Knee adduction moment relates to medial femoral and tibial cartilage morphology in clinical knee osteoarthritis

Maly, Monica R.; Acker, Stacey M.; Tötterman, S.; Tamez-Peña, José G.; Stratford, Paul W.; Callaghan, Jack P.; Adachi, Jonathan D.; Beattie, Karen A.

doi:10.1016/j.jbiomech.2015.04.039

Cited by 38 publications

(42 citation statements)

References 54 publications

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“…These findings were consistent with the landmark radiographic study by Miyazaki et al 54 and prospective analysis by Bennell et al 6 , and added weight to current evidence that indicates higher knee loading in already diseased joints is related to progression of the OA. As well, a cross-sectional study showed that in those patients with knee OA, larger peak KAM and KAM impulse were associated with thinner medial tibial and femoral cartilage, and worsening of bone marrow lesions 52 . This relationship between KAM measurements and either current cartilage impairment or future cartilage degeneration supports the foundational cross-sectional work by Andriacchi et al 4,43,66 .…”

Section: Intrinsic Factors Modifying Interrelationships Between Oa Anmentioning

confidence: 94%

Osteoarthritis year in review 2016: mechanics

Saxby

Lloyd

2017

Osteoarthritis and Cartilage

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Inappropriate biomechanics, namely wear-and-tear, has been long believed to be a main cause of osteoarthritis (OA). However, this view is now being re-evaluated, especially when examined alongside mechanobiology and new biomechanical studies. These are multiscale experimental and computational studies focussing on cell- and tissue-level mechanobiology through to organ- and whole-body-level biomechanics, which focuses on the biomechanical and biochemical environment of the joint tissues. This review examined papers from April 2015 to April 2016, with a focus on multiscale experimental and computational biomechanical studies of OA. Assessing the onset or progression of OA at organ- and whole-body-levels, gait analysis, medical imaging and neuromusculoskeletal modelling revealed the extent to which tissue damage changes the view of inappropriate biomechanics. Traditional gait analyses studies reported that conservative treatments can alter joint biomechanics, thereby improving pain and function experienced by those with OA. Results of animal models of OA were consistent with these human studies, showing interactions among bone, cartilage and meniscus biomechanics and the onset and/or progression OA. Going down size scales, experimental and computational studies probed the nanosize biomechanics of molecules, cells and extracellular matrix, and demonstrated how the interactions between biomechanics and morphology affect cartilage dynamic poroelastic behaviour and pathways to OA. Finally, integration of multiscale experimental data and computational models were proposed to predict cartilage extracellular matrix remodelling and the development of OA. Summarising, experimental and computational methods provided a nuanced biomechanical understanding of the sub-cellular, cellular, tissue, organ and whole-body mechanisms involved in OA.

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Section: Intrinsic Factors Modifying Interrelationships Between Oa Anmentioning

confidence: 94%

Osteoarthritis year in review 2016: mechanics

Saxby

Lloyd

2017

Osteoarthritis and Cartilage

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“…This longitudinal, observational study was approved by the Hamilton Integrated Research Ethics Board at McMaster University, Canada (prospective cohort study; level of evidence II). We previously reported on cross‐sectional relationships using baseline data from the same cohort …”

Section: Methodsmentioning

confidence: 99%

“…Within 1 week of baseline MRI, motion analyses were performed. Participant setup, instrumentation, and gait analysis protocol have been described previously . Briefly, three‐dimensional kinematics and kinetics were collected during barefoot walking trials at a self‐selected pace for five successful trials.…”

Section: Methodsmentioning

confidence: 99%

Baseline knee adduction moment interacts with body mass index to predict loss of medial tibial cartilage volume over 2.5 years in knee Osteoarthritis

Brisson

Wiebenga

Stratford

et al. 2017

Journal Orthopaedic Research

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This study aimed to determine the extent to which changes over 2.5 years in medial knee cartilage thickness and volume were predicted by: (1) Peak values of the knee adduction (KAM) and flexion moments; and (2) KAM impulse and loading frequency, representing cumulative load, after controlling for age, sex and body mass index (BMI). Adults with clinical knee osteoarthritis participated. At baseline and approximately 2.5 years follow-up, cartilage thickness and volume of the medial tibia and femur were segmented from magnetic resonance imaging scans. Gait kinematics and kinetics, and daily knee loading frequency were also collected at baseline. Multiple linear regressions predicted changes in cartilage morphology from baseline gait mechanics. Data were collected from 52 participants (41 women) [age 61.0 (6.9) y; BMI 28.5 (5.7) kg/m ] over 2.56 (0.51) years. There were significant KAM peak-by-BMI (p = 0.023) and KAM impulse-by-BMI (p = 0.034) interactions, which revealed that larger joint loads in those with higher BMIs were associated with greater loss of medial tibial cartilage volume. In conclusion, with adjustments for age, sex, and cartilage measurement at baseline, large magnitude KAM peak and KAM impulse each interacted with BMI to predict loss of cartilage volume of the medial tibia over 2.5 years among individuals with knee osteoarthritis. These data suggest that, in clinical knee osteoarthritis, exposure to large KAMs may be detrimental to cartilage in those with larger BMIs. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2476-2483, 2017.

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“…In addition, during dynamic movements such as gait, knee malalignment places the joint into a varus position, which results in increased medial knee compression force (Vincent et al, 2012). The medial knee compression force has been estimated using inverse dynamics during three-dimensional gait analysis measuring the external knee adduction moment (EKAM) and the knee adduction angular impulse (KAAI), which is normally increased in this population (Maly et al, 2015;Miyazaki et al, 2002;Sharma et al, 1998). Studies have shown that hip abductor strength has a positive but not significant relationship with external hip adduction moment (EHAM) and EKAM (Kean, Bennell, Wrigley, & Hinman, 2015;Rutherford, Hubley-Kozey, & Stanish, 2014).…”

mentioning

confidence: 99%

The role of hip abductor strength on the frontal plane of gait in subjects with medial knee osteoarthritis

Selistre

Gonçalves

Nakagawa

et al. 2019

Physiotherapy Res Intl

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Objective This study aimed to investigate the relationship of hip abductor strength with external hip and knee adduction moments, pain and physical function, and trunk, pelvis, and hip kinematics in the frontal plane during walking in subjects with medial knee osteoarthritis. Methods Twenty‐five subjects with medial knee osteoarthritis were evaluated through an isokinetic strength test for hip abductor, three‐dimensional gait analysis (kinetics and kinematics), and pain and physical function scores. Regression models were used to control the influence of other parameters such as pain, age, gender, severity, walking speed, mass, and height. Results No relationship was found of hip abductor strength with peak of external knee adduction moment and knee adduction angular impulse. Hip abductor strength explained 17% of contralateral pelvic drop and 21% of hip adduction angle. In addition, hip abductor strength explained 4% and 1% of the variance in the WOMAC physical function score and 40‐m fast paced walk test, respectively. Conclusion Considering the relationship of hip abductor strength with contralateral pelvic drop and hip adduction angle, specific exercises might improve physical function and lower limb dynamic alignment during gait.

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Knee adduction moment relates to medial femoral and tibial cartilage morphology in clinical knee osteoarthritis

Cited by 38 publications

References 54 publications

Osteoarthritis year in review 2016: mechanics

Osteoarthritis year in review 2016: mechanics

Baseline knee adduction moment interacts with body mass index to predict loss of medial tibial cartilage volume over 2.5 years in knee Osteoarthritis

The role of hip abductor strength on the frontal plane of gait in subjects with medial knee osteoarthritis

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