Variations in Knee Articular Cartilage Morphology Are Associated With Biomechanics of Gait for Healthy, Osteoarthritic and ACL Deficient Subjects

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Abstract

Trauma, joint injuries and biological changes in the tissue can initiate the degeneration of cartilage and progress to osteoarthritis (OA). Accurate measurements of articular cartilage morphology helps understand cartilage physiology and monitor the progression of OA.

The objectives of this study were 1) to develop software to create three-dimensional (3D) cartilage models from magnetic resonance (MR) images and measure cartilage thickness in the regions of interest, 2) to understand in vivo functional adaptations of knee articular cartilage to biomechanical loading during walking, and 3) to study the cartilage thinning pattern of subjects with anterior cruciate ligament (ACL) rupture in relation to the knee kinematic changes during walking.

Methods that can delineate articular cartilage boundaries in MR images and build 3D surface models were developed. The accuracy of the articular cartilage model was evaluated using resected tibial plateau samples from total knee replacement patients. The dynamic loading in the knee during walking was compared to the knee articular cartilage thicknesses to understand the in vivo functional adaptation of articular cartilage in healthy, OA and ACL deficient subjects (2). The kinematic changes during walking in the ACL deficient knees relative to contralateral healthy knees were compared with the spatial cartilage thickness differences between the bilateral knees (3).

The results showed that healthy subjects had thicker cartilage with higher joint load, while OA subjects had thinner cartilage with higher joint load during walking. In addition, body mass index and contact surface shapes which can affect the local mechanical stress in cartilage were also associated with cartilage thicknesses in relatively young healthy subjects. The change in knee kinematics during walking after ACL rupture seems to influence cartilage thinning pattern in the early stage for ACL deficient subjects.

The development and validation of this software enables the investigation of the biomechanical factors that initiate and progress OA. In the future, the effects of biomechanical factors on cartilage physiology will be further investigated using the tool to understand the pathways of OA and prevent and treat OA.

Cited Works (18)

Year	Entry
2000	Smith RL, Lin J, Trindade MCD, Shida J, Kajiyama G, Vu T, Hoffman AR, van der Meulen MCH, Goodman SB, Schurman DJ, Carter DR. Time-dependent effects of intermittent hydrostatic pressure on articular chondrocyte type II collagen and aggrecan mRNA expression. J Rehab Res Dev. March–April 2000;37(2):153-181.
1991	Ateshian G, Soslowsky L, Mow V. Quantitation of articular surface topography and cartilage thickness in knee joints using stereophotogrammetry. J Biomech. January 1991;24(8):761-776.
2005	Andriacchi TP, Dyrby CO. Interactions between kinematics and loading during walking for the normal and ACL deficient knee. J Biomech. February 2005;38(2):293-298.
2003	Wong M, Carter DR. Articular cartilage functional histomorphology and mechanobiology: a research perspective. Bone. July 2003;33(1):1-13.
1998	Andriacchi TP, Alexander EJ, Toney MK, Dyrby C, Sum J. A point cluster method for in vivo motion analysis: applied to a study of knee kinematics. J Biomech Eng. December 1998;120(6):743-749.
1987	Carter DR, Orr TE, Fyhrie DP, Schurmant DJ. Influences of mechanical stress on prenatal and postnatal skeletal development. Clin Orthop Relat Res. June 1987;219:237-250.
1991	Schipplein OD, Andriacchi TP. Interaction between active and passive knee stabilizers during level walking. J Orthop Res. January 1991;9(1):113-119.
2004	Carter DR, Beaupré GS, Wong M, Smith RL, Andriacchi TP, Schurman DJ. The mechanobiology of articular cartilage development and degeneration. Clin Orthop Relat Res. October 2004;427(suppl):S69-S77.
2004	Smith RL, Carter DR, Schurman DJ. Pressure and shear differentially alter human articular chondrocyte metabolism: a review. Clin Orthop Relat Res. October 2004;427(suppl):S89-S95.
2004	Lohmander LS, Östenberg A, Englund M, Roos H. High prevalence of knee osteoarthritis, pain, and functional limitations in female soccer players twelve years after anterior cruciate ligament injury. Arthritis Rheum. October 2004;50(10):3145-3152.
1988	Carter DR, Wong M. The role of mechanical loading histories in the development of diarthrodial joints. J Orthop Res. 1988;6(6):804-816.
1992	Lafortune MA, Cavanagh PR, Sommer HJ III, Kalenak A. Three-dimensional kinematics of the human knee during walking. J Biomech. April 1992;25(4):347-357.
2004	Andriacchi TP, Mündermann A, Smith RL, Alexander EJ, Dyrby CO, Koo S. A framework for the in vivo pathomechanics of osteoarthritis at the knee. Ann Biomed Eng. March 2004;32(3):447-457.
1995	Roos H, Adalberth T, Dahlberg L, Lohmander LS. Osteoarthritis of the knee after injury to the anterior cruciate ligament or meniscus: the influence of time and age. Osteoarthritis Cartilage. December 1995;3(3):261-267.
1999	Cohen ZA, McCarthy DM, Kwak SD, Legrand P, Fogarasi F, Ciaccio EJ, Ateshian GA. Knee cartilage topography, thickness, and contact areas from MRI: in-vitro calibration and in-vivo measurements. Osteoarthritis Cartilage. January 1999;7(1):95-109.
1990	Wong M, Carter DR. A theoretical model of endochondral ossification and bone architectural construction in long bone ontogeny. Anat Embryol. July 1990;181(6):523-532.
1996	Smith RL, Rusk SF, Ellison BE, Wessells P, Tsuchiya K, Carter DR, Caler WE, Sandell LJ, Schurman DJ. In vitro stimulation of articular chondrocyte mRNA and extracellular matrix synthesis by hydrostatic pressure. J Orthop Res. 1996;14(1):53-60.
1994	Daniel DM, Stone ML, Dobson BE, Fithian DC, Rossman DJ, Kaufman KR. Fate of the ACL-injured patient: a prospective outcome study. Am J Sports Med. September–October 1994;22(5):632-644.