Gait mechanics influence healthy cartilage morphology and osteoarthritis of the knee

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Andriacchi, Thomas P.^1,2,3; Koo, Seungbum⁴; Scanlan, Sean F.^1,3

Gait mechanics influence healthy cartilage morphology and osteoarthritis of the knee

J Bone Joint Surg. February 2009;91A(suppl 1):95-101

©2009 The Journal of Bone and Joint Surgery, Incorporated

Affiliations

¹Department of Mechanical Engineering, Stanford University, Stanford, CA 94305-4038

²Department of Orthopaedic Surgery, Stanford University, Stanford, CA 94305-4038

³Department of Veterans Affairs Bone and Joint Center of Palo Alto, CA

⁴Department of Radiology, Stanford University, Stanford, CA 94305-4038
Abstract

The response of healthy and diseased cartilage of the knee to the mechanics of walking is examined, with the goal of providing insight into the relationship between the kinematics and kinetics of the knee during walking and the maintenance of cartilage health. The combination of information from three-dimensional thickness models of cartilage derived from magnetic resonance imaging and the analysis of the interaction between load at the knee and kinematic changes during walking associated with loss of the anterior cruciate ligament demonstrated the importance of considering walking mechanics as an important factor in the initiation and progression of osteoarthritis. In particular, this material suggests that knee cartilage becomes conditioned to loading and to the large number of repetitive cycles of loading that occur during walking and that healthy cartilage homeostasis is maintained as long as there are no changes to the normal patterns of locomotion, the structure of the knee joint, or cartilage biology. Thus, there is the potential for a degenerative pathway to be initiated when a condition such as anterior cruciate ligament injury causes the repetitive loading during walking to shift to a new location. The sensitivity of cartilage to the kinematic changes is illustrated with the anterior cruciate ligament-deficient knee and the regional variations in cartilage morphology. The material presented here supports the conclusion that individual variations in the range of loading and kinematics at the knee during walking can have a profound influence on the initiation and progression of osteoarthritis of the knee.
Links

DOI: 10.2106/JBJS.H.01408

PubMed: 19182033

WoS: 000263243000023

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2022	Sritharan P, Schache AG, Culvenor AG, Perraton LG, Bryant AL, Morris HG, Whitehead TS, Crossley KM. Patellofemoral and tibiofemoral joint loading during a single-leg forward hop following ACL reconstruction. J Orthop Res. January 2022;40(1):159-169.
2022	Erhart-Hledik JC, Titchenal MR, Migliore E, Asay JL, Andriacchi TP, Chu CR. Cartilage oligomeric matrix protein responses to a mechanical stimulus associate with ambulatory loading in individuals with anterior cruciate ligament reconstruction. J Orthop Res. April 2022;40(4):791-798.
2022	Rapagna S, Roberts BC, Solomon LB, Reynolds KJ, Thewlis D, Perilli E. Relationships between tibial articular cartilage, in vivo external joint moments and static alignment in end-stage knee osteoarthritis: a micro-CT study. J Orthop Res. May 2022;40(5):1125-1134.
2022	Thomeer LT, Guan S, Gray HA, Pandy MG. Articular contact motion at the knee during daily activities. J Orthop Res. August 2022;40(8):1756-1769.
2022	Neal K, Williams JR, Alfayyadh A, Capin JJ, Khandha A, Manal K, Snyder-Mackler L, Buchanan TS. Knee joint biomechanics during gait improve from 3 to 6 months after anterior cruciate ligament reconstruction. J Orthop Res. September 2022;40(9):2025-2038.
2023	Young-Shand KL, Roy PC, Dunbar MJ, Abidi SSR, Wilson JLA. Gait biomechanics phenotypes among total knee arthroplasty candidates by machine learning cluster analysis. J Orthop Res. February 2023;41(2):335-344.
2023	De Pieri E, Nüesch C, Pagenstert G, Viehweger E, Egloff C, Mündermann A. High tibial osteotomy effectively redistributes compressive knee loads during walking. J Orthop Res. March 2023;41(3):591-600.
2023	Bishop EL, McGibbon CA, Kuntze G, Clark ML, Cowper-Smith C, Ronsky JL. Tricompartment offloader knee brace reduces contact forces in adults with multicompartment knee osteoarthritis. J Orthop Res. September 2023;41(9):1925-1933.
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