scholarly journals Individuals with medial knee osteoarthritis show neuromuscular adaptation when perturbed during walking despite functional and structural impairments

2014 ◽  
Vol 116 (1) ◽  
pp. 13-23 ◽  
Author(s):  
Deepak Kumar ◽  
Charles (Buz) Swanik ◽  
Darcy S. Reisman ◽  
Katherine S. Rudolph
Keyword(s):  
Knee Osteoarthritis ◽  
Muscle Activation ◽  
Weight Bearing ◽  
Joint Space Width ◽  
Neuromuscular Control ◽  
Emg Activity ◽  
Initial Contact ◽  
Knee Motion ◽  
Quadriceps Weakness ◽  
Knee Oa

Neuromuscular control relies on sensory feedback that influences responses to changing external demands, and the normal response is for movement and muscle activation patterns to adapt to repeated perturbations. People with knee osteoarthritis (OA) are known to have pain, quadriceps weakness, and neuromotor deficits that could affect adaption to external perturbations. The aim of this study was to analyze neuromotor adaptation during walking in people with knee OA ( n = 38) and controls ( n = 23). Disability, quadriceps strength, joint space width, malalignment, and proprioception were assessed. Kinematic and EMG data were collected during undisturbed walking and during perturbations that caused lateral translation of the foot at initial contact. Knee excursions and EMG magnitudes were analyzed. Subjects with OA walked with less knee motion and higher muscle activation and had greater pain, limitations in function, quadriceps weakness, and malalignment, but no difference was observed in proprioception. Both groups showed increased EMG and decreased knee motion in response to the first perturbation, followed by progressively decreased EMG activity and increased knee motion during midstance over the first five perturbations, but no group differences were observed. Over 30 trials, EMG levels returned to those of normal walking. The results illustrate that people with knee OA respond similarly to healthy individuals when exposed to challenging perturbations during functional weight-bearing activities despite structural, functional, and neuromotor impairments. Mechanisms underlying the adaptive response in people with knee OA need further study.

scholarly journals RADIOLOGICAL ASSESSMENT OF KNEE JOINT WIDTH DIFFERENCES IN OLDER ADULTS WITH SYMPTOMATIC MEDIAL KNEE OSTEOARTHRITIS

2021 ◽  
Author(s):  
SAMWON YOON ◽  
YOUNGJOO CHA ◽  
HYUNSIK YOON ◽  
KYOUNGTAE KIM ◽  
ILBONG PARK ◽  
...  
Keyword(s):  
Older Adults ◽  
Knee Joint ◽  
Knee Osteoarthritis ◽  
Joint Space Width ◽  
Lower Limbs ◽  
Unaffected Side ◽  
Medial Knee ◽  
Knee Oa ◽  
Affected Side ◽  
Significant Difference

Knee osteoarthritis (OA) is a degenerative articular disease. The knee joint space width (JSW) is used for grading the severity of knee OA. However, there is a lack of research on differences in the widths of knee joints between both lower limbs in unilateral OA. The purpose of this research was to examine the radiological difference in the affected knee joint and contralateral knee joint by analyzing unilateral older adults with medial knee OA using both knees’ JSW differences. Twenty-five subjects with unilateral medial knee OA participated. X-ray radiographs were used to assess knee JSW, and the paired [Formula: see text]-test was performed to assess the knee joint gap width between the affected side and the unaffected side in the respective medial and lateral sides. The independent [Formula: see text]-test compared the differences between the lateral and medial knee JSWs on the affected side and unaffected side. The paired [Formula: see text]-test did not show a significant difference in the medial and lateral knee JSW on the affected side compared to the unaffected side ([Formula: see text]; 0.11). Meanwhile, the independent [Formula: see text]-test revealed a significant difference between the affected and unaffected sides ([Formula: see text]). This study showed no significant changes in affected knee JSWs compared to unaffected sides, but the difference between the lateral and medial JSWs was significant between the knees affected and unaffected by OA in the older adults with medial knee OA.

