Knee biomechanics of patients with total knee replacement during downhill walking on different slopes

Wen, Chen; Cates, Harold E.; Weinhandl, Joshua T.; Crouter, Scott E.; Zhang, Songning

doi:10.1016/j.jshs.2021.01.009

Cited by 10 publications

(3 citation statements)

References 38 publications

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“…Moreover, the walking intervention may not have provided sufficient mechanical stress in this plane to elicit a measurable difference in cartilage thickness. For instance, running or walking on decline surfaces may increase the mechanical demands on the knee extensors 48 to provide additional mechanical stimuli to the femoral cartilage.…”

Section: Discussionmentioning

confidence: 99%

Cartilage deformation following a walking bout in individuals with anterior cruciate ligament reconstruction

Pamukoff,

Holmes,

Heredia

et al. 2023

Journal Orthopaedic Research

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The purpose was to (1) compare the effect of a walking bout on femoral cartilage deformation between limbs with and without anterior cruciate ligament reconstruction (ACLR) and (2) examine the association between gait kinetics and the magnitude of cartilage deformation. A total of 30 individuals with primary unilateral ACLR completed this study [14 male, 16 female; age = 22.57 (3.78) years; body mass index (BMI) = 25.88 (5.68) kg/m2; time since ACLR = 61.00 (16.43) months]. Overground walking biomechanics were assessed on day 1, and a 30‐min walking bout or 30‐min resting bout (control) were completed on days 2 and 3 (counterbalanced order). Femoral cartilage thickness was measured using ultrasound before, immediately following, and 30‐min following each intervention. Linear mixed effects models compared the effect of walking on cartilage thickness between the ACLR and contralateral limbs after adjusting for sex, BMI, speed, and the number of steps. Stepwise regression examined the association between the external knee flexion and adduction moments and cartilage deformation following walking. There was a significant limb × time interaction for medial cartilage thickness. Post hoc analyses indicated that cartilage thickness decreased immediately following walking in the contralateral but not ACLR limb. Main effects of limb were observed for medial, central, and lateral cartilage thickness indicating thicker cartilage in the ACLR compared with contralateral limb. A higher knee adduction moment was associated with greater cartilage deformation in the ACLR limb. Femoral cartilage in the ACLR limb exhibited a less dynamic response to walking than the uninvolved limb, which may be due to habitual underloading during gait.

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Section: Discussionmentioning

confidence: 99%

Cartilage deformation following a walking bout in individuals with anterior cruciate ligament reconstruction

Pamukoff,

Holmes,

Heredia

et al. 2023

Journal Orthopaedic Research

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show abstract

“…The markers located at the calcaneus, as well as the first, second, and fifth metatarsal heads, were attached to the shoes, and the feet were assumed as rigid bodies. Four rigid clusters were also placed bilaterally, on the anterior−lateral aspect of the thigh and of the lower-leg to better follow the segments [24]. A static calibration of the markers was performed before walking trials for all of the conditions.…”

Section: Equipment and Data Acquisitionmentioning

confidence: 99%

“…Forty-tw tive markers were placed on each subject's bony landmarks, bilaterally, to recons position and orientation of the lower limbs and pelvis as described in previous [22,23]. The markers located at the calcaneus, as well as the first, second, and fif tarsal heads, were attached to the shoes, and the feet were assumed as rigid bodi rigid clusters were also placed bilaterally, on the anterior−lateral aspect of the th of the lower-leg to better follow the segments [24]. A static calibration of the mark performed before walking trials for all of the conditions.…”

Section: Equipment and Data Acquisitionmentioning

confidence: 99%

Can Slight Variations to Lateral Wedge Insoles Induce Significant Biomechanical Changes in Patients with Knee Osteoarthritis?

et al. 2022

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Lateral wedge insoles are recommended in order to minimize the impacts of osteoarthritis of the knee. The amount of wedging required to induce a biomechanical response with clinical significance is still controversial. This study aimed to investigate the immediate biomechanical effects of different amounts of wedging in symptomatic medial knee OA. A 3D motion capture system and five force platforms were used to acquire walking kinematic and kinetic data along a 10 m walkway. Each participant was tested for six different lateral wedge insoles (0, 2, 4, 6, 8, and 10°) in a randomized order. Thirty-eight patients with medial osteoarthritis of the knee were recruited. The application of insoles resulted in an incremental reduction of the first peak of the external knee adduction moment under all experimental conditions in comparison with the control condition (0° insole). A significant increase (p < 0.05) was observed in peak ankle eversion and in ankle eversion at the first peak of the external knee adduction moment with insoles higher than 8° and 6°, respectively. Slight variations to lateral wedge insoles, greater than 2°, appear to induce significant biomechanical changes in patients with knee osteoarthritis.

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Number of conditioning trials, but not stimulus intensity, influences operant conditioning of brain responses after total knee arthroplasty

Rodriguez,

Krishnan,

Palmieri‐Smith

2024

Knee surg. sports traumatol. arthrosc.

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PurposeThe primary purpose of this randomized, cross‐sectional study was to determine whether operant conditioning of motor evoked torque (MEPTORQUE) in individuals with total knee arthroplasty (TKA) increases quadriceps MEPTORQUE responses within a single session and induces acute corticospinal adaptations by producing sustained increases in MEPTORQUE after training. A secondary purpose was to determine if these changes were affected by the stimulus intensity and number of training trials.MethodsThirty participants were block‐randomized into one of three groups based on the participant's active motor threshold (100%, 120%, and 140%) to evaluate the effect of stimulus intensity. Participants received three blocks of conditioning trials (COND), where they trained to increase their MEPTORQUE. Control (CTRL) transcranial magnetic stimulation pulses were provided before and after each COND block to establish baseline corticospinal excitability and to evaluate the effect of the number of training trials. Two MEPTORQUE recruitment curves were collected to evaluate the effect of up‐conditioning on acute corticospinal adaptations.ResultsTKA participants were able to successfully increase their MEPTORQUE in a single session (F3,81 = 10.719, p < 0.001) and induce acute corticospinal adaptations (F1,27 = 20.029, p < 0.001), indicating sustained increases in quadriceps corticospinal excitability due to operant conditioning. While the stimulus intensity used during training did not affect the ability to increase MEPTORQUE (F2,26 = 0.021, n.s.) or its associated acute adaptations (F2,27 = 0.935, n.s.), the number of training trials significantly influenced these outcomes (F3,81 = 10.719, p < 0.001; F3,81 = 4.379, p = 0.007, respectively).ConclusionOperant conditioning is a feasible approach for improving quadriceps corticospinal excitability following TKA. While any of the three stimulus intensities evaluated in this study may be used in future operant conditioning interventions, using a low or moderate stimulus intensity and 150 training trials are recommended to improve treatment efficiency and patient adherence.Level of EvidenceLevel II.

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Knee biomechanics of patients with total knee replacement during downhill walking on different slopes

Cited by 10 publications

References 38 publications

Cartilage deformation following a walking bout in individuals with anterior cruciate ligament reconstruction

Cartilage deformation following a walking bout in individuals with anterior cruciate ligament reconstruction

Can Slight Variations to Lateral Wedge Insoles Induce Significant Biomechanical Changes in Patients with Knee Osteoarthritis?

Number of conditioning trials, but not stimulus intensity, influences operant conditioning of brain responses after total knee arthroplasty

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