Analysis of patellofemoral arthrokinematic motion quality in open and closed kinetic chains using vibroarthrography

Abstract

BackgroundKnee movements performed in open (OKC) and closed (CKC) kinetic chains generate various patterns of muscle activities and especially distinct contact stresses in the patellofemoral joint (PFJ). In contrast to these features, the arthrokinematic motion quality (AMQ) of the PFJ has not been compared between mentioned conditions. In this study we performed vibroarthrographic analysis of AMQ in movements performed in OKC and CKC, in healthy subjects and individuals with chondromalacia patellae, to assess which of the test conditions is more efficient in differentiation between healthy and deteriorated joints. Moreover, our analysis will broaden the knowledge related to behavior of normal and pathological synovial joints during motion with and without weight bearing. It is an essential issue, due to the recently observed significant interest in comparing potential benefits and limitations of CKC and OKC exercises as they relate to lower extremity rehabilitation.Methods100 subjects (62 healthy controls and 38 subjects with PFJ chondromalacia) were enrolled. During repeated knee flexion/extension motions performed in OKC (in a sitting position) and CKC (sit-to-stand movements), the vibroarthrographic signals were collected using an accelerometer and described by variability (VMS), amplitude (R4), and spectral power in 50–250 Hz (P1) and 250–450 Hz (P2) bands.ResultsSignificant differences in VMS [V], R4 [V], P1 [V2/Hz] and P2 [V2/Hz] between OKC and CKC were found (0.0001, 0.969. 0.800 0.041 vs 0.013, 3.973, 6.790, 0.768, respectively, P < 0.001). Moreover, in both analyzed load-related conditions the subjects with chondromalacia were characterized by significantly higher values of all parameters, when compared to controls (P < 0.001), with effect size values over 0.6.ConclusionsWe showed that motion of the physiological, unloaded PFJ articular surfaces in OKC is nearly vibrationless, which corresponds with optimal AMQ of PFJ, while loaded movements in CKC are characterized by a higher vibroacoustic emission level. Moreover, chondral lesions should be considered as an increased friction-related, aggravating factor of AMQ, which is critical in CKC movements under load. Nonetheless, OKC and CKC conditions are characterized by large effect sizes, and provide an efficient test frame for differentiating physiological knees and joints with chondral lesions.

Reliability of Vibroarthrography to Assess Knee Joint Sounds in Motion

“…Kiselev et al [2] showed a diagnostic accuracy of the acoustic emissions measurement from good to very good. Moreover, knee sounds produced by the articulation of joint components not only contain information on the joint health and morphology, but also have been well discussed as surrogates of knee joint loading during motion [1,4,[6][7][8]. These findings appear to be particularly important, because vibroarthrography presents a new perspective on knee arthrokinematics.…”

Vibroarthrographic analysis of patellofemoral joint arthrokinematics during squats with increasing external loads

“…Following previous publications, our experiment assumed that the intensity of acquired vibroacoustic emission waves is closely associated with the kinetic friction and represents friction-induced vibrations generated by relative sliding and rolling of adjacent articular surfaces. From biomechanical and tribological points of view the ability of the articular surfaces to move smoothly against each other with low frictional noise indicates optimal arthrokinematic motion related with low kinetic friction, and as a result contributes to slow wear of cartilage [20]. The presented ndings of this study con rm that during a knee exion-extension movement with the load of the body weight, the PFJ arthrokinematic motion possesses low-vibration characteristics, despite relatively high values of articular surface load, typical for this analyzed condition.…”

“…Based on previous studies, assessment of the PFJ arthrokinematic motion quality was performed with an accelerometer sensor placed 1 cm above the apex of the patella [11,20,36].…”

“…It has been previously shown that VAG possess not only high accuracy and speci city when differentiating synovial joints' deteriorations with various biomechanical and morphological origins, but also is sensitive for identifying the changes in arthrokinematics related to the level of the joint load at the end of a performed task [16][17][18][19][20]. From an arthrology perspective, this nding seems to be particularly important, because the load on articular surfaces is one of the most essential factors affecting the level of kinetic friction and joint wear [7,21].…”

Vibroarthrographic analysis of patellofemoral joint arthrokinematics during squats with increasing external loads

“…Based on previous studies, assessment of the PFJ arthrokinematic motion quality was performed with an accelerometer sensor placed 1 cm above the apex of the patella [11,20,37].…”