Patient-oriented and performance-based outcomes after knee autologous chondrocyte implantation: a timeline for the first year of recovery

Effects of exercise mode in knee cartilage thickness

BACKGROUND

It is unclear how cycling and running would differ in terms of changes in cartilage thickness. Also, given squats are a popular type of exercise used to strengthen lower limbs, it is critical to assess if loads used during resisted training could lead to changes in cartilage cushioning properties. Therefore, the purpose of this study was to compare the effects of exercise mode in knee cartilage thickness.

METHODS

This study utilized a randomized cross-over design with repeated measures. All sessions were completed between 48hrs and seven days, at the same time of the day. Fourteen (seven males and seven females) apparently healthy participants without musculoskeletal or neurological diseases volunteered for the study. Participants were assessed after squats and functional exercises (n = 18 knees) or after running and cycling (n = 10 knees). All ultrasound images were collected at participants' arrival in the laboratory (Baseline), after warm-up (Pre-exercise), after the completion of each exercise protocol (Post-exercise), and at five (5-min) and 10 minutes (10-min) after exercise.

RESULTS

Cartilage thickness did not change after squats performed with 60% of 1-RM or after a set of three functional exercises (i.e. sit-to-stand, lunges, and step-ups; p = 0.68). However, longer duration exercises (i.e. cycling and running) led to increases in cartilage thickness after 5-min from the completion of the exercise (p = 0.02).

CONCLUSION

Knee cartilage may have capacity to sustain short-term cyclical loads applied during exercise (i.e. squats and functional exercises) but not to moderate duration exercises (i.e. cycling and running).

Knee Pain and Mobility Impairments: Meniscal and Articular Cartilage Lesions Revision 2018

The Orthopaedic Section of the American Physical Therapy Association (APTA) has an ongoing effort to create evidence-based practice guidelines for orthopaedic physical therapy management of patients with musculoskeletal impairments described in the World Health Organization's International Classification of Functioning, Disability, and Health (ICF). The purpose of these revised clinical practice guidelines is to review recent peer-reviewed literature and make recommendations related to meniscus and articular cartilage lesions. J Orthop Sports Phys Ther. 2018;48(2):A1-A50. doi:10.2519/jospt.2018.0301.

The immediate effect of patellar tendon strap on weight-bearing asymmetry during squatting in patients with unilateral knee osteoarthritis: A pilot study

BACKGROUND

Knee osteoarthritis has commonly been associated with a symptom of pain resulting in an inter-limb weight-bearing asymmetry during functional tasks. Patellar tendon strap is one of the non-pharmacologic interventions to alleviate knee pain.

OBJECTIVES

To investigate the immediate effect of a patellar tendon strap on weight-bearing asymmetry during squatting in people with unilateral knee osteoarthritis.

STUDY DESIGN

Cross-sectional study.

METHODS

Ten patients with unilateral knee osteoarthritis and 10 healthy subjects were included in the study. Weight-bearing asymmetry of patients was assessed using a weight-bearing squat test during squatting at 30° and 60° both with and without patellar tendon strap. Pain intensity was assessed during squatting in unstrapped and strapped conditions with Visual Analog Scale.

RESULTS

The decrease in weight-bearing asymmetry values immediately after wearing patellar tendon strap during 30° (p = 0.006) and 60° (p = 0.011) of squatting tests was significantly higher in knee osteoarthritis patients than in healthy subjects. Reported pain intensity was similar in unstrapped and strapped conditions (p = 0.066).

CONCLUSION

The results of this study showed improved inter-limb weight-bearing symmetry during squatting. Further research with larger sample sizes investigating the effect of patellar tendon strap on weight-bearing asymmetry during functional activities in people with knee osteoarthritis is warranted.

CLINICAL RELEVANCE

Patellar tendon straps (easily fit and cheap unlike knee braces) had more improvements in inter-limb weight-bearing symmetry during squatting in people with knee osteoarthritis compared to healthy subjects. This study is a new insight for future studies to investigate clinical benefits of wearing patellar tendon straps in this population.