academic Center for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Josepha Godivier
- Department of Bioengineering, Imperial College London, London, UK
| | | | - Jiaxin Pei
- School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, UK
| | - Niamh Nowlan
- Department of Bioengineering, Imperial College London, London, UK
| | - Chrissy Hammond
- School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, UK
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17
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In Silico-Enhanced Treatment and Rehabilitation Planning for Patients with Musculoskeletal Disorders: Can Musculoskeletal Modelling and Dynamic Simulations Really Impact Current Clinical Practice? APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10207255] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Over the past decades, the use of computational physics-based models representative of the musculoskeletal (MSK) system has become increasingly popular in many fields of clinically driven research, locomotor rehabilitation in particular. These models have been applied to various functional impairments given their ability to estimate parameters which cannot be readily measured in vivo but are of interest to clinicians. The use of MSK modelling and simulations allows analysis of relevant MSK biomarkers such as muscle and joint contact loading at a number of different stages in the clinical treatment pathway in order to benefit patient functional outcome. Applications of these methods include optimisation of rehabilitation programs, patient stratification, disease characterisation, surgical pre-planning, and assistive device and exoskeleton design and optimisation. This review provides an overview of current approaches, the components of standard MSK models, applications, limitations, and assumptions of these modelling and simulation methods, and finally proposes a future direction.
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18
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Liu A, Sanderson WJ, Ingham E, Fisher J, Jennings LM. Development of a specimen-specific in vitro pre-clinical simulation model of the human cadaveric knee with appropriate soft tissue constraints. PLoS One 2020; 15:e0238785. [PMID: 33052931 PMCID: PMC7556525 DOI: 10.1371/journal.pone.0238785] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 08/21/2020] [Indexed: 11/28/2022] Open
Abstract
A human cadaveric specimen-specific knee model with appropriate soft tissue constraints was developed to appropriately simulate the biomechanical environment in the human knee, in order to pre-clinically evaluate the biomechanical and tribological performance of soft tissue interventions. Four human cadaveric knees were studied in a natural knee simulator under force control conditions in the anterior posterior (AP) and tibial rotation (TR) axes, using virtual springs to replicate the function of soft tissues. The most appropriate spring constraints for each knee were determined by comparing the kinematic outputs in terms of AP displacement and TR angle of the human knee with all the soft tissues intact, to the same knee with all the soft tissues resected and replaced with virtual spring constraints (spring rate and free length/degree). The virtual spring conditions that showed the least difference in the AP displacement and TR angle outputs compared to the intact knee were considered to be the most appropriate spring conditions for each knee. The resulting AP displacement and TR angle profiles under the appropriate virtual spring conditions all showed similar shapes to the individual intact knee for each donor. This indicated that the application of the combination of virtual AP and TR springs with appropriate free lengths/degrees was successful in simulating the natural human knee soft tissue function. Each human knee joint had different kinematics as a result of variations in anatomy and soft tissue laxity. The most appropriate AP spring rate for the four human knees varied from 20 to 55 N/mm and the TR spring rate varied from 0.3 to 1.0 Nm/°. Consequently, the most appropriate spring condition for each knee was unique and required specific combinations of spring rate and free length/degree in each of the two axes.
