Effects of Viscosupplementation on Knee Joint Arthrokinematics – Pilot Study

Abstract

Background. Osteoarthritis is one of the most common dysfunctions of the musculoskeletal system and viscosup­plementation is becoming an increasingly popular treatment in OA. However, current knowledge regarding biomechanical changes in synovial joints reveals many discrepancies. Therefore, the aim of our study was to evaluate the effect of visco­supplementation on knee joint arthrokinematics as analyzed by vibroarthrography. Material and methods. Seventeen individuals diagnosed with moderate knee osteoarthritis (VSC) were examined before and after a single injection of hyaluronate. A control group consisted of 30 asymptomatic individuals. During alter­nating extension/flexion of the knee joint, a 6-second vibroarthrographic signal was recorded using an accelerometer. The following parameters were calculated: variance (VMS), amplitude (R4), and spectral power density in the 50-250 Hz (P1) and 250-450 Hz (P2) bands. Results. Statistical analysis showed significant differences (p<0.05) in the values of R4 and P2, which were higher in the VSC group than among the controls. After viscosupplementation, the values of R4, P1 and P2 in the VSC group de­creased to a level not significantly different from that seen among the controls. Conclusions. 1. After a single intra-articular HA injection, joint motion-related vibrations were reduced, which was recorded as a decreased intensity of vibroacoustic emission. 2. This suggests that the use of viscosupplementation in pa­tients with moderate knee osteoarthritis may improve qualitative aspects of arthrokinematics.

Reliability of Vibroarthrography to Assess Knee Joint Sounds in Motion

“…These findings appear to be particularly important, because vibroarthrography presents a new perspective on knee arthrokinematics. Aside from providing information on structural joint health, like traditional diagnostic techniques, knee joint sounds may additionally indicate functional changes in knee joint cartilage [9,10].…”

Effect of warm-up and muscle fatiguing exercise on knee joint sounds in motion by vibroarthrography: A randomized crossover trial

“…The increase in MDF found at the patella can not be attributed explicitly to knee load [9,10,28]. On the one hand, Bączkowicz et al [5] established the connection between the knee joint sounds and the arthrokinematic motion quality and showed that an unloaded flexion-extension movement in healthy participants is almost vibration-free, whereas standing up and sitting down is associated with higher sound amplitude and frequency.…”

“…To date, it has not been investigated whether the acute effects of physical activity on the joint can be measured by joint sounds. The physiological mechanisms that could influence the knee joint sound include, in particular, the distribution of pressure on the cartilage and the concentration of the synovial fluid [8,9]. According to Kersting et al [10], muscular co-activation has the greatest influence on cartilage volume changes, thus, muscle activation may be of great importance [5,11].…”

“…The present study, therefore, examined the effects of a warm-up and a muscle fatiguing exercise on knee joint sounds which were assessed by vibroarthrography during the sit-tostand movement. We hypothesized that a general warm-up reduces the knee sound amplitude, in comparison to a control measurement, by improving lubrication [14,16] as well as elasticity of articular cartilage [9] and by improving neuromuscular control. Furthermore, we hypothesize that the execution of a knee-loading exercise until task failure increases the sound amplitude, in comparison to a control measurement, by reducing neuromuscular control and joint stability [20][21][22][23][24] as well as increasing the viscosity of the synovial fluid and, thus, reducing the smooth gliding of the joint surfaces [16,25].…”

Analysis of differences in vibroacoustic signals between healthy and osteoarthritic knees using EMD algorithm and statistical analysis

“…Such a method should be fast, low-cost and easy to perform. As articular cartilage degrades, it becomes cracked, uneven and the joint fluid changes its physiological properties [16], causing changes in the friction between the articular surfaces and therefore affecting the acoustic signals generated by the knee joint. The change in mechanical properties, in particular, the appearance of bumps, cracks or cartilage defects in the successive stages of degenerative changes [17,18] changes the vibroacoustic image during movement of the knee joint.…”