Objective parameters to measure (in)stability of the knee joint during gait: A review of literature

Schrijvers, J.; Noort, Josien C. van den; Esch, M. van der; Dekker, Joost; Harlaar, Jaap

doi:10.1016/j.gaitpost.2019.03.016

Cited by 12 publications

(9 citation statements)

References 103 publications

(199 reference statements)

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“…As knee joint instability in these populations is prevented by the original or reconstructed ACL, it is difficult to transfer the results on brace stabilization effects to ACLdeficient patients. Finally, we recorded 3D knee joint kinematics as these have been suggested to indicate knee joint stability (Schrijvers et al, 2019).…”

Section: Embedding Of the Results Into The Current State Of Researchmentioning

confidence: 99%

“…Three-dimensional marker trajectories were filtered using a second-order Butterworth low-pass filter with a cut-off frequency of 6 Hz for the walking condition and 10 Hz for the cutting condition (Kirtley, 2006). An inverse kinematics approach using the multi-body model Dynamicus (Härtel and Hermsdorf, 2006) was used to calculate 3D knee angles as objective parameters suggested in the literature to be indicators for knee joint stability (Schrijvers et al, 2019). Based on the preprocessed data, peak joint angles (minimum and maximum), ranges of motion (RoM), joint angles at touch down (TD) and at resultant peak ground reaction force (Peak GRF) in the sagittal, frontal and transverse planes were calculated for the knee joint during the stance phases of walking and cutting.…”

Section: Data Processing and Analysismentioning

confidence: 99%

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Effect of Different Knee Braces in ACL-Deficient Patients

Focke

Steingrebe

Möhler

et al. 2020

Front. Bioeng. Biotechnol.

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Knee braces are often used during rehabilitation after ACL injury. There are two main concepts, rigid and soft braces, but studies comparing the two show conflicting results. Most studies used movement tasks with low translational or rotational loads and did not provide joint kinematics. Therefore, the purpose of this study was to investigate the influence of two different knee braces (rigid vs. soft) on knee joint kinematics in ACL-deficient patients compared to an unbraced control condition using two tasks (walking and 180 • cutting) provoking knee movements in the frontal and transverse planes. 17 subjects with ACL-deficient knees participated in this study. 3D knee joint kinematics were recorded. To provoke frontal plane knee joint motion a laterally tilting plate was applied during a walking task. Both braces reduced the maximum valgus angle compared to the unbraced condition, stabilizing the knee joint against excessive valgus motion. Yet, no differences in peak abduction angle between the two braces were found. However, a significant extension deficit was observed with the rigid brace. Moreover, both braces increased transverse plane RoM and peak internal rotation angle, with the effects being significantly larger with the rigid brace. These effects have been associated with decreased knee stability and unphysiological cartilage loading. Therefore, the soft brace seems to be able to limit peak abduction with a lesser impact on physiological gait compared to the rigid brace. The cutting task was selected to provoke transverse plane knee movement and large external knee rotation was expected. However, none of the braces was able to reduce peak external knee rotation. Again, an increase in transverse plane RoM was observed with both braces. Based on these results, no brace outmatched the other in the second task. This study was the first attempt to clarify the effect of brace design for the stabilization of the knee joint during movements with frontal and transverse plane loading. However, to provide physicians and patients with a comprehensive guideline for brace usage, future studies will have to extent these findings to other daily or sportive movement tasks.

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Section: Embedding Of the Results Into The Current State Of Researchmentioning

confidence: 99%

Section: Data Processing and Analysismentioning

confidence: 99%

Effect of Different Knee Braces in ACL-Deficient Patients

Focke

Steingrebe

Möhler

et al. 2020

Front. Bioeng. Biotechnol.

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“…Objectifying knee instability that patients experience during daily living still remains a challenge. 19 Laxity in the knee joint measured via different diagnostic techniques is different from instability experienced by the patient.…”

Section: Discussionmentioning

confidence: 99%

Why, When, and in Which Patients Nonoperative Treatment of Anterior Cruciate Ligament Injury Fails: An Exploratory Analysis of the COMPARE Trial