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Affiliation(s)
- Aiqin Liu
- Institute of Medical and Biological Engineering, School of Mechanical Engineering, Faculty of Engineering and Physical Sciences, University of Leeds, Leeds, United Kingdom
- * E-mail:
| | - William J. Sanderson
- Institute of Medical and Biological Engineering, School of Mechanical Engineering, Faculty of Engineering and Physical Sciences, University of Leeds, Leeds, United Kingdom
| | - Eileen Ingham
- Institute of Medical and Biological Engineering, School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds, United Kingdom
| | - John Fisher
- Institute of Medical and Biological Engineering, School of Mechanical Engineering, Faculty of Engineering and Physical Sciences, University of Leeds, Leeds, United Kingdom
| | - Louise M. Jennings
- Institute of Medical and Biological Engineering, School of Mechanical Engineering, Faculty of Engineering and Physical Sciences, University of Leeds, Leeds, United Kingdom
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19
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Eskelinen ASA, Tanska P, Florea C, Orozco GA, Julkunen P, Grodzinsky AJ, Korhonen RK. Mechanobiological model for simulation of injured cartilage degradation via pro-inflammatory cytokines and mechanical stimulus. PLoS Comput Biol 2020; 16:e1007998. [PMID: 32584809 PMCID: PMC7343184 DOI: 10.1371/journal.pcbi.1007998] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 07/08/2020] [Accepted: 05/28/2020] [Indexed: 01/12/2023] Open
Abstract
Post-traumatic osteoarthritis (PTOA) is associated with cartilage degradation, ultimately leading to disability and decrease of quality of life. Two key mechanisms have been suggested to occur in PTOA: tissue inflammation and abnormal biomechanical loading. Both mechanisms have been suggested to result in loss of cartilage proteoglycans, the source of tissue fixed charge density (FCD). In order to predict the simultaneous effect of these degrading mechanisms on FCD content, a computational model has been developed. We simulated spatial and temporal changes of FCD content in injured cartilage using a novel finite element model that incorporates (1) diffusion of the pro-inflammatory cytokine interleukin-1 into tissue, and (2) the effect of excessive levels of shear strain near chondral defects during physiologically relevant loading. Cytokine-induced biochemical cartilage explant degradation occurs near the sides, top, and lesion, consistent with the literature. In turn, biomechanically-driven FCD loss is predicted near the lesion, in accordance with experimental findings: regions near lesions showed significantly more FCD depletion compared to regions away from lesions (p<0.01). Combined biochemical and biomechanical degradation is found near the free surfaces and especially near the lesion, and the corresponding bulk FCD loss agrees with experiments. We suggest that the presence of lesions plays a role in cytokine diffusion-driven degradation, and also predisposes cartilage for further biomechanical degradation. Models considering both these cartilage degradation pathways concomitantly are promising in silico tools for predicting disease progression, recognizing lesions at high risk, simulating treatments, and ultimately optimizing treatments to postpone the development of PTOA. Post-traumatic osteoarthritis is a musculoskeletal disorder where inflammatory processes and abnormal joint loading predispose articular cartilage to degradation after a mechanical injury. Since inflamed and injured cartilage cannot be reversed back to healthy state, prevention of osteoarthritis progression is advisable, a prestigious goal where computational models could serve as tools. The current literature is short of computational models combining both biochemical and biomechanical aspects of osteoarthritis. Thus, here we implemented inflammation of living cartilage tissue followed by biochemical perturbations of tissue homeostasis and shear strain-induced biomechanical degradation in novel cell-to-tissue-level finite element models. The models presented in this paper and enriched by our experimental findings/previous literature provide profound new mechanobiological insights and predictions about cartilage degradation in injured and inflamed tissue under physiologically relevant mechanical loading. We suggest that mechanobiological computational models could be applied as in silico analysis tools that provide clinicians information of the personalized progression of post-traumatic osteoarthritis and decision-making guidance for treatment of the disease.
