Muscle and external load contribution to knee joint contact loads during normal gait

Winby, C.R.; Lloyd, David G.; Besier, Thor F.; Kirk, T.B.

doi:10.1016/j.jbiomech.2009.06.019

Cited by 303 publications

(321 citation statements)

References 34 publications

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“…This is of significance as both are independently associated with cartilage degradation. By looking strictly at our data, this study could not entirely sustain the suggestion (13)(14)(15)17) of the importance of maintaining knee muscle structure and function in an effort to maintain knee joint health in OA. Indeed, multivariate analyses assessing the baseline size or change in the VM area were not significantly associated with cartilage volume loss or BML score change.…”

Section: Discussioncontrasting

confidence: 64%

“…These MRI studies and randomized controlled trials have proven to be instrumental in providing reliable and sensitive infor-mation about these OA changes, as well as predicting clinically relevant outcomes, such as total knee replacement (10,11). An additional factor that could impact knee structure change over time is the vastus medialis (VM) status, since it is one of the principal contributors to functional knee joint stability through muscle support and loading during ambulation (12,13). A recent study using quantitative MRI to assess structure in knee OA has proposed the VM muscle cross-sectional area (VM area) as a novel variable associated with significant cartilage volume loss over time (14).…”

Section: Introductionmentioning

confidence: 99%

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Magnetic Resonance Imaging–Assessed Vastus Medialis Muscle Fat Content and Risk for Knee Osteoarthritis Progression: Relevance From a Clinical Trial

Raynauld

Pelletier

Roubille

et al. 2015

Arthritis Care & Research

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Objective. Studies have proposed vastus medialis (VM) muscle cross-sectional area change as a variable associated with cartilage volume loss in knee osteoarthritis (OA). However, the VM also includes fat (%Fat), which may influence knee function. This study analyzed the VM area and %Fat data, separately and in combination, to predict symptoms, cartilage volume loss, and bone marrow lesion (BML) change in knee OA. Methods. This study included the according-to-protocol population (n 5 143) of a 2-year knee OA randomized clinical trial having magnetic resonance imaging at baseline and 2 years. Correlations used multivariate analyses. Results. Greater baseline value for VM area and %Fat were significantly associated with sex (male, area; female, %Fat), higher body mass index (BMI), and Western Ontario and McMaster Universities Osteoarthritis Index stiffness, function, and total scores (better, high area; worse, high %Fat). Moreover, a VM %Fat increase of 1% at 2 years was associated with worsening of cartilage volume loss in the global knee (P 5 0.015) and some subregions (P £ 0.030), and with an increment of BML global score change (P < 0.001). A 1% decrease in VM area at 2 years was associated with worsening of knee pain score (P 5 0.048). Importantly, the concurrent presence of low VM area, high VM %Fat, and high BMI identified a subgroup of patients with greater cartilage volume loss in the medial femur (P 5 0.028) than the rest of the cohort. Conclusion. These data demonstrated, for the first time, that VM fat content is a strong predictor of cartilage volume loss and the occurrence and progression of BML. Importantly, the combined data of VM area, VM %Fat, and BMI identified patients at higher risk for OA progression.

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Section: Discussioncontrasting

confidence: 64%

Section: Introductionmentioning

confidence: 99%

Magnetic Resonance Imaging–Assessed Vastus Medialis Muscle Fat Content and Risk for Knee Osteoarthritis Progression: Relevance From a Clinical Trial

Raynauld

Pelletier

Roubille

et al. 2015

Arthritis Care & Research

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“…Because direct measurement of in vivo joint loading is invasive, several biomechanical endpoints are commonly used to indirectly estimate these loads during gait evaluations [32]. Ambulation with a lower limb prosthesis alters gait mechanics [27], and some of these alterations are consistent with the biomechanical variables that have been associated with arthritis, including larger and more prolonged forces transmitted through the intact limb.…”

Section: Introductionmentioning

confidence: 99%

Does Intact Limb Loading Differ in Servicemembers With Traumatic Lower Limb Loss?

