Association of tibial acceleration during walking to pain and impact loading in adults with knee osteoarthritis

Osteoarthritis year in review 2024: Biomechanics

OBJECTIVE

We aimed to systematically review and summarize the literature of the past year on osteoarthritis (OA) and biomechanics, to highlight gaps and challenges, and to present some promising approaches and developments.

METHODS

A systematic literature search was conducted using Pubmed and the Web of Science Core Collection. We included original articles and systematic reviews on OA and biomechanics in human subjects published between April 2023 and April 2024.

RESULTS

Of the 155 studies that met the inclusion criteria, 9 were systematic reviews and 146 were original (mostly cross-sectional) studies that included a total of 6488 patients and 1921 controls with a mean age of 57.5 and 44.7 years, respectively. Promising advances have been made in medical imaging of affected soft tissue structures, the relationship between soft tissue properties and biomechanical changes in OA, new technologies to facilitate easier assessment of ambulatory biomechanics, and personalized physics-based models that also include complex chemical and mechanobiological mechanisms, all of which are relevant to gaining mechanistic insights into the pathophysiology of OA.

CONCLUSIONS

There is still an unmet need for larger longitudinal data sets that combine clinical, radiological, and biomechanical outcomes to characterize the biomechanical fingerprint that underlies the trajectory of functional decline and biomechanical phenotypes of OA. In addition, criteria and guidelines for control groups, as well as methods and standards for model verification allowing for comparisons between studies are needed.

Peak tibial axial acceleration during walking is related to intact-side lower limb pain in persons with unilateral transtibial amputation

BACKGROUND

Persons who undergo unilateral transtibial amputation are at an increased risk of secondary musculoskeletal joint pain and degeneration, which has been linked to excessive loading rates of the intact-side limb. Tibial axial acceleration, a feasible measure of loading rates with wearable sensors, would be clinically useful to relate to joint pain in persons with unilateral transtibial amputation.

RESEARCH QUESTION

What is the relationship between peak tibial axial accelerations and intact-side joint pain in persons with unilateral transtibial amputation during walking?

METHODS

Persons with unilateral transtibial amputation (n = 51) were separated into two groups based on the presence of intact-side limb pain (with pain: n = 16; without pain: n = 35). Tibial axial accelerations were measured with bilateral shank-mounted IMUs while participants completed three 10-meter walk tests. Peak tibial axial accelerations for each limb and between-limb symmetry were compared between groups using analysis of co-variance; significance was set at 0.05.

RESULTS

Between persons with vs. without intact-side limb pain, peak tibial axial accelerations were smaller on the prosthetic side (0.64 vs. 0.81 g; p = 0.04), similar on the intact side (0.82 vs. 0.79 g; p = 0.53), and more asymmetrical between sides (intact > prosthetic) (0.81 vs. 1.03 g; p = 0.01).

SIGNIFICANCE

Symmetry in peak tibial axial acceleration can assist with identifying preferential limb loading during walking and, with future research, could serve as a useful clinical target for intact-side limb unloading strategies to help mitigate secondary musculoskeletal pain in persons with unilateral transtibial amputation.