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Affiliation(s)
| | - Petri Tanska
- Department of Applied Physics, University of Eastern Finland, Finland
| | - Cristina Florea
- Department of Applied Physics, University of Eastern Finland, Finland
- Departments of Biological Engineering, Electrical Engineering and Computer Science and Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, United States of America
| | - Gustavo A. Orozco
- Department of Applied Physics, University of Eastern Finland, Finland
| | - Petro Julkunen
- Department of Applied Physics, University of Eastern Finland, Finland
- Department of Clinical Neurophysiology, Kuopio University Hospital, Finland
| | - Alan J. Grodzinsky
- Departments of Biological Engineering, Electrical Engineering and Computer Science and Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, United States of America
| | - Rami K. Korhonen
- Department of Applied Physics, University of Eastern Finland, Finland
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20
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Mukherjee S, Nazemi M, Jonkers I, Geris L. Use of Computational Modeling to Study Joint Degeneration: A Review. Front Bioeng Biotechnol 2020; 8:93. [PMID: 32185167 PMCID: PMC7058554 DOI: 10.3389/fbioe.2020.00093] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 01/31/2020] [Indexed: 12/13/2022] Open
Abstract
Osteoarthritis (OA), a degenerative joint disease, is the most common chronic condition of the joints, which cannot be prevented effectively. Computational modeling of joint degradation allows to estimate the patient-specific progression of OA, which can aid clinicians to estimate the most suitable time window for surgical intervention in osteoarthritic patients. This paper gives an overview of the different approaches used to model different aspects of joint degeneration, thereby focusing mostly on the knee joint. The paper starts by discussing how OA affects the different components of the joint and how these are accounted for in the models. Subsequently, it discusses the different modeling approaches that can be used to answer questions related to OA etiology, progression and treatment. These models are ordered based on their underlying assumptions and technologies: musculoskeletal models, Finite Element models, (gene) regulatory models, multiscale models and data-driven models (artificial intelligence/machine learning). Finally, it is concluded that in the future, efforts should be made to integrate the different modeling techniques into a more robust computational framework that should not only be efficient to predict OA progression but also easily allow a patient’s individualized risk assessment as screening tool for use in clinical practice.
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Affiliation(s)
- Satanik Mukherjee
- Prometheus, Division of Skeletal Tissue Engineering, KU Leuven, Leuven, Belgium.,Biomechanics Section, KU Leuven, Leuven, Belgium
| | - Majid Nazemi
- GIGA in silico Medicine, University of Liège, Liège, Belgium
| | - Ilse Jonkers
- Human Movement Biomechanics Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | - Liesbet Geris
- Prometheus, Division of Skeletal Tissue Engineering, KU Leuven, Leuven, Belgium.,Biomechanics Section, KU Leuven, Leuven, Belgium.,GIGA in silico Medicine, University of Liège, Liège, Belgium
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21
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Muscle-specific changes of lower extremities in the early period after total knee arthroplasty: Insight from tensiomyography. JOURNAL OF MUSCULOSKELETAL & NEURONAL INTERACTIONS 2020; 20:390-397. [PMID: 32877975 PMCID: PMC7493442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This study aimed to evaluate changes in i) muscle contractile properties of both lower extremities by using tensiomyography (TMG); ii) patients' physical function, and iii) electromechanical efficiency (EME) of the gastrocnemius medialis muscle in total knee arthroplasty (TKA) patients from before to one-month after TKA. METHODS Twenty-six patients scheduled for TKA were included. RESULTS The significant muscle*time interaction was found for sustain time and maximal radial displacement (Dm) (η2≥0.219) only, whereas time*leg interaction was found for time delay and Dm (η2≥0.254) only. Post hoc analysis showed a significant decrease of Dm of vastus medialis and increase in contraction time (Tc) of both the vastus lateralis and rectus femoris muscles of the involved leg, respectively. Furthermore, reduction of knee extensors (-55.4%) and flexors (-22.2%) strength, timed up and go (-26.9%), 30s chair stand (-28.9%) and EME (-38.2%) was observed. CONCLUSION TKA treatment altered physical function as well as contractile properties of the main skeletal muscles surrounding the involved joint in the early period after surgery; however, alterations showed to be both limb and muscle-specific. This might provide clinicians and physiotherapist with additional information on how to adapt rehabilitation to the needs of an individual patient.
