Synovial fluid concentrations of matrix Metalloproteinase-3 and Interluekin-6 following anterior cruciate ligament injury associate with gait biomechanics 6 months following reconstruction

Evans‐Pickett, Alyssa; Longobardi, Lara; Spang, Jeffery T.; Creighton, R. Alexander; Kamath, Gurudutt M; Davis-Wilson, Hope; Loeser, Richard F.; Blackburn, J. Troy; Pietrosimone, Brian

doi:10.1016/j.joca.2021.03.014

Cited by 18 publications

(18 citation statements)

References 48 publications

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“…A previous study (20) demonstrated a moderate effect (0.61BW × Height; d = 0.65) for the largest magnitude differences in KFM waveforms between individuals after ACLR with low and high concentrations of inflammatory cytokines throughout stance using the functional waveform gait analysis. We utilized parameters consistent with previously published literature (20–22) to define the calculation of mean differences between the groups and variability estimates across the waveform using five gait trials from each participant.…”

Section: Methodsmentioning

confidence: 89%

“…Joint moments were reported as external moments and normalized to the product of body weight (in newtons) and height (in meters). Data during the stance phase of walking were time normalized to 101 data points before analysis (20,22).…”

Section: Methodsmentioning

confidence: 99%

“…Statistical analyses: Gait analyses. We performed functional waveform gait analyses (20,22,32) to evaluate planned comparisons between 1) ACLR-T1ρ High and ACLR-T1ρ Low , 2) ACLR-T1ρ High and uninjured controls, and 3) T1ρ Low and uninjured controls. The functional waveform gait analysis allows for the detection of between-group differences throughout stance for biomechanical outcomes of interest.…”

Section: Methodsmentioning

confidence: 99%

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Worse Tibiofemoral Cartilage Composition Is Associated with Insufficient Gait Kinetics After ACL Reconstruction

Evans‐Pickett

Lisee

Horton

et al. 2022

Medicine &Amp; Science in Sports &Amp; Exercise

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Purpose: Greater articular cartilage T1ρ magnetic resonance imaging relaxation times indicate less proteoglycan density and are linked to posttraumatic osteoarthritis development after anterior cruciate ligament reconstruction (ACLR). Although changes in T1ρ relaxation times are associated with gait biomechanics, it is unclear if excessive or insufficient knee joint loading is linked to greater T1ρ relaxation times 12 months post-ACLR. The purpose of this study was to compare external knee adduction (KAM) and flexion (KFM) moments in individuals after ACLR with high versus low tibiofemoral T1ρ relaxation profiles and uninjured controls. Methods: Gait biomechanics were collected in 26 uninjured controls (50% females; age, 22 ± 4 yr; body mass index, 23.9 ± 2.8 kg•m −2 ) and 26 individuals after ACLR (50% females; age, 22 ± 4 yr; body mass index, 24.2 ± 3.5 kg•m −2 ) at 6 and 12 months post-ACLR. ACLR-T1ρ High (n = 9) and ACLR-T1ρ Low (n = 17) groups were created based on 12-month post-ACLR T1ρ relaxation times using a k-means cluster analysis. Functional analyses of variance were used to compare KAM and KFM. Results: ACLR-T1ρ High exhibited lesser KAM than ACLR-T1ρ Low and uninjured controls 6 months post-ACLR. ACLR-T1ρ Low exhibited greater KAM than uninjured controls 6 and 12 months post-ACLR. KAM increased in ACLR-T1ρ High and decreased in ACLR-T1ρ Low between 6 and 12 months, both groups becoming more similar to uninjured controls. There were scant differences in KFM between ACLR-T1ρ High and ACLR-T1ρ Low 6 or 12 months post-ACLR, but both groups demonstrated lesser KFM compared with uninjured controls. Conclusions: Associations between worse T1ρ profiles and increases in KAM may be driven by the normalization of KAM in individuals who initially exhibit insufficient KAM 6 months post-ACLR.

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Section: Methodsmentioning

confidence: 89%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Worse Tibiofemoral Cartilage Composition Is Associated with Insufficient Gait Kinetics After ACL Reconstruction

Evans‐Pickett

Lisee

Horton

et al. 2022

Medicine &Amp; Science in Sports &Amp; Exercise

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“…Functional waveform gait analysis. Functional waveform analyses were conducted to allow for the evaluation of gait differences or relationships at multiple portions of stance using a single analysis (11,31,32). Previous studies have demonstrated that individuals after ACLR demonstrate differences in gait biomechanics compared with uninjured controls over multiple portions of stance (11).…”

