Context: Knee osteoarthritis (OA) frequently develops following knee injury/surgery. It is accepted that knee injury/surgery precipitates OA with previous studies examining this link in terms of years after injury/surgery. However, postinjury OA prevalence has not been examined by decade of life; thereby, limiting our understanding of the age at which patients are diagnosed with posttraumatic knee OA. Objective: Evaluate the association between the knee injury and/or surgical history, present age, and history of receiving a diagnosis of knee OA. Design: Cross-sectional survey. Setting: Online survey. Participants: A total of 3660 adults were recruited through ResearchMatch©. Of these, 1723 (47.1%) were included for analysis due to history of (1) knee surgery (SURG: n = 276; age = 53.8 [15.3] y; and body mass index [BMI] = 29.9 [8.0] kg/m2), (2) nonsurgical knee injury (INJ: n = 449; age = 46.0 [15.6] y; and BMI = 27.5 [6.9] kg/m2), or (3) no knee injury (CTRL: n = 998; age = 44.0 [25.2] y; and BMI = 26.9 [6.6] kg/m2). Respondents were subdivided by decade of life (20–29 through 70+). Intervention: An electronic survey regarding knee injury history, treatment, and diagnosis of knee OA. Main Outcome Measures: Binary logistic regression determined the association between knee surgical status and OA by decade of life. Participants with no histories of OA or lower-extremity injury were the referent categories. BMI was a covariate in all analyses. Results: SURG respondents were more likely to report having knee OA than CTRL for all age groups (odds ratios: 11.43–53.03; P < .001). INJ respondents aged 30 years and older were more likely to have OA than CTRL (odds ratios: 2.99–14.22; P < .04). BMI influenced associations for respondents in their 50s (P = .001) and 60s (P < .001) only. Conclusions: INJ increased the odds of reporting a physician diagnosis of knee OA in adults as young as 30 to 39 years. Importantly, SURG yielded 3 to 4 times greater odds of being diagnosed with knee OA compared with INJ in adults as young as 20 to 29 years. Delaying disease onset in these young adults is imperative to optimize the quality of life long term after surgery.
Abbey C. Thomas, Janet E. Simon, Rachel Evans, Michael J. Turner, Luzita I. Vela and Phillip A. Gribble
Laura S. Kox, P. Paul F.M. Kuijer, Dagmar A.J. Thijssen, Gino M.M.J. Kerkhoffs, Rick R. van Rijn, Monique H.W. Frings-Dresen and Mario Maas
joint degeneration, previous fractures and mechanical factors like work with heavy loading of the wrist are thought to play a role. 66 , 67 Many wrist-loading sports involve similar repetitive mechanical loading of the wrist, and overuse injuries due to microtrauma also occur in wrist-loading sports
Brian S. Baum, Hiroaki Hobara, Yoon Hyuk Kim and Jae Kun Shim
Individuals with lower extremity amputation must adapt the mechanical interactions between the feet and ground to account for musculoskeletal function loss. However, it is currently unknown how individuals with amputation modulate three-dimensional ground reaction forces (GRFs) when running. This study aimed to understand how running with running-specific prostheses influences three-dimensional support forces from the ground. Eight individuals with unilateral transtibial amputations and 8 control subjects ran overground at 2.5, 3.0, and 3.5 m/s. Ten force plates measured GRFs at 1000 Hz. Peak and average GRFs and impulses in each plane were compared between limbs and groups. Prosthetic limbs generated reduced vertical impulses, braking forces and impulses, and mediolateral forces while generating similar propulsive impulses compared with intact and control limbs. Intact limbs generated greater peak and average vertical forces and average braking forces than control subjects’ limbs. These data indicate that the nonamputated limb experiences elevated mechanical loading compared with prosthetic and control limbs. This may place individuals with amputation at greater risk of acute injury or joint degeneration in their intact limb. Individuals with amputation adapted to running-specific prosthesis force production limitations by generating longer periods of positive impulse thus producing propulsive impulses equivalent to intact and control limbs.
Michelle M. McLeod, Phillip Gribble, Kate R. Pfile and Brian G. Pietrosimone
Arthroscopic partial meniscectomy (APM) after meniscal tear has been widely accepted and associated with quick return to activity. Unfortunately, meniscectomy is associated with risk for knee osteoarthritis, which may be attributed to postsurgical quadriceps weakness. This has important implications, as the quadriceps play a prominent role in knee stabilization and energy attenuation in the lower extremity.
To determine the magnitude of interlimb quadriceps strength deficits in people with unilateral APM by systematically reviewing the current literature.
The Web of Knowledge databases were searched on September 22, 2010, using terms meniscus OR meniscectomy AND quadriceps strength OR quadriceps weakness. Included articles were written in English, reporting means and SDs of isokinetic peak torque at 60° and 180°/s for both limbs.
