High muscle co‐contraction does not result in high joint forces during gait in anterior cruciate ligament deficient knees

Khandha, Ashutosh; Manal, Kurt; Capin, Jacob J.; Wellsandt, Elizabeth; Marmon, Adam R.; Snyder‐Mackler, Lynn; Buchanan, Thomas S.

doi:10.1002/jor.24141

Cited by 23 publications

(30 citation statements)

References 44 publications

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“…T 2 relaxation time values are typically higher in the patellar and trochlear cartilage than the weight‐bearing tibiofemoral cartilage . Walking speeds also vary both within and across studies, and our mean walking speed (1.61 m/s) is very similar to previous studies in separate cohorts from our lab (means of 1.5–1.6 m/s), albeit similar to or faster than other cohorts . Our study sample was young and free of any serious previous or concomitant injury.…”

Section: Discussionsupporting

confidence: 76%

“…The present study has cartilage T 2 relaxation times and walking speeds that fall within the range found in the literature . Cartilage T 2 relaxation time values, however, vary greatly in the literature, from approximately 23 ms in the deep layers of the medial femoral cartilage of ACL‐injured knees at baseline to higher than 60 ms in the superficial central trochlear cartilage 3 years after ACLR .…”

Section: Discussionsupporting

confidence: 65%

“…The present study has cartilage T 2 relaxation times and walking speeds that fall within the range found in the literature. 13,17,19,20,37,[50][51][52][53][54][55] Cartilage T 2 relaxation time values, however, vary greatly in the literature, from approximately 23 ms in the deep layers of the medial femoral cartilage of ACL-injured knees at baseline 54 to higher than 60 ms in the superficial JOURNAL OF ORTHOPAEDIC RESEARCH ® MARCH 2020 TROCHLEAR CARTILAGE DEGRADATION AFTER ACLR central trochlear cartilage 3 years after ACLR. 50 T 2 relaxation time values are typically higher in the patellar and trochlear cartilage than the weight-bearing tibiofemoral cartilage.…”

Section: Discussionmentioning

confidence: 99%

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Slower Walking Speed Is Related to Early Femoral Trochlear Cartilage Degradation After ACL Reconstruction

Capin

Williams

Neal

et al. 2019

Journal Orthopaedic Research

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Post‐traumatic patellofemoral osteoarthritis (OA) is prevalent after anterior cruciate ligament reconstruction (ACLR) and early cartilage degradation may be especially common in the femoral trochlear cartilage. Determining the presence of and factors associated with early femoral trochlear cartilage degradation, a precursor to OA, is a critical preliminary step in identifying those at risk for patellofemoral OA development and designing interventions to combat the disease. Early cartilage degradation can be detected using quantitative magnetic resonance imaging measures, such as tissue T2 relaxation time. The purposes of this study were to (i) compare involved (ACLR) versus uninvolved (contralateral) femoral trochlear cartilage T2 relaxation times 6 months after ACLR, and (ii) determine the relationship between walking speed and walking mechanics 3 months after ACLR and femoral trochlear cartilage T2 relaxation times 6 months after ACLR. Twenty‐six individuals (age 23 ± 7 years) after primary, unilateral ACLR participated in detailed motion analyses 3.3 ± 0.6 months after ACLR and quantitative magnetic resonance imaging 6.3 ± 0.5 months after ACLR. There were no limb differences in femoral trochlear cartilage T2 relaxation times. Slower walking speed was related to higher (worse) femoral trochlear cartilage T2 relaxation times in the involved limb (Pearson's r: −0.583, p = 0.002) and greater interlimb differences in trochlear T2 relaxation times (Pearson's r: −0.349, p = 0.080). Walking mechanics were weakly related to trochlear T2 relaxation times. Statement of clinical significance: Slower walking speed was by far the strongest predictor of worse femoral trochlear cartilage health, suggesting slow walking speed may be an early clinical indicator of future patellofemoral OA after ACLR. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 38:645–652, 2020

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Section: Discussionsupporting

confidence: 76%

Section: Discussionsupporting

confidence: 65%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Slower Walking Speed Is Related to Early Femoral Trochlear Cartilage Degradation After ACL Reconstruction

Capin

Williams

Neal

et al. 2019

Journal Orthopaedic Research

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“…Tsai et al reported that greater co‐activation was associated with greater tibiofemoral compressive force during single‐leg landing in individuals with ACLR. However, Khandha et al found that though co‐activation was greater in the affected limb in ACL‐deficient individuals during gait, co‐activation was not associated with tibiofemoral compressive force, and the compressive force was lower in the ACL‐deficient limb. Wellsandt et al reported that the compressive force was consistently lower in their PTOA cohort 6 months, 1 year, and 2 years post‐ACLR (effect sizes = 1.39, 0.92, and 0.42, respectively) compared with those who did not develop PTOA, and that co‐activation was negatively correlated with compressive force.…”