Modulation of Frontal-Plane Knee Kinematics by Hip-Extensor Strength and Gluteus Maximus Recruitment During a Jump-Landing Task in Healthy Women

2013 ◽  
Vol 22 (3) ◽  
pp. 184-190 ◽  
Author(s):  
John H. Hollman ◽  
Jeffrey M. Hohl ◽  
Jordan L. Kraft ◽  
Jeffrey D. Strauss ◽  
Katie J. Traver
Keyword(s):  
Outcome Measures ◽  
Weight Bearing ◽  
Three Dimensional ◽  
Knee Kinematics ◽  
Frontal Plane ◽  
Gluteus Maximus ◽  
Neuromuscular Control ◽  
Knee Motion ◽  
Jump Landing ◽  
Hip Motion

Context:Abnormal lower extremity kinematics during dynamic activities may be influenced by impaired gluteus maximus function.Objective:To examine whether hip-extensor strength and gluteus maximus recruitment are associated with dynamic frontal-plane knee motion during a jump-landing task.Design:Exploratory study.Setting:Biomechanics laboratory.Participants:40 healthy female volunteers.Main Outcome Measures:Isometric hip-extension strength was measured bilaterally with a handheld dynamometer. Three-dimensional hip and knee kinematics and gluteus maximus electromyography data were collected bilaterally during a jumplanding test. Data were analyzed with hierarchical linear regression and partial correlation coefficients (α = .05).Results:Hip motion in the transverse plane was highly correlated with knee motion in the frontal plane (partial r = .724). After controlling for hip motion, reduced magnitudes of isometric hip-extensor strength (partial r = .470) and peak gluteus maximus recruitment (partial r = .277) were correlated with increased magnitudes of knee valgus during the jump-landing task.Conclusion:Hip-extensor strength and gluteus maximus recruitment, which represents a measure of the muscle’s neuromuscular control, are both associated with frontal-plane knee motions during a dynamic weight-bearing task.

scholarly journals Association of subchondral bone marrow lesion localisation with weight bearing pain in people with knee osteoarthritis: data from the Osteoarthritis Initiative

2021 ◽  
Author(s):  
Koji Aso ◽  
Seyed Mohsen Shahtaheri ◽  
Daniel F. McWilliams ◽  
David A. Walsh
Keyword(s):  
Bone Marrow ◽  
Knee Osteoarthritis ◽  
Knee Pain ◽  
Subchondral Bone ◽  
Negative Binomial ◽  
Weight Bearing ◽  
The Other ◽  
Knee Oa ◽  
Pain Scores ◽  
Osteoarthritis Initiative

Abstract Background Subchondral bone marrow lesions (BMLs) detected on MRI in knee osteoarthritis (OA) are associated with knee pain. The prevalence and progression of subchondral BMLs are increased by mechanical knee load. However, associations of subchondral BML location with weight-bearing knee pain are currently unknown. In this study, we aim to demonstrate associations of subchondral BML location and size with weight-bearing knee pain in knee OA.Methods We analyzed 1412 and 582 varus knees from cross-sectional and longitudinal Osteoarthritis Initiative datasets, respectively. BML scores were semi-quantitatively analysed with the MRI Osteoarthritis Knee Score for 4 subchondral regions (median and lateral femorotibial, medial and lateral patellofemoral) and subspinous region. Weight-bearing and non-weight-bearing pain scores were derived from WOMAC pain items. Correlation and negative binomial regression models were used for analysis of associations between the BML scores and pain at baseline, and changes in the BML scores and changes in pain after 24-month follow up.Results Greater BML scores at medial femorotibial and lateral patellofemoral compartments were associated with greater weight-bearing pain scores, and statistical significance was retained after adjusting for BML scores at the other 4 joint compartments and other OA features, as well as for non-weight-bearing pain, age, sex and Body Mass Index (BMI) (medial femorotibial; B=0.08, p=0.02. patellofemoral; B=0.13, p=0.01). Subanalysis revealed that greater medial femorotibial BML scores were associated with greater pain on walking and standing (B=0.11, p=0.01, and B=0.10, p=0.04, respectively). Lateral patellofemoral BML scores were associated with pain on climbing, respectively B=0.14, p=0.02. Increases or decreases over 24 months in BML score in the medial femorotibial compartment were significantly associated with increases or decreases in weight-bearing pain severity after adjusting for non-weight-bearing pain, age, sex, baseline weight-bearing pain, BMI, and BML at the other 4 joint compartments (B=0.10, p=0.01). Conclusions Subchondral BML size at the medial femorotibial joint compartment was specifically associated with the severity and the change in weight-bearing pain, independent of non-weight-bearing pain, in knee OA. Specific associations of weight-bearing pain with subchondral BMLs in weight-bearing compartments of the knee indicate that BMLs in subchondral bone contribute to biomechanically-induced OA pain.