Four articles were included in the final analysis. Effect sizes and 95% confidence intervals (CI) were calculated between limbs for periods less than 1 mo, 1–3 mo, 3–6 mo, and more than 6 mo.
Homogeneous effect sizes indicate quadriceps weakness in the involved limb. Effects were strong at less than 1 mo (d = −1.01 to −1.62), while weak to strong effects were found for 1–3 mo (d = −0.40 to −8.04) and 3–6 mo (d = −0.40 to −5.11). Weak effects were found at more than 6 mo (d = −0.30 to −0.37). Definitive effects with a CI not crossing zero were found in 65% of the data. Although APM patients return to function within weeks after surgery, prolonged quadriceps strength deficits may increase the risk of knee-joint degeneration. Furthermore, evidence of bilateral dysfunction after unilateral injury may suggest that neuromuscular deficits post-APM are greater than the interlimb differences found in this review. Further research should be conducted to determine the nature of strength deficits and the best methods for restoring strength after APM.
Lindsey K. Lepley, Abbey C. Thomas, Scott G. McLean and Riann M. Palmieri-Smith
As individuals returning to activity after anterior cruciate ligament reconstruction (ACLr) likely experience fatigue, understanding how fatigue affects knee-muscle activation patterns during sport-like maneuvers is of clinical importance. Fatigue has been suggested to impair neuromuscular control strategies. As a result, fatigue may place ACLr patients at increased risk of developing posttraumatic osteoarthritis (OA).
To determine the effects of fatigue on knee-muscle activity post-ACLr.
12 individuals 7–10 mo post-ACLr (7 male, 5 female; age 22.1 ± 4.7 y; 1.8 ± 0.1 m; mass 77.7 ± 11.9 kg) and 13 controls (4 male, 9 female; age 22.9 ± 4.3 y; 1.7 ± 0.1 m; mass 66.9 ± 9.8 kg).
Fatigue was induced via repetitive sets of double-leg squats (n = 8), which were interspersed with sets of single-leg landings (n = 3), until squats were no longer possible.
Main Outcome Measures:
2 × 2 repeated-measures ANOVA was used to detect the main effects of group (ACLr, control) and fatigue state (prefatigue, postfatigue) on quadriceps:hamstring cocontraction index (Q:H CCI).
All subjects demonstrated higher Q:H CCI at prefatigue compared with postfatigue (F 1,23 = 66.949, P ≤ .001). Q:H CCI did not differ between groups (F 1,23 = 0.599, P = .447).
The results indicate that regardless of fatigue state, ACLr individuals are capable of restoring muscle-activation patterns similar to those in healthy subjects. As a result, excessive muscle cocontraction, which has been hypothesized as a potential mechanism of posttraumatic OA, may not contribute to joint degeneration after ACLr.
Erik A. Wikstrom, Kyeongtak Song, Kimmery Migel and Chris J. Hass
potentially reduce PTOA prevalence. While the underlying etiology of ankle joint degeneration has not yet been elucidated, a growing body of evidence is emerging regarding possible biomechanical 6 – 8 influences on cartilage health. Vertical ground reaction force (vGRF) and vGRF loading rate, defined as the
Sarah C. Moudy, Neale A. Tillin, Amy R. Sibley and Siobhán Strike
muscle force, 14 , 15 which has been identified as a risk factor associated with joint degeneration. 16 Increasing trunk flexion when landing has been found as a compensatory strategy to reduce the reliance on the eccentric contraction of the quadriceps. Greater trunk flexion is related to greater
Jonathan S. Goodwin, Robert A. Creighton, Brian G. Pietrosimone, Jeffery T. Spang and J. Troy Blackburn
. Arthroscopic mosaicplasty: long-term outcome and joint degeneration progression . Knee . 2015 ; 22 ( 1 ): 36 – 40 . PubMed ID: 25482347 doi:10.1016/j.knee.2014.10.001 10.1016/j.knee.2014.10.001 25482347 5. Ciccotti MC , Kraeutler MJ , Austin LS , et al . The prevalence of articular cartilage
Komeil Dashti Rostami, Aynollah Naderi and Abbey Thomas
Anterior cruciate ligament (ACL) injury occurs frequently during athletic activity, precipitating numerous immediate and long-term consequences such as pain, disability, and ultimately joint degeneration. 1 In many individuals with ACL injury, altered movement patterns have been demonstrated
Pier Paolo Mariani, Luca Laudani, Jacopo E. Rocchi, Arrigo Giombini and Andrea Macaluso
, Keays AC , Newcombe PA , Bullock MI . A 6-year follow-up of the effect of graft site on strength, stability, range of motion, function, and joint degeneration after anterior cruciate ligament reconstruction: patellar tendon versus semitendinosus and Gracilis tendon graft . Am J Sports Med