scholarly journals Biomechanical Characteristics of the Knee Joint during Gait in Obese versus Normal Subjects

2022 ◽  
Vol 19 (2) ◽  
pp. 989
Author(s):  
Fadi Al Khatib ◽  
Afif Gouissem ◽  
Raouf Mbarki ◽  
Malek Adouni
Keyword(s):  
Knee Joint ◽  
Mechanical Load ◽  
Disease Process ◽  
Element Model ◽  
Normal Subjects ◽  
Normal Weight ◽  
Medial Gastrocnemius ◽  
Knee Oa ◽  
Lower Extremity Muscle ◽  
Muscle Groups

Knee osteoarthritis (OA) is a growing source of pain and disability. Obesity is the most important avoidable risk factor underlying knee OA. The processes by which obesity impacts osteoarthritis are of tremendous interest to osteoarthritis researchers and physicians, where the joint mechanical load is one of the pathways generally thought to cause or intensify the disease process. In the current work, we developed a hybrid framework that simultaneously incorporates a detailed finite element model of the knee joint within a musculoskeletal model to compute lower extremity muscle forces and knee joint stresses in normal-weight (N) and obese (OB) subjects during the stance phase gait. This model accounts for the synergy between the active musculature and passive structures. In comparing OB subjects and normal ones, forces significantly increased in all muscle groups at most instances of stance. Mainly, much higher activation was computed with lateral hamstrings and medial gastrocnemius. Cartilage contact average pressure was mostly supported by the medial plateau and increased by 22%, with a larger portion of the load transmitted via menisci. This medial compartment experienced larger relative movement and cartilage stresses in the normal subjects and continued to do so with a higher level in the obese subjects. Finally, the developed bioengineering frame and the examined parameters during this investigation might be useful clinically in evaluating the initiation and propagation of knee OA.

scholarly journals Tibial Condyle Valgus Osteotomy for Ipsilateral Knee Osteoarthritis after Hip Arthrodesis

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Daisuke Fukuhara ◽  
Hiroaki Inoue ◽  
Shuji Nakagawa ◽  
Yuji Arai ◽  
Kenji Takahashi
Keyword(s):  
Knee Joint ◽  
Knee Osteoarthritis ◽  
Mechanical Load ◽  
Weight Bearing ◽  
Valgus Osteotomy ◽  
Hip Arthrodesis ◽  
Knee Oa ◽  
Early Loosening ◽  
Tibial Condyle ◽  
End Stage

We report a case of tibial condylar valgus osteotomy (TCVO) for ipsilateral knee osteoarthritis (OA) after hip arthrodesis. A 58-year-old woman developed right purulent hip arthritis at one month of age and underwent right hip fusion at 16 years old. She visited our department at the age of 57 because her right knee joint pain worsened. The range of motion for her right knee was 80° and -5° of flexion and extension, respectively, and she experienced medial weight-bearing pain. A plain X-ray image showed that the right knee joint had end-stage knee OA with a bone defect inside the tibia, and the tibial plateau shape was the pagoda type. There was a marked instability in her right knee with a valgus of 9° and varus of 7° on stress photography. She underwent TCVO on her right knee and was allowed full load four weeks after surgery. Computed tomography imaging showed bone union nine months after surgery. Two years after the operation, there was no correction loss, and she could walk independently without pain. In general, total knee arthroplasty (TKA) is indicated for end-stage knee OA; however, there are problems, such as early loosening due to the increased mechanical load on the knee after hip OA. In this case, since a good course was obtained, TCVO is considered a treatment option for terminal knee OA after hip arthrodesis.