scholarly journals El impacto inicial con antepié incrementa la actividad muscular del gastrocnemios durante la carrera. Un estudio cuantitativo de actividad electromiográfica (The initial impact with forefoot increases the muscular activity of gastrocnemius during running)

Retos ◽  
2020 ◽  
pp. 271-275
Author(s):  
Oscar Valencia ◽  
Iver Cristi ◽  
Dario Ahumada ◽  
Keiny Meza ◽  
Rodrigo Salas ◽  
...  
Keyword(s):  
Lower Limb ◽  
Stance Phase ◽  
Maximum Voluntary Contraction ◽  
Neuromuscular Control ◽  
Voluntary Contraction ◽  
Medial Gastrocnemius ◽  
Emg Activity ◽  
Myoelectric Activity ◽  
Initial Contact ◽  
Limb Injuries

Un importante porcentaje de las lesiones de miembros inferiores ha sido vinculado a la técnica de carrera, en particular, al contacto inicial con retropié (RP) o antepié (AP). Sin embargo, existe limitada evidencia de la actividad electromiográfica (EMG) para ambas condiciones. El objetivo de este estudio fue comparar la amplitud EMG en miembros inferiores al utilizar técnicas de RP vs AP durante la carrera. Trece corredores fueron evaluado a una velocidad de trote autoseleccionada en dos condiciones: contacto inicial con RP y AP. Se registró la actividad mioeléctrica del recto femoral (RF), bíceps femoral (BF), tibial anterior (TA), gastrocnemio medial (GM) y lateral (GL). Se consideró la amplitud promedio de la EMG en 10 ciclos de carrera, normalizados a la contracción voluntaria máxima. Los resultados destacan una mayor activación significativa de los músculos GM y GL en el contacto AP durante la fase de apoyo, balanceo y en todo el ciclo de carrera. Adicionalmente, el TA presentó una mayor activación durante la fase de vuelo y el 100% del ciclo de carrera para la condición RP. No se encontraron otras diferencias significativas. En conclusión, el uso de la técnica AP incrementa la actividad muscular de GM y GL, posiblemente asociado a una mayor absorción del impacto durante la fase de apoyo. Por otro lado, el TA incrementa su actividad con RP, lo que podría implicar un mayor control previo al contacto inicial. La técnica de carrera se presenta como una condición modificable según situaciones de rendimiento o patología.Abstract. Running technique has an impact on lower limb injuries, particularly the initial contact pattern such as rearfoot (RF) or forefoot (FF). However, there is limited evidence of the electromyographic (EMG) activity for both conditions. The aim of this study was to compare the lower limb muscles EMG amplitude between RF and FF techniques during running. Thirteen runners were evaluated at a self-selected running speed under two conditions: initial contact with RF and FF. The myoelectric activity of the rectus femoris (RE), biceps femoris (BF), tibialis anterior (TA), medial gastrocnemius (GM) and lateral (GL) were analysed. The EMG amplitudes of 10 running cycles were averaged and normalized to the maximum voluntary contraction. The results included a significantly higher activation of GM and GL muscles for the FF condition during the stance phase, balance and the entire running cycle. In addition, TA showed higher activation during the swing phase and the 100% running cycle for the RP condition. No other significant differences were found. In conclusion, FF technique increases GM and GL myoelectric activity, possibly associated with a higher impact absorption during the stance phase. On the other hand, TA increases its activity for RF condition which may imply a greater neuromuscular control prior to initial contact. Finally, the running technique is presented as a modifiable condition which can be changed to enhance performance or in pathologic circumstances.