Section: Discussionmentioning

confidence: 98%

Somatosensory Function Influences Aberrant Gait Biomechanics Following Anterior Cruciate Ligament Reconstruction

Blackburn

Pietrosimone

Spang

et al. 2019

Journal Orthopaedic Research

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Osteoarthritis is common following anterior cruciate ligament reconstruction (ALCR), and aberrant gait biomechanics are considered a primary contributor. Somatosensory dysfunction potentially alters gait biomechanics, but this association is unclear. Therefore, the purposes of this investigation were to compare somatosensory function between limbs and evaluate associations between somatosensory function and gait biomechanics linked to osteoarthritis development in individuals with ALCR. Seventy‐three volunteers with ALCR participated. Gait biomechanics (peak vertical ground reaction force magnitude and loading rate, peak internal knee extension and valgus moments, peak knee flexion and varus angles, and quadriceps/hamstrings co‐activation) were assessed as subjects walked at their preferred speed. The somatosensory function was assessed via joint position sense error (knee flexion) and vibratory perception threshold (femoral epicondyles, malleoli, and first metatarsal). Though somatosensory function did not differ between the ACLR and contralateral limbs, poorer joint position sense in the ACLR limb was associated with lower loading rates and internal knee extension moments, and greater co‐activation. Poorer vibratory perception at the medial and lateral malleoli and first metatarsal head in the ACLR limb was associated with lower loading rates, greater internal knee valgus moments and varus angles, and greater co‐activation. Poorer vibratory perception at the medial malleolus and first metatarsal head in the contralateral limb was associated with greater peak knee varus angles and internal knee valgus moments. These results suggest that future research evaluating rehabilitation approaches for improving somatosensory function is warranted as a potential approach for restoring normal gait biomechanics and reducing osteoarthritis risk. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 38:620–628, 2020

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“…Meyer et al (2013) used an implant also consisting of 6 DoFs (3 for the force and 3 for the moment components) but the geometry varied slightly compared to the instrumented prosthesis used in the other 2 studies. The studies, which used an EMG-informed MSK model (Kumar et al, 2013;Winby et al, 2013;Manal et al, 2015;Saxby et al, 2016;Wellsandt et al, 2017;Khandha et al, 2019), based their calculations of the internal KCF on the same equations (Lloyd and Besier, 2003;Winby et al, 2009), which allow separate calculation of the medial and lateral compartmental loading. An extension (Lloyd and Buchanan, 1996) of the generic 1 DoF knee model (Delp et al, 1990) was used as the anatomical model.…”

Section: Estimation Of External Joint Moments and Internal Joint Contmentioning

confidence: 99%

A Systematic Review of the Associations Between Inverse Dynamics and Musculoskeletal Modeling to Investigate Joint Loading in a Clinical Environment

Holder

Trinler

Meurer

et al. 2020

Front. Bioeng. Biotechnol.

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The assessment of knee or hip joint loading by external joint moments is mainly used to draw conclusions on clinical decision making. However, the correlation between internal and external loads has not been systematically analyzed. This systematic review aims, therefore, to clarify the relationship between external and internal joint loading measures during gait. A systematic database search was performed to identify appropriate studies for inclusion. In total, 4,554 articles were identified, while 17 articles were finally included in data extraction. External joint loading parameters were calculated using the inverse dynamics approach and internal joint loading parameters by musculoskeletal modeling or instrumented prosthesis. It was found that the medial and total knee joint contact forces as well as hip joint contact forces in the first half of stance can be well predicted using external joint moments in the frontal plane, which is further improved by including the sagittal joint moment. Worse correlations were found for the peak in the second half of stance as well as for internal lateral knee joint contact forces. The estimation of external joint moments is useful for a general statement about the peak in the first half of stance or for the maximal loading. Nevertheless, when investigating diseases as valgus malalignment, the estimation of lateral knee joint contact forces is necessary for clinical decision making because external joint moments could not predict the lateral knee joint loading sufficient enough. Dependent on the clinical question, either estimating the external joint moments by inverse dynamics or internal joint contact forces by musculoskeletal modeling should be used.

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High muscle co‐contraction does not result in high joint forces during gait in anterior cruciate ligament deficient knees

Cited by 23 publications

References 44 publications

Slower Walking Speed Is Related to Early Femoral Trochlear Cartilage Degradation After ACL Reconstruction

Slower Walking Speed Is Related to Early Femoral Trochlear Cartilage Degradation After ACL Reconstruction

Somatosensory Function Influences Aberrant Gait Biomechanics Following Anterior Cruciate Ligament Reconstruction

A Systematic Review of the Associations Between Inverse Dynamics and Musculoskeletal Modeling to Investigate Joint Loading in a Clinical Environment

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