Osteoarthritis year in review 2016: mechanics

Abstract

Inappropriate biomechanics, namely wear-and-tear, has been long believed to be a main cause of osteoarthritis (OA). However, this view is now being re-evaluated, especially when examined alongside mechanobiology and new biomechanical studies. These are multiscale experimental and computational studies focussing on cell- and tissue-level mechanobiology through to organ- and whole-body-level biomechanics, which focuses on the biomechanical and biochemical environment of the joint tissues. This review examined papers from April 2015 to April 2016, with a focus on multiscale experimental and computational biomechanical studies of OA. Assessing the onset or progression of OA at organ- and whole-body-levels, gait analysis, medical imaging and neuromusculoskeletal modelling revealed the extent to which tissue damage changes the view of inappropriate biomechanics. Traditional gait analyses studies reported that conservative treatments can alter joint biomechanics, thereby improving pain and function experienced by those with OA. Results of animal models of OA were consistent with these human studies, showing interactions among bone, cartilage and meniscus biomechanics and the onset and/or progression OA. Going down size scales, experimental and computational studies probed the nanosize biomechanics of molecules, cells and extracellular matrix, and demonstrated how the interactions between biomechanics and morphology affect cartilage dynamic poroelastic behaviour and pathways to OA. Finally, integration of multiscale experimental data and computational models were proposed to predict cartilage extracellular matrix remodelling and the development of OA. Summarising, experimental and computational methods provided a nuanced biomechanical understanding of the sub-cellular, cellular, tissue, organ and whole-body mechanisms involved in OA.

Gait Mechanics in Women of the ACL‐SPORTS Randomized Control Trial: Interlimb Symmetry Improves Over Time Regardless of Treatment Group

“…Women also are more likely than men to exhibit aberrant and asymmetric lower extremity movement patterns both before and after ACL injury . Aberrant and asymmetric movements may not only play a role in primary ACL injury risk, but also influence the development and progression of post‐traumatic osteoarthritis . While movement asymmetries may persist years after ACLR, little is known about the effect of post‐operative rehabilitation programs on movement patterns, particularly in women, after ACLR.…”

Computational evaluation of altered biomechanics related to articular cartilage lesions observed in vivo

“…The degeneration mechanisms in articular cartilage are complicated and comprise several factors from the abnormal joint structure to inflammation processes . Inevitably, biomechanics of the joint and loading of the tissue contribute to the degeneration process . Nevertheless, no clear consensus exists on which kind of lesions result in OA and which characteristics might be the most contributory related to further degeneration.…”

Gluteal tendinopathy and hip osteoarthritis: Different pathologies, different hip biomechanics

“…OA [21,44] given emerging evidence of an association between reduced knee joint loading and early osteoarthritis in individuals with anterior cruciate ligament reconstruction [45,46]. "…”

“…This suggests sagittal plane kinematics are particularly relevant for HOA. Lesser hip extension is thought to reduce the surface area of cartilage that is loaded during the stance phase of gait, contributing to regional overload and under-load with potential relevance for disease progression [44]. Specifically, a 2 degree increase in hip…”