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.

scholarly journals Automating classification of osteoarthritis according to Kellgren-Lawrence in the knee using deep learning in an unfiltered adult population

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Simon Olsson ◽  
Ehsan Akbarian ◽  
Anna Lind ◽  
Ali Sharif Razavian ◽  
Max Gordon
Keyword(s):  
Deep Learning ◽  
Knee Osteoarthritis ◽  
Adult Population ◽  
Weight Bearing ◽  
Correct Diagnosis ◽  
University Hospital ◽  
Knee Oa ◽  
Orthopedic Surgeons ◽  
Visual Disturbances

Abstract Background Prevalence for knee osteoarthritis is rising in both Sweden and globally due to increased age and obesity in the population. This has subsequently led to an increasing demand for knee arthroplasties. Correct diagnosis and classification of a knee osteoarthritis (OA) are therefore of a great interest in following-up and planning for either conservative or operative management. Most orthopedic surgeons rely on standard weight bearing radiographs of the knee. Improving the reliability and reproducibility of these interpretations could thus be hugely beneficial. Recently, deep learning which is a form of artificial intelligence (AI), has been showing promising results in interpreting radiographic images. In this study, we aim to evaluate how well an AI can classify the severity of knee OA, using entire image series and not excluding common visual disturbances such as an implant, cast and non-degenerative pathologies. Methods We selected 6103 radiographic exams of the knee taken at Danderyd University Hospital between the years 2002-2016 and manually categorized them according to the Kellgren & Lawrence grading scale (KL). We then trained a convolutional neural network (CNN) of ResNet architecture using PyTorch. We evaluated the results against a test set of 300 exams that had been reviewed independently by two senior orthopedic surgeons who settled eventual interobserver disagreements through consensus sessions. Results The CNN yielded an overall AUC of more than 0.87 for all KL grades except KL grade 2, which yielded an AUC of 0.8 and a mean AUC of 0.92. When merging adjacent KL grades, all but one group showed near perfect results with AUC > 0.95 indicating excellent performance. Conclusion We have found that we could teach a CNN to correctly diagnose and classify the severity of knee OA using the KL grading system without cleaning the input data from major visual disturbances such as implants and other pathologies.

scholarly journals Locomotor patterns in cerebellar ataxia

2014 ◽  
Vol 112 (11) ◽  
pp. 2810-2821 ◽  
Author(s):  
G. Martino ◽  
Y. P. Ivanenko ◽  
M. Serrao ◽  
A. Ranavolo ◽  
A. d'Avella ◽  
...  
Keyword(s):  
Cerebellar Ataxia ◽  
Muscle Activity ◽  
Muscle Activation ◽  
Rating Scale ◽  
Reaction Force ◽  
Neuromuscular Control ◽  
Pattern Generation ◽  
Heel Strike ◽  
Emg Activity ◽  
Foot Loading

Several studies have demonstrated how cerebellar ataxia (CA) affects gait, resulting in deficits in multijoint coordination and stability. Nevertheless, how lesions of cerebellum influence the locomotor muscle pattern generation is still unclear. To better understand the effects of CA on locomotor output, here we investigated the idiosyncratic features of the spatiotemporal structure of leg muscle activity and impairments in the biomechanics of CA gait. To this end, we recorded the electromyographic (EMG) activity of 12 unilateral lower limb muscles and analyzed kinematic and kinetic parameters of 19 ataxic patients and 20 age-matched healthy subjects during overground walking. Neuromuscular control of gait in CA was characterized by a considerable widening of EMG bursts and significant temporal shifts in the center of activity due to overall enhanced muscle activation between late swing and mid-stance. Patients also demonstrated significant changes in the intersegmental coordination, an abnormal transient in the vertical ground reaction force and instability of limb loading at heel strike. The observed abnormalities in EMG patterns and foot loading correlated with the severity of pathology [International Cooperative Ataxia Rating Scale (ICARS), a clinical ataxia scale] and the changes in the biomechanical output. The findings provide new insights into the physiological role of cerebellum in optimizing the duration of muscle activity bursts and the control of appropriate foot loading during locomotion.

