Interactions between kinematics and loading during walking for the normal and ACL deficient knee

Andriacchi, Thomas P.; Dyrby, Chris O.

doi:10.1016/j.jbiomech.2004.02.010

Cited by 348 publications

(283 citation statements)

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“…Anterior cruciate ligament injury is associated with premature osteoarthritis of the knee [18][19][20][21][22] . Kinematic changes at the knee following anterior cruciate ligament injury have been implicated as a factor in the cause of premature osteoarthritis in this population [23][24][25] . The normal external rotation and anterior translation of the tibia that occurs as the knee extends during terminal swing is reduced in the absence of the anterior cruciate ligament, and the tibia maintains this offset relative to normal throughout the stance phase of the walking cycle 23 .…”

mentioning

confidence: 99%

“…Kinematic changes at the knee following anterior cruciate ligament injury have been implicated as a factor in the cause of premature osteoarthritis in this population [23][24][25] . The normal external rotation and anterior translation of the tibia that occurs as the knee extends during terminal swing is reduced in the absence of the anterior cruciate ligament, and the tibia maintains this offset relative to normal throughout the stance phase of the walking cycle 23 . Recent studies have reported that kinematic changes in the anterior cruciate ligament-deficient knee were associated with the spatial pattern of articular cartilage thinning in the knee 26,27 .…”

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confidence: 99%

“…The anterior-posterior translational and internal-external rotational offsets were calculated by subtracting the average anteriorposterior translation and internal-external rotation of the contralateral anterior cruciate ligament-intact knee from those of the anterior cruciate ligament-deficient knee, respectively, for each anterior cruciate ligament-deficient subject. As a group, the anterior cruciate ligament-deficient knees had an average shift toward internal tibial rotation 23 during walking. However, when the kinematic changes could be classified into an anterior (femur on tibia) shift group and a posterior (femur on tibia) shift group, the kinematic changes could be related to region-specific cartilage thinning 26 .…”

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Gait Mechanics Influence Healthy Cartilage Morphology and Osteoarthritis of the Knee

Andriacchi

Koo

Scanlan

2009

Journal of Bone and Joint Surgery

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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.

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Gait Mechanics Influence Healthy Cartilage Morphology and Osteoarthritis of the Knee

Andriacchi

Koo

Scanlan

2009

Journal of Bone and Joint Surgery

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407

366

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“…With use of the robotic testing system, we measured the kinematics in nine cadaver tibiofemoral joints, from full extension to 90°of flexion both before and after anterior cruciate ligament resection, and found that anterior cruciate ligament deficiency not only altered anterior translation and axial rotation of the tibia (findings that have been documented extensively in the in vitro and in vivo literature [31][32][33][34][35][36] ) but also increased the medial translation of the tibia 37 . Our in vivo dual fluoroscopic imaging analysis of the tibiofemoral kinematics in ten patients with acute anterior cruciate ligament deficiency revealed analogous findings: an increased anterior translation (approximately 3 mm, Fig.…”

Section: Disturbed Tibiofemoral Joint Kinematicsmentioning

confidence: 96%

Evaluation of Kinematics of Anterior Cruciate Ligament-Deficient Knees with Use of Advanced Imaging Techniques, Three-Dimensional Modeling Techniques, and Robotics

Velde

Gill

2009

Journal of Bone and Joint Surgery

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Measuring knee biomechanics in six degrees of freedom with acceptable accuracy has been proven to be technically challenging. At our bioengineering laboratory, we have employed both an in vitro robotic testing system and an in vivo combined dual fluoroscopic and magnetic resonance imaging technique to analyze the impact of anterior cruciate ligament rupture on the knee joint.When measuring the tibiofemoral kinematics of nine cadavers with the robotic testing system, we found that anterior cruciate ligament deficiency not only altered anterior translation and axial rotation of the tibia, but it also increased the medial translation of the tibia as well. The in vivo dual fluoroscopic imaging analysis of tibiofemoral kinematics in ten anterior cruciate ligament-deficient patients revealed analogous findings: an increased medial translation of the tibia of approximately 1 mm between 15°and 90°of flexion was found in anterior cruciate ligament-deficient knees, in addition to an increased anterior translation (approximately 3 mm) and internal rotation (approximately 2°) of the tibia at low flexion angles. In a subsequent study of tibiofemoral cartilage contact, we found that the cartilage contact points shifted posteriorly-as was expected on the basis of the increased anterior tibial translation-as well as laterally on the surface of the tibial plateau.The data demonstrate how rupture of the anterior cruciate ligament initiates a cascade of events that eventually results in abnormal tibiofemoral cartilage contact in both the anteroposterior and mediolateral directions. If the restoration of normal knee homeostasis is the ultimate goal of ligament reconstruction, the normal function of the anterior cruciate ligament should be restored as closely as possible in all degrees of freedom.

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“…Although reconstructive surgery can partially restore joint stability following ACL rupture, it is unlikely that surgery fully restores normal biomechanical loading across the knee 45,[52][53][54] . An altered loading pattern causes a shift in compressive and tension load-bearing to unconditioned regions, and reduces loads in conditioned regions 55,56 .…”

Section: Why the Increased Prevalence Of Oa Following Acl Rupture?mentioning

confidence: 99%

The Health and Structural Consequences of Acute Knee Injuries Involving Rupture of the Anterior Cruciate Ligament

Riordan

Frobell

Roemer

et al. 2013

Rheumatic Disease Clinics of North America

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Word Count: 4183 2 3 SynopsisAlthough there is an abundance of literature regarding the development of knee osteoarthritis following rupture of the anterior cruciate ligament (ACL), the exact mechanism underlying this link is still not clear.Recent studies have reported that a number of factors may be predictive of the subsequent development of osteoarthritis, with damage to the menisci and articular cartilage during the initial trauma, altered knee biomechanics post-injury, and episodic instability chief among them. This article summarizes recent developments in the understanding of the joint damage resulting from an ACL tear, and the influence that current and future treatment methods may have on the long-term progression to osteoarthritis.

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Interactions between kinematics and loading during walking for the normal and ACL deficient knee

Cited by 348 publications

References 31 publications

Gait Mechanics Influence Healthy Cartilage Morphology and Osteoarthritis of the Knee

Gait Mechanics Influence Healthy Cartilage Morphology and Osteoarthritis of the Knee

Evaluation of Kinematics of Anterior Cruciate Ligament-Deficient Knees with Use of Advanced Imaging Techniques, Three-Dimensional Modeling Techniques, and Robotics

The Health and Structural Consequences of Acute Knee Injuries Involving Rupture of the Anterior Cruciate Ligament

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