Lower Extremity Muscle Activity Patterns During Lateral (Frontal) Side Stepping Task Modulation From Different Heights

2012 ◽  
Author(s):  
Dinesh Bhatia ◽  
Mario Novo ◽  
Ranu Jung ◽  
Denis Brunt ◽  
Tatiana Bejarano
Keyword(s):  
Activity Patterns ◽  
Frontal Plane ◽  
Joint Disease ◽  
Loss Of Function ◽  
Knee Oa ◽  
Pain Disability ◽  
Lower Extremity Muscle ◽  
Closed Chain ◽  
Muscle Groups ◽  
Frontal Side

Different muscle groups function in a synchronized and coordinated manner to perform a given task, wherein the activity of one muscle group affects that of another (1, 3). Osteoarthritis (OA) is a common, chronic joint disease characterized by pain, disability and progressive loss of function. It is the most common musculoskeletal complaint worldwide and is associated with significant health and welfare costs (2, 7). The knee is the most frequently affected joint of the lower limb and prevalence of knee OA increases with age (6). Several studies have shown that muscle recruitment patterns and neuromuscular efficiency are different for patients with OA compared to normal controls during simple closed chain activities (4). However, no studies have investigated frontal plane control or the modulation of control due to, for example, a change in time or distance in OA (5).

scholarly journals Design and Evaluation of a New Type of Knee Orthosis to Align the Mediolateral Angle of the Knee Joint with Osteoarthritis

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Amir Esrafilian ◽  
Mohammad Taghi Karimi ◽  
Arezoo Eshraghi
Keyword(s):  
Knee Joint ◽  
Effective Treatment ◽  
Normal Subjects ◽  
Motion Analysis System ◽  
Knee Oa ◽  
Gait Parameters ◽  
Distal Migration ◽  
New Type ◽  
Analysis System ◽  
Knee Orthosis

Background. Osteoarthritis (OA) is a disease which influences the performance of the knee joint. Moreover, the force and moments applied on the joint increase in contrast to normal subjects. Various types of knee orthoses have been designed to solve the mentioned problems. However, there are other problems in terms of distal migration during walking and the alignment of the orthosis which cannot be changed following the use of brace. Therefore, the main aim of the research was to design an orthosis to solve the aforementioned problems.Method. A new type of knee orthosis was designed with a modular structure. Two patients with knee OA participated in this research project. The force applied on the foot, moment transmitted through the knee joint, and spatiotemporal gait parameters were measured by use of a motion analysis system.Results. The results of the research showed that the adduction moment applied on the knee joint decreased while subjects walked with the new knee orthosis (P-value < 0.05).Conclusion. The new design of the knee brace can be used as an effective treatment to decrease the loads applied on the knee joint and to improve the alignment whilst walking.

scholarly journals An Evidence-Based Systematic Review of Human Knee Post-Traumatic Osteoarthritis (PTOA): Timeline of Clinical Presentation and Disease Markers, Comparison of Knee Joint PTOA Models and Early Disease Implications

2021 ◽  
Vol 22 (4) ◽  
pp. 1996 ◽  
Author(s):  
Christine M. Khella ◽  
Rojiar Asgarian ◽  
Judith M. Horvath ◽  
Bernd Rolauffs ◽  
Melanie L. Hart
Keyword(s):  
Synovial Fluid ◽  
Knee Joint ◽  
Ex Vivo ◽  
Disease Process ◽  
Early Disease ◽  
Knee Trauma ◽  
Post Traumatic ◽  
Acute Knee

Understanding the causality of the post-traumatic osteoarthritis (PTOA) disease process of the knee joint is important for diagnosing early disease and developing new and effective preventions or treatments. The aim of this review was to provide detailed clinical data on inflammatory and other biomarkers obtained from patients after acute knee trauma in order to (i) present a timeline of events that occur in the acute, subacute, and chronic post-traumatic phases and in PTOA, and (ii) to identify key factors present in the synovial fluid, serum/plasma and urine, leading to PTOA of the knee in 23–50% of individuals who had acute knee trauma. In this context, we additionally discuss methods of simulating knee trauma and inflammation in in vivo, ex vivo articular cartilage explant and in vitro chondrocyte models, and answer whether these models are representative of the clinical inflammatory stages following knee trauma. Moreover, we compare the pro-inflammatory cytokine concentrations used in such models and demonstrate that, compared to concentrations in the synovial fluid after knee trauma, they are exceedingly high. We then used the Bradford Hill Framework to present evidence that TNF-α and IL-6 cytokines are causal factors, while IL-1β and IL-17 are credible factors in inducing knee PTOA disease progresssion. Lastly, we discuss beneficial infrastructure for future studies to dissect the role of local vs. systemic inflammation in PTOA progression with an emphasis on early disease.

