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Hori M, Terada M, Suga T, Isaka T. The effect of attending rehabilitation after traumatic knee joint injury on femoral articular cartilage morphology in collegiate rugby players with a history of intracapsular knee joint injury during two-year consecutive rugby seasons. Front Sports Act Living 2024; 5:1309938. [PMID: 38274032 PMCID: PMC10808301 DOI: 10.3389/fspor.2023.1309938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 12/14/2023] [Indexed: 01/27/2024] Open
Abstract
Introduction This present study aimed to compare ultrasonographic measures of femoral articular cartilage during two-year seasons between collegiate rugby players who have attended supervised rehabilitation following intracapsular knee joint injury and those without a history of knee injury. Methods Using a prospective observational study design, 12 male collegiate rugby players with a previous history of intracapsular knee joint injury who have received and completed supervised rehabilitation following their injury and 44 players without knee joint injury participated in this study. Ultrasonographic images were used to verify changes in femoral articular cartilage thickness and cross-sectional area (CSA) with or without a previous history of knee joint injury over two consecutive rugby seasons. Results Significant time main effects were observed for the lateral condylar thickness (p < 0.001), the intercondylar thickness (p = 0.001), the medial condylar thickness (p < 0.001), and CSA (p < 0.001). No significant interactions nor group main effects were identified for all femoral articular cartilage (p < 0.05). Conclusions Collegiate rugby players demonstrated a decrease in femoral articular cartilage thickness and CSA over two-year consecutive rugby seasons. These findings indicate that engaging in collegiate rugby induces alterations in femoral articular cartilage structure. Furthermore, there were no differences in all femoral cartilage outcome measures between rugby players with and without a previous history of traumatic knee joint injury. Therefore, attending supervised rehabilitation at the time of their knee joint injury appeared to reduce the impact of a previous history of intracapsular knee joint injury on the change in femoral articular cartilage thickness and CSA among active rugby players.
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Affiliation(s)
- Miyuki Hori
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Japan
| | - Masafumi Terada
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Japan
| | - Tadashi Suga
- Research Organization of Science and Technology, Ritsumeikan University, Kusatsu, Japan
| | - Tadao Isaka
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu, Japan
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Spierings J, Van den Hengel M, Janssen RPA, Van Rietbergen B, Ito K, Foolen J. Knee instability caused by altered graft mechanical properties after anterior cruciate ligament reconstruction: the early onset of osteoarthritis? Front Bioeng Biotechnol 2023; 11:1244954. [PMID: 37691908 PMCID: PMC10484411 DOI: 10.3389/fbioe.2023.1244954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 08/15/2023] [Indexed: 09/12/2023] Open
Abstract
Anterior cruciate ligament (ACL) rupture is a very common knee joint injury. Torn ACLs are currently reconstructed using tendon autografts. However, half of the patients develop osteoarthritis (OA) within 10 to 14 years postoperatively. Proposedly, this is caused by altered knee kine(ma)tics originating from changes in graft mechanical properties during the in vivo remodeling response. Therefore, the main aim was to use subject-specific finite element knee models and investigate the influence of decreasing graft stiffness and/or increasing graft laxity on knee kine(ma)tics and cartilage loading. In this research, 4 subject-specific knee geometries were used, and the material properties of the ACL were altered to either match currently used grafts or mimic in vivo graft remodeling, i.e., decreasing graft stiffness and/or increasing graft laxity. The results confirm that the in vivo graft remodeling process increases the knee range of motion, up to >300 percent, and relocates the cartilage contact pressures, up to 4.3 mm. The effect of remodeling-induced graft mechanical properties on knee stability exceeded that of graft mechanical properties at the time of surgery. This indicates that altered mechanical properties of ACL grafts, caused by in vivo remodeling, can initiate the early onset of osteoarthritis, as observed in many patients clinically.