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22
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Mohd Sharif NA, Usman J, Wan Safwani WKZ, Siew Li G, Abdul Karim S, Mohamed NA, Khan SS, Khan SJ. Effects of simple knee sleeves on pain and knee adduction moment in early unilateral knee osteoarthritis. Proc Inst Mech Eng H 2019; 233:1132-1140. [PMID: 31597554 DOI: 10.1177/0954411919874614] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Knee sleeves are often prescribed to alleviate pain in people with early knee osteoarthritis. However, the biomechanics underlying their pain-relieving effect are still not well understood. This pre-post study aims at evaluating and comparing the effects of two different types of knee sleeves on knee adduction moment. Patients with clinically diagnosed knee osteoarthritis were recruited from the University of Malaya Medical Centre and were randomly assigned to two test groups using (1) a simple knee sleeve and (2) a simple sleeve with patella cutout. Knee adduction moment was collected using the Vicon motion capture system with two Kistler force plates. Pain, stiffness and physical functions were recorded using the Western Ontario and McMaster Universities Osteoarthritis Index. All measurements were taken before, immediately after and at the completion of 6 weeks of application (primary time point). In total, 17 participants with early unilateral knee osteoarthritis (47.7 (9.7) years) completed the study. Overall results show significant reduction in pain, early stance and late stance knee adduction moment and increased walking speed after 6 weeks of both knee sleeves application. This study results suggest that knee sleeves can reduce knee adduction moments in early unilateral knee osteoarthritis by 14.0% and 12.1% using the simple sleeve and the sleeve with patella cutout, respectively, and can potentially delay disease progression. In addition, knee sleeve with patella cutout does not provide additional benefits when compared to the simple knee sleeve.
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Affiliation(s)
| | - Juliana Usman
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia.,Centre for Applied Biomechanics, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Goh Siew Li
- Sports Medicine Unit, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Samihah Abdul Karim
- Sports Medicine Unit, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nur Anisah Mohamed
- Institute of Mathematical Sciences, Faculty of Science, University of Malaya, Kuala Lumpur, Malaysia
| | - Soobia Saad Khan
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia
| | - Saad Jawaid Khan
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia.,Department of Biomedical Engineering, Faculty of Engineering Science and Technology, Ziauddin University, Karachi, Pakistan
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23
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Pastrama MI, Ortiz AC, Zevenbergen L, Famaey N, Gsell W, Neu CP, Himmelreich U, Jonkers I. Combined enzymatic degradation of proteoglycans and collagen significantly alters intratissue strains in articular cartilage during cyclic compression. J Mech Behav Biomed Mater 2019; 98:383-394. [PMID: 31349141 DOI: 10.1016/j.jmbbm.2019.05.040] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 05/22/2019] [Accepted: 05/24/2019] [Indexed: 12/25/2022]
Abstract
As degenerative joint diseases such as osteoarthritis (OA) progress, the matrix constituents, particularly collagen fibrils and proteoglycans, become damaged, therefore deteriorating the tissue's mechanical properties. This study aims to further the understanding of the effect of degradation of the different cartilage constituents on the mechanical loading environment in early stage OA. To this end, intact, collagen- and proteoglycan-depleted cartilage plugs were cyclically loaded in axial compression using an experimental model simulating in vivo cartilage-on-cartilage contact conditions in a micro-MRI scanner. Depletion of collagen and proteoglycans was achieved through enzymatic degradation with collagenase and chondroitinase ABC, respectively. Using a displacement-encoded imaging sequence (DENSE), strains were computed and compared in intact and degraded samples. The results revealed that, while degradation with one or the other enzyme had little effect on the contact strains, degradation with a combination of both enzymes caused an increase in the means and variance of the transverse, axial and shear strains, particularly in the superficial zone of the cartilage. This effect indicates that the balance between cartilage matrix constituents plays an essential role in maintaining the mechanical properties of the tissue, and a disturbance in this balance leads to a decrease of the load bearing capacity associated with degenerative joint diseases such as OA.
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Affiliation(s)
- Maria-Ioana Pastrama
- KU Leuven, Department of Movement Sciences, Human Movement Biomechanics Research Group, Leuven, Belgium; Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.