scholarly journals Evaluation of Individualized Functional Electrical Stimulation-Induced Acute Changes during Walking: A Case Series in Children with Cerebral Palsy

Sensors ◽  
2021 ◽  
Vol 21 (13) ◽  
pp. 4452
Author(s):  
Nicole Zahradka ◽  
Ahad Behboodi ◽  
Ashwini Sansare ◽  
Samuel C. K. Lee
Keyword(s):  
Cerebral Palsy ◽  
Electrical Stimulation ◽  
Functional Electrical Stimulation ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Case Series ◽  
Phase Detection ◽  
Lower Extremity Muscle ◽  
Children With Cerebral Palsy ◽  
Muscle Groups

Functional electrical stimulation (FES) walking interventions have demonstrated improvements to gait parameters; however, studies were often confined to stimulation of one or two muscle groups. Increased options such as number of muscle groups targeted, timing of stimulation delivery, and level of stimulation are needed to address subject-specific gait deviations. We aimed to demonstrate the feasibility of using a FES system with increased stimulation options during walking in children with cerebral palsy (CP). Three physical therapists designed individualized stimulation programs for six children with CP to target participant-specific gait deviations. Stimulation settings (pulse duration and current) were tuned to each participant. Participants donned our custom FES system that utilized gait phase detection to control stimulation to lower extremity muscle groups and walked on a treadmill at a self-selected speed. Motion capture data were collected during walking with and without the individualized stimulation program. Eight gait metrics and associated timing were compared between walking conditions. The prescribed participant-specific stimulation programs induced significant change towards typical gait in at least one metric for each participant with one iteration of FES-walking. FES systems with increased stimulation options have the potential to allow the physical therapist to better target the individual’s gait deviations than a one size fits all device.

scholarly journals Medial knee joint contact force in the intact limb during walking in recently ambulatory service members with unilateral limb loss: a cross-sectional study

PeerJ ◽  
2017 ◽  
Vol 5 ◽  
pp. e2960 ◽  
Author(s):  
Ross H. Miller ◽  
Rebecca L. Krupenevich ◽  
Alison L. Pruziner ◽  
Erik J. Wolf ◽  
Barri L. Schnall
Keyword(s):  
Knee Joint ◽  
Limb Loss ◽  
Service Members ◽  
Model Parameters ◽  
Joint Loading ◽  
Cross Sectional ◽  
Medial Knee ◽  
Knee Oa ◽  
Joint Contact ◽  
Intact Limb

BackgroundIndividuals with unilateral lower limb amputation have a high risk of developing knee osteoarthritis (OA) in their intact limb as they age. This risk may be related to joint loading experienced earlier in life. We hypothesized that loading during walking would be greater in the intact limb of young US military service members with limb loss than in controls with no limb loss.MethodsCross-sectional instrumented gait analysis at self-selected walking speeds with a limb loss group (N = 10, age 27 ± 5 years, 170 ± 36 days since last surgery) including five service members with transtibial limb loss and five with transfemoral limb loss, all walking independently with their first prosthesis for approximately two months. Controls (N = 10, age 30 ± 4 years) were service members with no overt demographical risk factors for knee OA. 3D inverse dynamics modeling was performed to calculate joint moments and medial knee joint contact forces (JCF) were calculated using a reduction-based musculoskeletal modeling method and expressed relative to body weight (BW).ResultsPeak JCF and maximum JCF loading rate were significantly greater in limb loss (184% BW, 2,469% BW/s) vs. controls (157% BW, 1,985% BW/s), with large effect sizes. Results were robust to probabilistic perturbations to the knee model parameters.DiscussionAssuming these data are reflective of joint loading experienced in daily life, they support a “mechanical overloading” hypothesis for the risk of developing knee OA in the intact limb of limb loss subjects. Examination of the evolution of gait mechanics, joint loading, and joint health over time, as well as interventions to reduce load or strengthen the ability of the joint to withstand loads, is warranted.