Association Between Clinical Symptoms and Radiographic Features in Late-Stage Knee Osteoarthritis Using a New Radiographic Parameter

Pain Medicine ◽  
2021 ◽  
Author(s):  
Tengjiao Zhu ◽  
Xing Xin ◽  
Bin Yang ◽  
Chen Liu ◽  
Bolong Kou ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Correlation Coefficient ◽  
Late Stage ◽  
Tibial Plateau ◽  
Weight Bearing ◽  
Womac Pain ◽  
Radiographic Parameter ◽  
Radiographic Features ◽  
Knee Oa ◽  
The Relationship

Abstract Objective In this study, we proposed a new radiographic parameter, the plateau attrition index (PAI), and the PAI grades (PAIs) to explore the relationship between subchondral attrition of the tibial plateau and symptoms of knee osteoarthritis (OA) in patients with late-stage knee osteoarthritis. Method One hundred nineteen patients with late-stage knee osteoarthritis were enrolled. The Kellgren and Lawrence (K/L) grades and hip-knee-ankle (HKA) angle were used to characterize the radiographic features of knee OA. The bone attrition of the tibial plateau was determined by the PAI and PAIs. The symptoms of knee OA were assessed by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), which is composed of the WOMAC pain (WOMP), WOMAC stiffness (WOMS) and WOMAC function (WOMF) subscores. WOMAC pain scores were divided into non-weight-bearing pain (NWBP) and weight-bearing pain (WBP) subcategories. The Pearson correlation coefficient was used to determine the relationship between the PAI, HKA angle, and WOMAC scores. The Spearman rank correlation coefficient was used to evaluate the correlation between the WOMAC score and the PAIs and K/L grades. Results The distribution of the WOMAC scores according to the PAIs was significant (p < 0.01). A positive correlation was identified between the PAI and the WOMAC, WOMP, WOMF and WBP scores (r = 0.29, 0.34, 0.26 and 0.34, p < 0.01, respectively). In addition, the PAIs was also significantly correlated with the WOMAC, WOMP, WOMF and WBP scores (r = 0.37, 0.38, 0.35 and 0.44, p < 0.01, respectively). Conclusion The attrition of tibial subchondral bone determined by the new parameter, the plateau attrition index, was correlated with symptoms, especially weight-bearing pain in late-stage knee OA.

scholarly journals Association of Cross Linked C-Telopeptide II Collagen and Hyaluronic Acid with Knee Osteoarthritis Severity

2013 ◽  
Vol 5 (3) ◽  
pp. 179
Author(s):  
John Butar Butar ◽  
Zola Wijayanti ◽  
Beatrix Tjahyana ◽  
Veli Sunggono ◽  
Hori Hariyanto
Keyword(s):  
Hyaluronic Acid ◽  
Knee Osteoarthritis ◽  
Metabolic Diseases ◽  
Weight Bearing ◽  
Interleukin 1 ◽  
High Sensitivity ◽  
Type I ◽  
Knee Oa ◽  
Reactive Protein ◽  
Hs Crp

BACKGROUND: This study was carried out to investigate the association of Cross Linked C-Telopeptide Type I & II Collagen (CTX-I and II) and hyaluronic acid (HA) with knee osteoarthritis (OA) severity.METHODS: Sixty menopause women with primary knee OA were enrolled in this study during their visits to the Outpatient Department. Patients with knee pain during weight bearing, active or passive range of motion, or tenderness with Kellgren-Lawrence (KL) grade of more than I were included. Patients with injury, inflammatory and metabolic diseases were excluded. Patients were put in a 10-hour fasting prior to withdrawal of morning blood samples for examinations of HA, CTX-I, interleukin 1 beta (IL-1β), and high sensitivity C reactive protein (hs-CRP) level. Second void morning urine specimens were taken for CTXII assessment. HA, CTX-I and II levels were measured by enzyme-linked immunosorbent assay.RESULTS: Sixty menopausal female patients were included in this study, 35 with KL grade II, 17 grade III, and 8 grade IV. Means of CTX-II were significantly different between subjects KL grade IV and III (p=0.021). Correlation of KL grade was significant with CTX-II (p=0.001, r=0.412) and HA (p=0.0411, r=0.269). KL grades were not significantly associated with CTX-I (p=0.8364, r=-0.0272); IL-1β (p=0.5773, r=0.0853) and hs-CRP (p=0.2625, r=0.1470).CONCLUSION: CTX-II and HA were associated with severity of knee OA, suggesting that CTX-II and HA can be used as marker for knee OA severity.KEYWORDS: CTX-II, hyaluronic acid, otestoarthritis, knee

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