| | - Ana Caxaido Ortiz
- KU Leuven, Department of Movement Sciences, Human Movement Biomechanics Research Group, Leuven, Belgium
| | - Lianne Zevenbergen
- KU Leuven, Department of Movement Sciences, Human Movement Biomechanics Research Group, Leuven, Belgium
| | - Nele Famaey
- KU Leuven, Department of Mechanical Engineering, Soft Tissue Biomechanics Research Group, Leuven, Belgium
| | - Willy Gsell
- University Hospital Leuven, Department of Imaging and Pathology, Biomedical MRI/Molecular Small Animal Imaging Center (MoSAIC), Leuven, Belgium
| | - Corey P Neu
- Department of Mechanical Engineering, University of Colorado, Boulder, Colorado, United States
| | - Uwe Himmelreich
- University Hospital Leuven, Department of Imaging and Pathology, Biomedical MRI/Molecular Small Animal Imaging Center (MoSAIC), Leuven, Belgium
| | - Ilse Jonkers
- KU Leuven, Department of Movement Sciences, Human Movement Biomechanics Research Group, Leuven, Belgium
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High Tibial Osteotomy: Review of Techniques and Biomechanics. JOURNAL OF HEALTHCARE ENGINEERING 2019; 2019:8363128. [PMID: 31191853 PMCID: PMC6525872 DOI: 10.1155/2019/8363128] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 04/15/2019] [Indexed: 12/15/2022]
Abstract
High tibial osteotomy becomes increasingly important in the treatment of cartilage damage or osteoarthritis of the medial compartment with concurrent varus deformity. HTO produces a postoperative valgus limb alignment with shifting the load-bearing axis of the lower limb laterally. However, maximizing procedural success and postoperative knee function still possess many difficulties. The key to improve the postoperative satisfaction and long-term survival is the understanding of the vital biomechanics of HTO in essence. This review article discussed the alignment principles, surgical technique, and fixation plate of HTO as well as the postoperative gait, musculoskeletal dynamics, and contact mechanics of the knee joint. We aimed to highlight the recent findings and progresses on the biomechanics of HTO. The biomechanical studies on HTO are still insufficient in the areas of gait analysis, joint kinematics, and joint contact mechanics. Combining musculoskeletal dynamics modelling and finite element analysis will help comprehensively understand in vivo patient-specific biomechanics after HTO.
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Falisse A, Van Rossom S, Gijsbers J, Steenbrink F, van Basten BJH, Jonkers I, van den Bogert AJ, De Groote F. OpenSim Versus Human Body Model: A Comparison Study for the Lower Limbs During Gait. J Appl Biomech 2018; 34:496-502. [PMID: 29809082 DOI: 10.1123/jab.2017-0156] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 04/16/2018] [Accepted: 05/04/2018] [Indexed: 11/18/2022]
Abstract
Musculoskeletal modeling and simulations have become popular tools for analyzing human movements. However, end users are often not aware of underlying modeling and computational assumptions. This study investigates how these assumptions affect biomechanical gait analysis outcomes performed with Human Body Model and the OpenSim gait2392 model. The authors compared joint kinematics, kinetics, and muscle forces resulting from processing data from 7 healthy adults with both models. Although outcome variables had similar patterns, there were statistically significant differences in joint kinematics (maximal difference: 9.8° [1.5°] in sagittal plane hip rotation), kinetics (maximal difference: 0.36 [0.10] N·m/kg in sagittal plane hip moment), and muscle forces (maximal difference: 8.51 [1.80] N/kg for psoas). These differences might be explained by differences in hip and knee joint center locations up to 2.4 (0.5) and 1.9 (0.2) cm in the posteroanterior and inferosuperior directions, respectively, and by the offset in pelvic reference frames of about 10° around the mediolateral axis. The choice of model may not influence the conclusions in clinical settings, where the focus is on interpreting deviations from the reference data, but it will affect the conclusions of mechanical analyses in which the goal is to obtain accurate estimates of kinematics and loading.