Section: Methodsmentioning

confidence: 99%

Linking Gait Biomechanics and Daily Steps After ACL Reconstruction

Lisee

Davis-Wilson

Evans‐Pickett

et al. 2022

Medicine &Amp; Science in Sports &Amp; Exercise

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Purpose: Aberrant biomechanics and altered loading frequency are associated with poor knee joint health in osteoarthritis development. After anterior cruciate ligament reconstruction (ACLR), individuals demonstrate underloading (lesser vertical ground reaction force (vGRF)) with stiffened knee gait biomechanics (lesser knee extension moment (KEM) and knee flexion angle) and take fewer daily steps as early as 6 months after surgery. The purpose of this cross-sectional laboratory study is to compare gait biomechanics throughout stance between individuals 6-12 months after ACLR who take the lowest, moderate, and highest daily steps. Methods: Individuals with primary, unilateral history of ACLR between the ages of 16 and 35 yr were included (n = 36, 47% females; age, 21 ± 5 yr; months since ACLR, 8 ± 2). Barefoot gait biomechanics of vGRF (body weight), KEM (body weight Â height), and knee flexion angle during stance were collected and time normalized. Average daily steps were collected via a waist-mounted accelerometer in free-living settings over 7 d. Participants were separated into tertiles based on lowest daily steps (3326-6042 daily steps), moderate (6043-8198 daily steps), and highest (8199-12,680 daily steps). Biomechanical outcomes of the ACLR limb during stance were compared between daily step groups using functional waveform gait analyses. Results: There were no significant differences in sex, body mass index, age, or gait speed between daily step groups. Individuals with the lowest daily steps walk with lesser vGRF and lesser KEM during weight acceptance, and lesser knee flexion angle throughout stance in the ACLR limb compared with individuals with highest and moderate daily steps. Conclusions: After ACLR, individuals who take the fewest daily steps also walk with lesser vGRF during weight acceptance and a stiffened knee strategy throughout stance. These results highlight complex interactions between joint loading parameters after ACLR.

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“…Besides, the level of inflammatory cytokines (IL-1) in the synovial fluid taken intra-operatively was associated with higher pain score and anterior knee laxity as well as lower functional outcome and return to sports in patients undergoing ACLR at 1-year follow-up ( Gupta et al, 2021 ). In addition, high concentration of IL-1 and MMP-3 in the synovial fluid early post-ACL injury was also associated with aberrant gait biomechanics in the injured limb at 6 months post-ACLR ( Evans-Pickett et al, 2021b ). In another clinical study, patients failing to meet the Knee Injury and Osteoarthritis Outcome Score (KOOS QoL) Patient Acceptable Symptom State (PASS) threshold and the International Knee Documentation Committee scores (IKDC) PASS threshold 2 years post-ACLR had significantly higher pre-operative concentrations of inflammatory cytokines and matrix remodeling enzyme in the synovial fluid ( Lattermann et al, 2018 ).…”

Section: Role Of Inflammation In Influencing Healing Responsementioning

confidence: 99%

Tackling the Challenges of Graft Healing After Anterior Cruciate Ligament Reconstruction—Thinking From the Endpoint

Yao

Yung

Lui

2021

Front. Bioeng. Biotechnol.

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Anterior cruciate ligament (ACL) tear is common in sports and accidents, and accounts for over 50% of all knee injuries. ACL reconstruction (ACLR) is commonly indicated to restore the knee stability, prevent anterior–posterior translation, and reduce the risk of developing post-traumatic osteoarthritis. However, the outcome of biological graft healing is not satisfactory with graft failure after ACLR. Tendon graft-to-bone tunnel healing and graft mid-substance remodeling are two key challenges of biological graft healing after ACLR. Mounting evidence supports excessive inflammation due to ACL injury and ACLR, and tendon graft-to-bone tunnel motion negatively influences these two key processes. To tackle the problem of biological graft healing, we believe that an inductive approach should be adopted, starting from the endpoint that we expected after ACLR, even though the results may not be achievable at present, followed by developing clinically practical strategies to achieve this ultimate goal. We believe that mineralization of tunnel graft and ligamentization of graft mid-substance to restore the ultrastructure and anatomy of the original ACL are the ultimate targets of ACLR. Hence, strategies that are osteoinductive, angiogenic, or anti-inflammatory should drive graft healing toward the targets. This paper reviews pre-clinical and clinical literature supporting this claim and the role of inflammation in negatively influencing graft healing. The practical considerations when developing a biological therapy to promote ACLR for future clinical translation are also discussed.

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Synovial fluid concentrations of matrix Metalloproteinase-3 and Interluekin-6 following anterior cruciate ligament injury associate with gait biomechanics 6 months following reconstruction

Cited by 18 publications

References 48 publications

Worse Tibiofemoral Cartilage Composition Is Associated with Insufficient Gait Kinetics After ACL Reconstruction

Worse Tibiofemoral Cartilage Composition Is Associated with Insufficient Gait Kinetics After ACL Reconstruction

Linking Gait Biomechanics and Daily Steps After ACL Reconstruction

Tackling the Challenges of Graft Healing After Anterior Cruciate Ligament Reconstruction—Thinking From the Endpoint

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