Proprioception and Mechanoreceptors in Osteoarthritis: A Systematic Literature Review

Abstract

Purpose: Osteoarthritis (OA) is one of the most common chronic diseases in the world. It is frequently accompanied by high levels of persistent pain, as well as substantial impairments in function and functional capacity. This review aims to systematically analyze the changes in proprioception and related mechanoreceptors in OA patients. Methods: Studies from September 2013 to September 2023 were identified by conducting searches on the PubMed, Web of Science, and Scopus electronic databases following the PRISMA statement. One reviewer independently assessed and screened the literature, extracted the data, and graded the studies. The body of evidence underwent an evaluation and grading process using the ROBINS-I tool, which was specifically designed to assess the risk of bias in non-randomized studies of interventions. Results were summarized using descriptive methods. Results: A search through 37 studies yielded 14 clinical studies that were ultimately included. The primary focus of the studies was on the knee joint, particularly the posterior cruciate ligament (PCL). The studies found that PCL in OA patients had impaired proprioceptive accuracy, possibly due to changes in mechanoreceptors (Ruffini, Pacini, and Golgi Mazzoni corpuscles). This suggests that dysfunctional articular mechanoreceptors, especially in severe cases of OA, may contribute to reduced proprioception. Dynamic stabilometry also identified significant proprioceptive deficits in patients with knee articular cartilage lesions, underscoring the impact of such lesions on knee proprioception. Conclusions: Literature data have shown that proprioceptive accuracy may play an important role in OA, particularly in the knee PCL and cartilage. However, the role of proprioception and related mechanoreceptors needs to be further clarified. Future studies focusing on the relationship between proprioception, OA disease, and symptoms, considering age and gender differences, and exploring OA joints other than the knee should be conducted to improve clinical and surgical outcomes in cases where proprioception and mechanoreceptors are impaired in OA patients.

Knee osteoarthritis patients assessed during walking for ankle inversion movement discrimination sensitivity

“…Although previous studies have found no significant correlation in proprioception scores between the ankle and knee joins ( Han et al, 2013a ; Han et al, 2013b ), the ankle proprioception impairment detected in the KOA cohort may be ascribed to a central mechanism resulting from KOA. Research has suggested that KOA may cause loss of mechanoreceptors, e.g., Golgi corpuscles, Ruffini corpuscles, and fusimotor hyperactivity abnormally induced by nociceptive stimulation, which contribute to peripheral impairments on joint position sense and movement sense in the affected knee joint ( Salamanna et al, 2023 ). No recent ankle injury history or ankle OA existed in the recruited KOA cohort in this study, indicating a possible altered central processing on neuromuscular control in the lower limb may exist in the KOA cohort.…”

“…First, most of the studies have focused on proprioception at the knee only, so little is known about the proprioceptive acuity of other lower limb joints, such as the ankle, or about their role during normal function ( Salamanna et al, 2023 ). Although it seems logical to investigate the capability of the “affected” joint, i.e., the knee, to achieve successful movement control in normal function, the brain has to integrate proprioceptive information from multiple joints in the kinetic chain ( Han et al, 2016a ).…”

“…However, a recent large-sample, prospective investigation based in an Asian community suggested that muscle strength was not associated with fear of falling ( Mat et al, 2020 ), signifying the need of further investigations regarding the characteristics of neuromuscular control during walking, as this remains the most common functional activity where fall accidents occur ( Promsri et al, 2023 ). To date, a gender difference on lower limb proprioception has been investigated in healthy cohorts, and some clinical populations ( Karkousha, 2016 ; Lu et al, 2022 ; Shi et al, 2023a ), yet not in KOA ( Salamanna et al, 2023 ). It remains unclear whether ankle proprioception during walking could be affected to different degrees in female and male patients with KOA.…”

Balancing act: Unraveling the link between muscle strength, proprioception, and stability in unilateral hip osteoarthritis

“…Osteoarthritis (OA) of the hip is a prevalent degenerative joint disease that significantly impacts the musculoskeletal system, leading to pain, disability, and a diminished quality of life [1,2]. The pathophysiology of hip OA involves not only the cartilaginous wear and changes in bone structure but also extends to muscular weakness, proprioceptive deficits, and balance impairments [3,4]. These factors contribute to the complexity of the condition and the challenge it poses to clinical management [4].…”

“…The pathophysiology of hip OA involves not only the cartilaginous wear and changes in bone structure but also extends to muscular weakness, proprioceptive deficits, and balance impairments [3,4]. These factors contribute to the complexity of the condition and the challenge it poses to clinical management [4].…”