Perspectives: A biomechanical model of the pathogenesis of arthroses

Frost, Harold M.

doi:10.1002/ar.1092400103

Cited by 57 publications

(18 citation statements)

References 95 publications

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“…We hypothesise that this might occur due to increased reliance on upper limbs for daily activities such as getting out of chairs and cars, or using stairs (requiring use of rails) in people who have lost leg muscle strength. This would seem consistent with existing theoretical frameworks, including biomechanical interrelationships 23,24 , which might be a consequence of abnormal joint loading 25,26 , or altered lifting patterns 18 .…”

Section: Discussionsupporting

confidence: 89%

Knee Pain Predicts Subsequent Shoulder Pain and the Association Is Mediated by Leg Weakness: Longitudinal Observational Data from the Osteoarthritis Initiative

Laslett

Otáhal²,

Hensor³

et al. 2016

J Rheumatol

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Objective: To assess whether the 'spread' of joint pain is related to pain-associated muscle loss in one joint leading to increased loading and subsequent pain in other joints. Methods:Associations between persistent knee pain (pain in one or two knees over years 0-3 versus no persistent pain) and incident shoulder pain at year 4 were examined in participants from the longitudinal NIH Osteoarthritis Initiative (OAI).Associations were assessed using log multinomial modelling, adjusted for age, sex, BMI, depression score, other lower limb pain and baseline leg weakness (difficulty standing from a sitting position). Results:In older adults with clinically significant knee OA or at risk of knee OA (n=3486), the number of painful joints increased yearly, from 2.1 joints (95% CI 2.0, 2.2) at baseline increasing by 5.2% (95% CI 2.2%, 8.3%) at year 4. Shoulders were the next most commonly affected joint after knees (28.5%). Persistent pain in 1 or 2 knees increased risk of bilateral shoulder pain at year 4 (1 knee RR 1.59 (95% CI 0.97, 2.61); 2 knees RR 2.02 (1.17, 3.49)) after adjustment for confounders. Further adjustment for leg weakness attenuated effect sizes (1 knee RR 1.13 (95% CI 0.60, Page 2 2.11); 2 knees RR 1.44 (0.75, 2.77)), indicating mediation by functional leg weakness. Conclusions:Spread of joint pain is not random. Persistently painful knees predict new bilateral shoulder pain, which is likely mediated by leg weakness; suggesting that biomechanical factors influence the spread of pain.

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Section: Discussionsupporting

confidence: 89%

Knee Pain Predicts Subsequent Shoulder Pain and the Association Is Mediated by Leg Weakness: Longitudinal Observational Data from the Osteoarthritis Initiative

Laslett

Otáhal²,

Hensor³

et al. 2016

J Rheumatol

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“…Local biochemical and metabolic differences within the same tibial plateau can be found [24,26]. We also realize that mice, although they are adult, still have open epiphyses and may have a higher capacity to repair [36]; therefore, they may have a pathogenesis that is different from that seen in humans. The mice do, however, develop OAlike changes.…”

Section: Discussionmentioning

confidence: 91%

The relation between cartilage damage and osteophyte size in a murine model for osteoarthritis in the knee

et al. 1996

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The aim of this study was to investigate the relationship between location and size of osteophytes and cartilage loss in an instability-induced experimental model for osteoarthritis. Osteoarthritis was induced in murine knee joints by injection of highly purified bacterial collagenase, causing joint instability. The size of the osteophytes and the cartilage loss were measured at different locations in the joint using image analysis on histological sections of total kees. Cartilage damage did not occur without osteophytes. Osteophytes were located on both medial and lateral sides, independent of the location of cartilage damage, but the size of the osteophytes was related to the amount of cartilage damage on the corresponding side. Cartilage loss on the lateral tibial plateau correlated well with the size of lateral osteophytes, in particular with the osteophyte at the margin of the lateral tibial plateau. Cartilage loss on the medial tibial plateau appeared to have a good correlation with the size of medial osteophytes, which was most pronounced for the osteophyte on the medial margin of the tibial plateau. This side-specific correlation between cartilage damage and osteophyte formation suggests compartmentalization of the osteoarthritic process.

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“…Increased loads on medial compartment of the knee are related to the development and progression of knee OA [5]. Loads on the medial compartment of the knee are 2.5 times greater than those on the lateral compartment of the knee, and patients with knee OA have more frequent involvement in the medial compartment of the joint [6].…”

Section: Introductionmentioning

confidence: 99%

Effects of Arch Support Insoles on Gait Patterns of Patients with Knee Osteoarthritis

Lou

Chen

2015

J. Med. Biol. Eng.

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Although arch support orthotics are prescribed for knee osteoarthritis (OA) patients in clinics, the biomechanical effects of such devices are not fully clear. This study conducts an experimental investigation to evaluate the short-term effects of shoes with arch support insoles on the gait patterns of patients with knee OA during level walking. Twelve adults with knee OA were recruited, and biomechanical data were measured under three test conditions: walking barefoot, walking in shoes, and walking in shoes and insoles. Participants' gait patterns were recorded and analyzed using a motion analysis system, Kistler force plates, and EVaRT software. Walking in shoes with insoles significantly increased the peak knee flexion angle and the peak dorsiflexion and external rotation angles of the ankle, but reduced the peak ankle internal rotation angle compared to those for walking barefoot. Both walking in shoes with insoles and walking in shoes significantly reduced the toe-out angle compared to that for walking barefoot. However, no significant difference was observed in the peak knee varus moment. The results suggest that the foot insoles and shoes tested in this study might have influenced the ankle joint in OA patients. In view of the significantly decreased toe-out angle of the foot and increasing trend in the knee varus moment, the use of shoes with insoles may be unsuitable for knee OA patients.

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Perspectives: A biomechanical model of the pathogenesis of arthroses

Cited by 57 publications

References 95 publications

Knee Pain Predicts Subsequent Shoulder Pain and the Association Is Mediated by Leg Weakness: Longitudinal Observational Data from the Osteoarthritis Initiative

Knee Pain Predicts Subsequent Shoulder Pain and the Association Is Mediated by Leg Weakness: Longitudinal Observational Data from the Osteoarthritis Initiative

The relation between cartilage damage and osteophyte size in a murine model for osteoarthritis in the knee

Effects of Arch Support Insoles on Gait Patterns of Patients with Knee Osteoarthritis

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