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26
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Van Rossom S, Khatib N, Holt C, Van Assche D, Jonkers I. Subjects with medial and lateral tibiofemoral articular cartilage defects do not alter compartmental loading during walking. Clin Biomech (Bristol, Avon) 2018; 60:149-156. [PMID: 30366244 DOI: 10.1016/j.clinbiomech.2018.10.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 08/07/2018] [Accepted: 10/11/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Healthy cartilage is essential for optimal joint function. Although, articular cartilage defects are highly prevalent in the active population and hamper joint function, the effect of articular cartilage defects on knee loading is not yet documented. Therefore, the present study compared knee contact forces and pressures between patients with tibiofemoral cartilage defects and healthy controls. Potentially this provides additional insights in movement adaptations and the role of altered loading in the progression from defect towards OA. METHODS Experimental gait data collected in 15 patients with isolated cartilage defects (8 medial involvement, 7 lateral-involvement) and 19 healthy asymptomatic controls was processed using a musculoskeletal model to calculate contact forces and pressures. Differences between two patient groups and controls were evaluated using Kruskal-Wallis tests and individually compared using Mann-Whitney-U tests (alpha <0.05). FINDINGS The patients with lateral involvement walked significantly slower compared to the healthy controls. No movement adaptations to decrease the loading on the injured condyle were observed. Additionally, the location of loading was not significantly affected. INTERPRETATION The current results suggest that isolated cartilage defects do not induce significant changes in the knee joint loading distribution. Consequently, the involved condyle will capture a physiological loading magnitude that should however be distributed over the cartilage surrounding the defect. This may cause local degenerative changes in the cartilage and in combination with inflammatory responses, might play a key role in the progression from articular cartilage defect to a more severe OA phenotype.
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Affiliation(s)
- Sam Van Rossom
- Human Movement Biomechanics Research Group, Department of Movement Sciences, Katholieke Universiteit Leuven, Leuven, Belgium.
| | - Nidal Khatib
- Musculoskeletal Biomechanics Research Centre, University of Cardiff, Cardiff, United Kingdom.
| | - Cathy Holt
- Musculoskeletal Biomechanics Research Centre, University of Cardiff, Cardiff, United Kingdom.
| | - Dieter Van Assche
- Musculoskeletal Rehabilitation Research Group, Department of Rehabilitation Sciences, Katholieke Universiteit Leuven, Leuven, Belgium.
| | - Ilse Jonkers
- Human Movement Biomechanics Research Group, Department of Movement Sciences, Katholieke Universiteit Leuven, Leuven, Belgium.
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27
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Richards RE, Andersen MS, Harlaar J, van den Noort JC. Relationship between knee joint contact forces and external knee joint moments in patients with medial knee osteoarthritis: effects of gait modifications. Osteoarthritis Cartilage 2018; 26:1203-1214. [PMID: 29715509 DOI: 10.1016/j.joca.2018.04.011] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 04/10/2018] [Accepted: 04/17/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To evaluate 1) the relationship between the knee contact force (KCF) and knee adduction and flexion moments (KAM and KFM) during normal gait in people with medial knee osteoarthritis (KOA), 2) the effects on the KCF of walking with a modified gait pattern and 3) the relationship between changes in the KCF and changes in the knee moments. METHOD We modeled the gait biomechanics of thirty-five patients with medial KOA using the AnyBody Modeling System during normal gait and two modified gait patterns. We calculated the internal KCF and evaluated the external joint moments (KAM and KFM) against it using linear regression analyses. RESULTS First peak medial KCF was associated with first peak KAM (R2 = 0.60) and with KAM and KFM (R2 = 0.73). Walking with both modified gait patterns reduced KAM (P = 0.002) and the medial to total KCF ratio (P < 0.001) at the first peak. Changes in KAM during modified gait were moderately associated with changes in the medial KCF at the first peak (R2 = 0.54 and 0.53). CONCLUSIONS At the first peak, KAM is a reasonable substitute for the medial contact force, but not at the second peak. First peak KFM is also a significant contributor to the medial KCF. At the first peak, walking with a modified gait reduced the ratio of the medial to total KCF but not the medial KCF itself. To determine the effects of gait modifications on cartilage loading and disease progression, longitudinal studies and individualized modeling, accounting for motion control, would be required.
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Affiliation(s)
- R E Richards
- VU University Medical Center, Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam, The Netherlands.
| | - M S Andersen
- Department of Materials and Production, Aalborg University, Denmark.
| | - J Harlaar
- VU University Medical Center, Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam, The Netherlands; Delft University of Technology, Delft, The Netherlands.
| | - J C van den Noort
- VU University Medical Center, Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam, The Netherlands; Academic Medical Center, Musculoskeletal Imaging Quantification Center (MIQC), Department of Radiology and Nuclear Medicine, Amsterdam Movement Sciences, Amsterdam, The Netherlands.
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