scholarly journals Role of Occupational Footwear and Prolonged Walking on Lower Extremity Muscle Activation during Maximal Exertions and Postural Stability Tasks

Biomechanics ◽  
2021 ◽  
Vol 1 (2) ◽  
pp. 202-213
Author(s):  
Harish Chander ◽  
Sachini N. K. Kodithuwakku Arachchige ◽  
Alana J. Turner ◽  
Reuben F. Burch V ◽  
Adam C. Knight ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Muscle Activity ◽  
Repeated Measures ◽  
Postural Stability ◽  
Muscle Activation ◽  
Medial Gastrocnemius ◽  
Lower Extremity Muscle ◽  
Prolonged Duration ◽  
The Mean ◽  
The Impact

Background: Occupational footwear and a prolonged duration of walking have been previously reported to play a role in maintaining postural stability. The purpose of this paper was to analyze the impact of three types of occupational footwear: the steel-toed work boot (ST), the tactical work boot (TB), and the low-top work shoe (LT) on previously unreported lower extremity muscle activity during postural stability tasks. Methods: Electromyography (EMG) muscle activity was measured from four lower extremity muscles (vastus medialis (VM), medial hamstrings (MH), tibialis anterior (TA), and medial gastrocnemius (MG) during maximal voluntary isometric contractions (MVIC) and during a sensory organization test (SOT) every 30 min over a 4 h simulated workload while wearing ST, TB, and LT footwear. The mean MVIC and the mean and percentage MVIC during each SOT condition from each muscle was analyzed individually using a repeated measures ANOVA at an alpha level of 0.05. Results: Significant differences (p < 0.05) were found for maximal exertions, but this was limited to only the time main effect. No significant differences existed for EMG measures during the SOT. Conclusion: The findings suggest that occupational footwear type does not influence lower extremity muscle activity during both MVIC and SOT. Significantly lower muscle activity during maximal exertions over the course of the 4 h workload was evident, which can be attributed to localized muscular fatigue, but this was not sufficient to impact muscle activity during postural stability tasks.

scholarly journals POS0358 EVALUATION OF THE EFFECT OF mTOR EXPRESSION ON THE CLINICAL MANIFESTATIONS OF KNEE OSTEOARTHRITIS IN OBESE AND NORMAL WEIGHT PATIENTS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 409.2-409
Author(s):  
E. Strebkova ◽  
E. Tchetina ◽  
L. Alekseeva
Keyword(s):  
Body Weight ◽  
Knee Pain ◽  
Mammalian Target Of Rapamycin ◽  
Clinical Manifestations ◽  
Normal Weight ◽  
Womac Pain ◽  
Obese Patients ◽  
Normal Body ◽  
Knee Oa ◽  
Normal Body Weight

