Bone mineral density in the proximal tibia varies as a function of static alignment and knee adduction angular momentum in individuals with medial knee osteoarthritis

Thorp, Laura E.; Wimmer, Markus A.; Block, Joel A.; Moisio, Kirsten C.; Shott, Susan; Göker, Berna; Sumner, Dale R.

doi:10.1016/j.bone.2006.05.001

Cited by 94 publications

(91 citation statements)

References 24 publications

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“…This is consistent with some DXA studies of aBMD ratios (17,(49)(50)(51). However, it is important to note that medial: lateral ratios Ͼ1 are unable to distinguish between increased density on the medial side and decreased density on the lateral side.…”

Section: Discussionsupporting

confidence: 88%

Tibial subchondral trabecular volumetric bone density in medial knee joint osteoarthritis using peripheral quantitative computed tomography technology

Bennell¹,

Creaby²,

Wrigley³

et al. 2008

Arthritis & Rheumatism

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Objective. Knee osteoarthritis (OA) is an organlevel failure of the joint involving pathologic changes in articular cartilage and bone. This cross-sectional study compared apparent volumetric bone mineral density (vBMD) of proximal tibial subchondral trabecular bone in people with and without knee OA, using peripheral quantitative computed tomography (pQCT).Methods. Seventy-five individuals with mild or moderate medial compartment knee OA and 41 asymptomatic controls were recruited. Peripheral QCT was used to measure vBMD of trabecular bone beneath medial and lateral tibiofemoral compartments at levels of 2% and 4% of tibial length, distal to the tibial plateau.Results. There was no significant difference in vBMD beneath the overall medial and lateral compartments between the 3 groups. However, in the affected medial compartment of those with moderate OA, lower vBMD was seen in the 2 posterior subregions compared with controls and those with mild knee OA, while higher vBMD was seen in the anteromedial subregion. Beneath the unaffected or lesser affected lateral compartment, significantly lower vBMD was seen at the 2% level in the anterior and lateral subregions of those with moderate disease. Volumetric BMD ratios showed relatively higher vBMD in the medial compartment compared with the lateral compartment, but these ratios were not influenced by disease status.Conclusion. Subregional vBMD changes were evident beneath the medial and lateral compartments of those with moderate medial knee OA. Of import, the posterior subchondral trabecular regions of the medial tibial plateau have markedly lower vBMD.

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Section: Discussionsupporting

confidence: 88%

Tibial subchondral trabecular volumetric bone density in medial knee joint osteoarthritis using peripheral quantitative computed tomography technology

Bennell¹,

Creaby²,

Wrigley³

et al. 2008

Arthritis & Rheumatism

View full text Add to dashboard Cite

show abstract

“…In fact, using the AddImp, it is now possible to distinguish loading differences between patients with mild radiographic OA from those with moderate disease, and between symptomatic and asymptomatic individuals with the same degree of radiographic involvement [19••,20•]. The AddImp also appears to be more sensitive than the AddM for explaining variance in the proximal tibial BMD in knee OA [6]. Finally, there are multiple time-distance parameters, such as gait speed, cadence, and stride length, that are not fully independent from the loading parameters of the knee but that contribute complementary information because they are more dependent on functional status and on painful symptoms than are the external moments at the knee, which are normalized for weight and are chosen at standardized speeds.…”

Section: Dynamic Assessmentsmentioning

confidence: 95%

“…Over time, the bone response to its load history can be assessed noninvasively through techniques that quantify BMD, such as dual photon X-ray absorptiometry (DXA). Hence, prolonged overloading of the medial compartment of the knee, as is often observed in knee OA, may be detected by quantifying BMD in the periarticular bone of the proximal tibia or by analyzing the ratio of the BMD of the proximal medial tibia to that of the proximal lateral tibia [6]. In light of the sensitivity of DXA to load history, it is likely that strategies to durably alter loading patterns at the knee may be monitored by changes in the proximal tibial BMD; a precedent for this has been reported after treatment with knee braces [7].…”

Section: Static Assessmentsmentioning

confidence: 99%

The biomechanics of osteoarthritis: Implications for therapy

Block

Shakoor²

2009

Curr Rheumatol Rep

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The pathophysiology of osteoarthritis (OA) has been extensively studied. However, the basic approach to therapy, which consists of pain relief and maintenance of function, has not changed for decades. At present, there are no nonsurgical methods that clearly interfere with the natural history of OA or provide prolonged pain palliation. Much of OA disease progression is mediated by aberrant biomechanical forces or through pathologic responses to those forces. As understanding of these mechanisms improves, novel therapeutic approaches are being studied that may provide prolonged reductions in loading of OA joints. These new therapies may ultimately be shown to retard disease progression and palliate pain. This article reviews some of these strategies.

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“…Previous research has shown that joint moments calculated by inverse dynamics can give an indication of the loading that the joint experiences Thorp et al 2006). Therefore, the purpose of this aspect of the dissertation was to investigate how each component of traction independently affects lower extremity joint moments in order to gain insight into the injury mechanism regarding lower extremity non-contact footwear traction related injuries.…”

Section: Footwear Traction and Lower Extremity Joint Loadingmentioning

confidence: 99%

“…In biomechanics research, joint loading is measured as the peak joint moments, which represent the maximal torque or twisting loading on the joint, and joint angular impulse, which represents the cumulative loading experienced by the joint throughout the stance phase (calculated as the integral of the resultant joint moment vs. time curve). While joint moments and angular impulse calculated from inverse dynamics cannot determine the exact loading on the actual joint structures, it has been used as a valid predictor of the total load across a joint Thorp et al 2006).…”

Section: Introductionmentioning

confidence: 99%

Footwear traction and lower extremity non-contact injury

2011

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For the past forty years footwear traction has been thought to be one of the causes of noncontact lower extremity injury in sport. Previous studies have shown that rotational traction was associated with ACL injury, however, no studies have determined the relationship between footwear traction, both translational and rotational, and all lower extremity non-contact injuries. Therefore, the purposes of this thesis were to 1) determine if a relationship exists between an athlete's specific footwear traction (both translational and rotational) and lower extremity non-contact injury and 2) determine how independently altering translational and rotational traction affects ankle and knee joint loading.Over the course of three years, 555 athletes had their footwear traction tested on the actual playing surface; either an artificial or natural grass field. The athletes were followed over each season and any injury that they sustained during a game was recorded by certified athletic therapists on site at the field.No differences in injury rate were seen between the artificial and natural grass surfaces.A relationship was found between rotational traction and lower extremity non-contact injury, with increases in rotational traction leading to an increase in injury rate. A relationship was also seen between translational traction and injury with the mid-range of translational traction leading to a higher injury rate. PrefaceThe following three chapters are based on scientific manuscripts:

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Bone mineral density in the proximal tibia varies as a function of static alignment and knee adduction angular momentum in individuals with medial knee osteoarthritis

Cited by 94 publications

References 24 publications

Tibial subchondral trabecular volumetric bone density in medial knee joint osteoarthritis using peripheral quantitative computed tomography technology

Tibial subchondral trabecular volumetric bone density in medial knee joint osteoarthritis using peripheral quantitative computed tomography technology

The biomechanics of osteoarthritis: Implications for therapy

Footwear traction and lower extremity non-contact injury

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