et al. 2022

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Background: The optimal treatment strategy for patients with an anterior cruciate ligament (ACL) rupture is still under debate. Different determinants of the need for a reconstruction have not been thoroughly investigated before. Purpose: To investigate why, when, and which patients with an ACL rupture who initially started with rehabilitation therapy required reconstructive surgery. Study Design: Case-control study; Level of evidence, 3. Methods: In the Conservative versus Operative Methods for Patients with ACL Rupture Evaluation (COMPARE) trial, 167 patients with an ACL rupture were randomized to early ACL reconstruction or rehabilitation therapy plus optional delayed ACL reconstruction. We conducted an exploratory analysis of a subgroup of 82 patients from this trial who were randomized to rehabilitation therapy plus optional delayed ACL reconstruction. The reasons for surgery were registered for the patients who underwent a delayed ACL reconstruction. For these patients, we used the International Knee Documentation Committee (IKDC) subjective knee form, Numeric Rating Scale for pain, and instability question from the Lysholm questionnaire before surgery. To determine between-group differences between the nonoperative treatment and delayed ACL reconstruction group, IKDC and pain scores during follow-up were determined using mixed models and adjusted for sex, age, and body mass index. Results: During the 2-year follow-up of the trial, 41 of the 82 patients received a delayed ACL reconstruction after a median time of 6.4 months after inclusion (interquartile range, 3.9-10.3 months). Most reconstructions occurred between 3 and 6 months after inclusion (n = 17; 41.5%). Ninety percent of the patients (n = 37) reported knee instability concerns as a reason for surgery at the moment of planning surgery. Of these patients, 18 had an IKDC score ≤60, 29 had a pain score of ≥3, and 33 patients had knee instability concerns according to the Lysholm questionnaire before surgery. During follow-up, IKDC scores were lower and pain scores were higher in the delayed reconstruction group compared with the nonoperative treatment group. Patients in the delayed reconstruction group had a significantly younger age (27.4 vs 35.3 years; P = .001) and higher preinjury activity level compared with patients in the nonoperative treatment group. Conclusion: Patients who experienced instability concerns, had pain during activity, and had a low perception of their knee function had unsuccessful nonoperative treatment. Most patients received a delayed ACL reconstruction after 3 to 6 months of rehabilitation therapy. At baseline, patients who required reconstructive surgery had a younger age and higher preinjury activity level compared with patients who did not undergo reconstruction.

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“…Unfortunately, the evaluation of instability is based mainly on subjective self-reporting. Parameters measured with gait analysis have been studied as more objective indicators of instability; however, a recent review concluded that although many different candidates for an objective knee stability gait parameter are found in literature, all of them lack sufficient clinical evidence 13 . Here, we assessed the knee instability from one-leg-stand analysis, which we previously reported was associated with changes in morphological features of the cartilage assessed by radiography and MRI 19 .…”

Section: Discussionmentioning

confidence: 99%

“…Gait analysis has been suggested as a potential method to quantify the information occurring during walk and especially detect abnormal movement. Measured parameters from the gait analysis have been considered as suitable objective markers of kinematic instability 13 . However, while the previous studies have been focusing on video-based approaches, the recent developments of inertial measurement units (IMU) allow to evaluate similar information using embedded sensors into wearable devices.…”

Section: Introductionmentioning

confidence: 99%

Acoustic emissions and kinematic instability of the osteoarthritic knee joint: comparison with radiographic findings

Nevalainen

Veikkola

Thevenot

et al. 2021

Sci Rep

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To evaluate the acoustic emissions (AE) and kinematic instability (KI) of the osteoarthritic (OA) knee joints, and to compare these signals to radiographic findings. Sixty-six female and 43 male participants aged 44–67 were recruited. On radiography, joint-space narrowing, osteophytes and Kellgren–Lawrence (KL) grade were evaluated. Based on radiography, 54 subjects (the study group) were diagnosed with radiographic OA (KL-grade ≥ 2) while the remaining 55 subjects (KL-grade < 2) formed the control group. AE and KI were recorded with a custom-made prototype and compared with radiographic findings using area-under-curve (AUC) and independent T-test. Predictive logistic regression models were constructed using leave-one-out cross validation. In females, the parameters reflecting consistency of the AE patterns during specific tasks, KI, BMI and age had a significant statistical difference between the OA and control groups (p = 0.001–0.036). The selected AE signals, KI, age and BMI were used to construct a predictive model for radiographic OA with AUC of 90.3% (95% CI 83.5–97.2%) which showed a statistical improvement of the reference model based on age and BMI, with AUC of 84.2% (95% CI 74.8–93.6%). In males, the predictive model failed to improve the reference model. AE and KI provide complementary information to detect radiographic knee OA in females.

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Objective parameters to measure (in)stability of the knee joint during gait: A review of literature

Cited by 12 publications

References 103 publications

Effect of Different Knee Braces in ACL-Deficient Patients

Effect of Different Knee Braces in ACL-Deficient Patients

Why, When, and in Which Patients Nonoperative Treatment of Anterior Cruciate Ligament Injury Fails: An Exploratory Analysis of the COMPARE Trial

Acoustic emissions and kinematic instability of the osteoarthritic knee joint: comparison with radiographic findings

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