Background:Currently, a large number of molecular biological and genetic markers are known to be involved in the development of osteoarthritis (OA). The mammalian target of rapamycin (mTOR) signaling pathway is responsible for chondrocyte proliferation, cartilage matrix production, and cell growth. OA is characterized by increased mTOR synthesis, which is accompanied by an increase in proliferative activity and destruction of chondrocytes. Obesity is an important factor in the progression of knee OA. The study of mTOR expression in patients with OA and obesity is an urgent task in the development of personalized OA therapy.Objectives:To determine the expression of mTOR in patients with knee OA in combination with obesity and normal body weight. To evaluate the effect of mTOR on the clinical manifestations of OA in patients with different body mass index (BMI).Methods:The study included 73 female patients aged 45-65 y.o. with Kellgren-Lawrence stage II-III knee OA. The patients were divided into 2 groups: group 1 (n=50) with obesity (BMI > 30 kg / cm2) and group 2 (n=23) with normal or increased body weight (BMI < 30 kg/cm2). The average age of patients with obesity is 56.5 ± 5.87 years, without obesity - 58.7 ± 5.43 years. Clinical manifestations were evaluated by a WOMAС. RNA was isolated from the patients ‘ blood samples, which was used to determine the expression of mTOR.Results:Patients with knee OA with and without obesity did not differ in age. OA develops at an earlier age in obese patients, than in non-obese patients (p < 0.001). Patients from 1 group had a high BMI > 30 kg/m2 at the onset of OA. Obese patients had more severe knee OA is significantly more often detected: Kellgren-Lawrence stage III was determined in 10% of obese patients and in 4.35% - without obesity (p < 0.001). Significantly higher values of the WOMAC index pain, stiffness, joint functional failure, and total WOMAC were observed in obese patients (p = 0.006, p = 0.039, p = 0.037, and p = 0.014, respectively). Obese patients had higher VAS pain scores (p < 0.05) compared to patients with a lower BMI. Obese patients had a higher mTOR expression (p < 0.05) of 8.02±8.62, compared to non-obese patients. High mTOR expression was associated with VAS knee pain (r=0.78; p < 0.05) and WOMAC pain (r=0.89; p<0.05) in obese patients (Table 1).Table 1.Correlation of m-TORParametersmTOR (1 group, n=50)mTOR (2 group, n=23)Body weightр > 0,05р > 0,05Pain (VAS)r=0,78; р<0,05p = 0,07; r = 0,45Pain (WOMAC)r=0,89; р<0,05р > 0,05Total WOMACр > 0,05р > 0,05Conclusion:Our study showed that patients with obesity and knee OA have higher rates of mTOR expression, compared to patients with normal body weight. High mTOR expression correlates with the severity of knee pain in obese patients. Thus, the evaluation of mTOR expression in obese patients and knee OA plays an important role in predicting the severity of clinical manifestations of OA, and may influence the choice of personalized therapy tactics for such patients.Disclosure of Interests:None declared

scholarly journals Hereditary and environmental factors causing total joint replacement due to hip and knee osteoarthritis – a twin registry based prospective cohort study

2016 ◽  
Vol 26 (1-2) ◽  
Author(s):  
Karin Magnusson ◽  
Kåre Birger Hagen
Keyword(s):  
Environmental Factors ◽  
Knee Joint ◽  
Joint Replacement ◽  
Total Joint Replacement ◽  
Population Based ◽  
Genetic Contribution ◽  
Questionnaire Response ◽  
Knee Oa ◽  
Relative Contribution ◽  
Twin Registry

The relative contribution of genetic factors and more modifiable environmental factors to a clinically<br />relevant osteoarthritis (OA) diagnosis is unkown. In this paper we present an ongoing study on the genetic<br />contribution to total joint replacement (TJR) due to hip and knee OA and effects of lifestyle and lifestyle<br />related conditions on TJR due to OA. We have linked data on incident OA from the Norwegian Arthroplasty<br />Registry were l with the Norwegian Twin Registry on the National ID number in 2014, thus obtaining a<br />population based cohort of same-sex twins born 1915-60. Data on height, weight and lifestyle were selfreporteded<br />in questionnaires conducted between 1978 and 1992. The monozygotic (MZ) and dizygotic<br />(DZ) concordances as well as the genetic contribution vs. contribution of more modifiable, environmental<br />factors to arthroplasty will be examined in separate analyses for the hip and the knee joint. The sample<br />comprised N=18058 twins (N=3803 MZ and N=5226 DZ pairs) including N=9650 (53.4%) females and a<br />mean (SD) age of 38 (12.3) years at questionnaire response. Some preliminary analyses have been performed<br />showing a higher concordance for TJR due to hip OA among MZ (0.36) than DZ twins (0.16), which may<br />be consistent with a genetic contribution to hip OA. TJR due to hip OA may be determined by genetic<br />factors. Results for the knee joint as well as final results from hereditary analyses and co-twin control<br />analyses of will be published consecutively from 2016.

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