Pruziner

Werner

Copple

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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Background The initiation and progression of knee and hip arthritis have been related to limb loading during ambulation. Although altered gait mechanics with unilateral lower limb loss often result in larger and more prolonged forces through the intact limb, how these forces differ with traumatic limb loss and duration of ambulation have not been well described.Questions/purposes The purpose of this study was to determine whether biomechanical variables of joint and limb loading (external adduction moments, vertical ground reaction force loading rates, and impulses) are larger in the intact limb of servicemembers with versus without unilateral lower limb loss and whether intact limb loading differs between shorter (B 6 months) versus longer (C 2 years) durations of ambulation with a prosthesis. 4.45-16.79; 10.18-12.81] 4.64-14.47; 8.26-9.74 82-19.51; 12.98-15.05]; ES = 0.43; p = 0.001), respectively. Intact limb mean and peak vertical ground reaction force loading rates were also larger in subjects with transfemoral limb loss with B 6 months and C 2 years of experience ambulating with a prosthesis versus control subjects .68] versus 9.03 BW/s [4.64-14.47; 8.26-9.74]; ES C 0.53; p \ 0.001;.05]; ES C 0.68; p \ 0.001, respectively). Similarly, intact limb vertical ground reaction force impulses ; ES C 0.53, p \ 0.001) were also larger among both groups of transfemoral subjects versus control subjects, respectively. Limb loading variables were not statistically different between times ambulating with a prosthesis within groups with transtibial or transfemoral limb loss. Conclusions Larger intact limb loading in individuals with traumatic transtibial loss were only noted early in the rehabilitation process, but these variables were present early and late in the rehabilitation process for those with transfemoral limb loss. Such evidence suggests an increased risk for early onset and progression of arthritis in the intact limb, especially in those with transfemoral limb loss. Clinical Relevance Interventions should focus on correcting modifiable gait mechanics associated with arthritis, particularly among individuals with transfemoral limb loss, to potentially mitigate the development and progression in this population.versus 9.03 BW/s [

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“…Most muscle contractile parameters are difficult to measure in vivo, and are often estimated through a mathematical optimization procedure. 24,[33][34][35] Future modeling approaches that combine both direct measurements of muscle anatomic parameters and optimization procedures for muscle contractile parameters may further improve the accuracy and advance the application of an EMG-driven knee model.…”

mentioning

confidence: 99%

Greater muscle co‐contraction results in increased tibiofemoral compressive forces in females who have undergone anterior cruciate ligament reconstruction

Tsai

McLean

Colletti

et al. 2012

Journal Orthopaedic Research

112

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Individuals who have undergone ACL reconstruction (ACLR) have been shown to have a higher risk of developing knee osteoarthritis (OA). The elevated risk of knee OA may be associated with increased tibiofemoral compressive forces. The primary purpose of this study was to examine whether females with ACLR demonstrate greater tibiofemoral compressive forces, as well as greater muscle co-contraction and decreased knee flexion during a single-leg drop-land task when compared to healthy females. Ten females with ACLR and 10 healthy females (control group) participated. Each participant underwent two data collection sessions: (1) MRI assessment and (2) biomechanical analysis (EMG, kinematics, and kinetics) during a single-leg drop-land task. Joint kinematics, EMG, and MRI-measured muscle volumes and patella tendon orientation were used as input variables into a MRI-based EMGdriven knee model to quantify the peak tibiofemoral compressive forces during landing. Peak tibiofemoral compressive forces were significantly higher in the ACLR group when compared to the control group (97.3 AE 8.0 vs. 88.8 AE 9.8 N Á kg À1 ). The ACLR group also demonstrated significantly greater muscle co-contraction as well as less knee flexion than the control group. Our findings support the premise that individuals with ACLR demonstrate increased tibiofemoral compression as well as greater muscle co-contraction and decreased knee flexion during a drop-land task. Future studies are needed to examine whether correcting abnormal neuromuscular strategies and reducing tibiofemoral compressive forces following ACLR can slow the progression of joint degeneration in this population. ß

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Muscle and external load contribution to knee joint contact loads during normal gait

Cited by 303 publications

References 34 publications

Magnetic Resonance Imaging–Assessed Vastus Medialis Muscle Fat Content and Risk for Knee Osteoarthritis Progression: Relevance From a Clinical Trial

Magnetic Resonance Imaging–Assessed Vastus Medialis Muscle Fat Content and Risk for Knee Osteoarthritis Progression: Relevance From a Clinical Trial

Does Intact Limb Loading Differ in Servicemembers With Traumatic Lower Limb Loss?

Greater muscle co‐contraction results in increased tibiofemoral compressive forces in females who have undergone anterior cruciate ligament reconstruction

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