Higher knee contact forces might underlie increased osteoarthritis rates in high functioning amputees: A pilot study

Autor: Alexander N. Bennett, Hannah L. Jarvis, Ziyun Ding, Richard Baker, Anthony M. J. Bull
Přispěvatelé: The Royal British Legion
Rok vydání: 2020
Předmět:
Male
SYMMETRY
1106 Human Movement and Sports Sciences
Pilot Projects
02 engineering and technology
Osteoarthritis
Electromyography
STANCE
0302 clinical medicine
0903 Biomedical Engineering
STRENGTH
Medicine
Orthopedics and Sports Medicine
Gait
medicine.diagnostic_test
Biomechanics
Osteoarthritis
Knee
Joint contact
Biomechanical Phenomena
Military Personnel
ADJUSTMENTS
Female
Life Sciences & Biomedicine
WALKING
Adult
Risk
medicine.medical_specialty
JOINT CONTACT
THIGH MUSCLES
0206 medical engineering
Artificial Limbs
High functioning
Amputation
Surgical
knee osteoarthritis
Contact force
Young Adult
03 medical and health sciences
Physical medicine and rehabilitation
Amputees
CARTILAGE
unilateral transtibial amputee
Humans
Knee
musculoskeletal modeling
LOAD
Muscle
Skeletal
knee contact force
030203 arthritis & rheumatology
Science & Technology
business.industry
1103 Clinical Sciences
medicine.disease
020601 biomedical engineering
Orthopedics
Case-Control Studies
Gait analysis
MUSCULOSKELETAL MODEL
Stress
Mechanical
business
Zdroj: Journal of Orthopaedic Research. 39:850-860
ISSN: 1554-527X
0736-0266
DOI: 10.1002/jor.24751
Popis: © 2020 The Authors. Journal of Orthopaedic Research® published by Wiley Periodicals LLC on behalf of Orthopaedic Research Society High functioning military transtibial amputees (TTAs) with well-fitted state of the art prosthetics have gait that is indistinguishable from healthy individuals, yet they are more likely to develop knee osteoarthritis (OA) of their intact limbs. This contrasts with the information at the knees of the amputated limbs that have been shown to be at a significantly reduced risk of pain and OA. The hypothesis of this study is that biomechanics can explain the difference in knee OA risk. Eleven military unilateral TTAs and eleven matched healthy controls underwent gait analysis. Muscle forces and joint contact forces at the knee were quantified using musculoskeletal modeling, validated using electromyography measurements. Peak knee contact forces for the intact limbs on both the medial and lateral compartments were significantly greater than the healthy controls (P ≤.006). Additionally, the intact limbs had greater peak semimembranosus (P =.001) and gastrocnemius (P ≤.001) muscle forces compared to the controls. This study has for the first time provided robust evidence of increased force on the non-affected knees of high functioning TTAs that supports the mechanically based hypothesis to explain the documented higher risk of knee OA in this patient group. The results suggest several protentional strategies to mitigate knee OA of the intact limbs, which may include the improvements of the prosthetic foot control, socket design, and strengthening of the amputated muscles.
Databáze: OpenAIRE
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