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The influence of knee joint geometry and alignment on the tibiofemoral load distribution: A computational study.

ABSTRACT: BACKGROUND:Deviations in knee joint geometry and alignment were previously related to an increased risk for knee OA. These were hypothesized to influence the load distribution over the articular cartilage. Therefore, this study evaluated the effect of altered knee joint geometry and alignment in the coronal and transverse plane on the medial-lateral load distribution and ligament strain using a musculoskeletal modeling approach. METHODS:Joint kinematics during gait were measured in 15 healthy adults. Using different musculoskeletal models with altered geometry of the tibia plateau or knee joint malalignment in the coronal and transverse plane, the resulting muscle, ligament and contact forces were calculated. Next, the distribution of the load over the medial and lateral condyle was analyzed and compared to the reference loading distribution, with neutral geometry and alignment, using repeated-measures ANOVA and individual t-tests, with a Bonferroni-corrected alpha level. RESULTS:Coronal plane malalignment significantly affected the load distribution. Small changes in coronal tibial slope had less pronounced effects on the load distribution, but increased ligament strains. Transverse plane malalignment only minimally affected the load distribution. CONCLUSION:Coronal plane knee malalignment affected knee loading, with increased varus alignment resulting in increased medial loading. This confirms a causal relation between coronal malalignment and increased medial compartment loading and suggests a potential role of aberrant coronal plane alignment on OA initiation. Altered coronal tibial slope induced increased ligament strains, potentially contributing to a cascade of knee laxity and subsequently more extreme knee malalignment.

SUBMITTER: Van Rossom S

PROVIDER: S-EPMC6906219 | biostudies-literature | 2019 Aug

REPOSITORIES: biostudies-literature

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The influence of knee joint geometry and alignment on the tibiofemoral load distribution: A computational study.

Van Rossom Sam S Wesseling Mariska M Smith Colin R CR Thelen Darryl G DG Vanwanseele Benedicte B Dieter Van Assche VA Jonkers Ilse I

The Knee 20190627 4

<h4>Background</h4>Deviations in knee joint geometry and alignment were previously related to an increased risk for knee OA. These were hypothesized to influence the load distribution over the articular cartilage. Therefore, this study evaluated the effect of altered knee joint geometry and alignment in the coronal and transverse plane on the medial-lateral load distribution and ligament strain using a musculoskeletal modeling approach.<h4>Methods</h4>Joint kinematics during gait were measured i ...[more]

PMID: 31255528

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Project description:Little is known about the relationships of circulating levels of biomarkers of cartilage degradation with biomechanical outcomes relevant to knee osteoarthritis (OA) or biomarker changes following non-pharmacological interventions. The objectives of this exploratory, pilot study were to: 1) examine relationships between biomarkers of articular cartilage degradation and synthesis with measures of knee joint load during walking, and 2) examine changes in these biomarkers following 10 weeks of strengthening exercises.Seventeen (8 male, 9 female; 66.1 +/- 11.3 years of age) individuals with radiographically-confirmed medial tibiofemoral OA participated. All participants underwent a baseline testing session where serum and urine samples were collected, followed by a three-dimensional motion analysis. Motion analysis was used to calculate the external knee adduction moment (KAM) peak value and impulse. Following baseline testing, participants were randomized to either 10 weeks of: 1) physiotherapist-supervised lower limb muscle strengthening exercises, or 2) no exercises (control). Identical follow-up testing was conducted 11 weeks after baseline. Biomarkers included: urinary C-telopeptide of type II collagen (uCTX-II) and type II collagen cleavage neoepitope (uC2C), serum cartilage oligomeric matrix protein (sCOMP), serum hyaluronic acid (sHA) and serum C-propeptide of type II procollagen (sCPII). Linear regression analysis was used to examine relationships between measures of the KAM and biomarker concentrations as baseline, as well as between-group differences following the intervention.KAM impulse predicted significant variation in uCTX-II levels at baseline (p?=?0.04), though not when controlling for disease severity and walking speed (p?=?0.33). KAM impulse explained significant variation in the ratio uCTX-II;sCPII even when controlling for additional variables (p?=?0.04). Following the intervention, changes in sCOMP were significantly greater in the exercise group compared to controls (p?=?0.04). On average those in the control group experienced a slight increase in sCOMP and uCTX-II, while those in the exercise group experienced a reduction. No other significant findings were observed.This research provides initial evidence of a potential relationship between uCTX-II and knee joint load measures in patients with medial tibiofemoral knee OA. However, this relationship became non-significant after controlling for disease severity and walking speed, suggesting further research is necessary. It also appears that sCOMP is amenable to change following a strengthening intervention, suggesting a potential beneficial role of exercise on cartilage structure.Clinicaltrials.gov NCT01241812.

Dataset Information

The influence of knee joint geometry and alignment on the tibiofemoral load distribution: A computational study.

Publications

The influence of knee joint geometry and alignment on the tibiofemoral load distribution: A computational study.

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