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Affiliation(s)
- Janne Spierings
- Department of Biomedical Engineering, Orthopaedic Biomechanics, Eindhoven University of Technology, Eindhoven, Netherlands
- Institute of Complex Molecular Systems, Eindhoven University of Technology, Eindhoven, Netherlands
| | - Marloes Van den Hengel
- Department of Biomedical Engineering, Orthopaedic Biomechanics, Eindhoven University of Technology, Eindhoven, Netherlands
| | - Rob P. A. Janssen
- Department of Biomedical Engineering, Orthopaedic Biomechanics, Eindhoven University of Technology, Eindhoven, Netherlands
- Department of Orthopaedic Surgery and Trauma, Máxima Medical Centre Eindhoven/Veldhoven, Eindhoven, Netherlands
- Department of Paramedical Sciences, Health Innovations and Technology, Fontys University of Applied Sciences, Eindhoven, Netherlands
| | - Bert Van Rietbergen
- Department of Biomedical Engineering, Orthopaedic Biomechanics, Eindhoven University of Technology, Eindhoven, Netherlands
- Institute of Complex Molecular Systems, Eindhoven University of Technology, Eindhoven, Netherlands
| | - Keita Ito
- Department of Biomedical Engineering, Orthopaedic Biomechanics, Eindhoven University of Technology, Eindhoven, Netherlands
- Institute of Complex Molecular Systems, Eindhoven University of Technology, Eindhoven, Netherlands
| | - Jasper Foolen
- Department of Biomedical Engineering, Orthopaedic Biomechanics, Eindhoven University of Technology, Eindhoven, Netherlands
- Institute of Complex Molecular Systems, Eindhoven University of Technology, Eindhoven, Netherlands
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Xuan A, Chen H, Chen T, Li J, Lu S, Fan T, Zeng D, Wen Z, Ma J, Hunter D, Ding C, Zhu Z. The application of machine learning in early diagnosis of osteoarthritis: a narrative review. Ther Adv Musculoskelet Dis 2023; 15:1759720X231158198. [PMID: 36937823 PMCID: PMC10017946 DOI: 10.1177/1759720x231158198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 02/01/2023] [Indexed: 03/16/2023] Open
Abstract
Osteoarthritis (OA) is the commonest musculoskeletal disease worldwide, with an increasing prevalence due to aging. It causes joint pain and disability, decreased quality of life, and a huge burden on healthcare services for society. However, the current main diagnostic methods are not suitable for early diagnosing patients of OA. The use of machine learning (ML) in OA diagnosis has increased dramatically in the past few years. Hence, in this review article, we describe the research progress in the application of ML in the early diagnosis of OA, discuss the current trends and limitations of ML approaches, and propose future research priorities to apply the tools in the field of OA. Accurate ML-based predictive models with imaging techniques that are sensitive to early changes in OA ahead of the emergence of clinical features are expected to address the current dilemma. The diagnostic ability of the fusion model that combines multidimensional information makes patient-specific early diagnosis and prognosis estimation of OA possible in the future.
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Affiliation(s)
| | | | - Tianyu Chen
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Jia Li
- Division of Orthopaedic Surgery, Department of Orthopaedics, Nafang Hospital, Southern Medical University, Guangzhou, China
| | - Shilong Lu
- Department of Radiology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Tianxiang Fan
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Dong Zeng
- College of Automation Science and Engineering, South China University of Technology, Guangzhou, China
| | - Zhibo Wen
- Department of Radiology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Jianhua Ma
- School of Biomedical Engineering, Southern Medical University, Guangzhou, China
| | - David Hunter
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- Department of Rheumatology, Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney, NSW, Australia
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Daszkiewicz K, Łuczkiewicz P. Biomechanics of the medial meniscus in the osteoarthritic knee joint. PeerJ 2021; 9:e12509. [PMID: 34900428 PMCID: PMC8627128 DOI: 10.7717/peerj.12509] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 10/27/2021] [Indexed: 11/20/2022] Open
Abstract
Background Increased mechanical loading and pathological response of joint tissue to the abnormal mechanical stress can cause degradation of cartilage characteristic of knee osteoarthritis (OA). Despite osteoarthritis is risk factor for the development of meniscal lesions the mechanism of degenerative meniscal lesions is still unclear. Therefore, the aim of the study is to investigate the influence of medial compartment knee OA on the stress state and deformation of the medial meniscus. Methods The finite element method was used to simulate the stance phase of the gait cycle. An intact knee model was prepared based on magnetic resonance scans of the left knee joint of a healthy volunteer. Degenerative changes in the medial knee OA model were simulated by nonuniform reduction in articular cartilage thickness in specific areas and by a decrease in the material parameters of cartilage and menisci. Two additional models were created to separately evaluate the effect of alterations in articular cartilage geometry and material parameters of the soft tissues on the results. A nonlinear dynamic analysis was performed for standardized knee loads applied to the tibia bone. Results The maximum von Mises stress of 26.8 MPa was observed in the posterior part of the medial meniscus body in the OA model. The maximal hoop stress for the first peak of total force was 83% greater in the posterior horn and only 11% greater in the anterior horn of the medial meniscus in the OA model than in the intact model. The reduction in cartilage thickness caused an increase of 57% in medial translation of the medial meniscus body. A decrease in the compressive modulus of menisci resulted in a 2.5-fold greater reduction in the meniscal body width compared to the intact model. Conclusions Higher hoop stress levels on the inner edge of the posterior part of the medial meniscus in the OA model than in the intact model are associated with a greater medial translation of the meniscus body and a greater reduction in its width. The considerable increase in hoop stresses shows that medial knee OA may contribute to the initiation of meniscal radial tears.
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Affiliation(s)
- Karol Daszkiewicz
- Department of Mechanics of Materials and Structures, Faculty of Civil and Environmental Engineering, Gdańsk University of Technology, Gdańsk, Poland
| | - Piotr Łuczkiewicz
- II Department of Orthopaedics and Kinetic Organ Traumatology, Medical University of Gdańsk, Gdańsk, Poland
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Development of robust finite element models of porcine tibiofemoral joints loaded under varied flexion angles and tibial freedoms. J Mech Behav Biomed Mater 2020; 109:103797. [PMID: 32347215 DOI: 10.1016/j.jmbbm.2020.103797] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 03/20/2020] [Accepted: 04/12/2020] [Indexed: 11/22/2022]
Abstract
The successful development of cartilage repair treatments for the knee requires understanding of the biomechanical environment within the joint. Computational finite element models play an important role in non-invasively understanding knee mechanics, but it is important to compare model findings to experimental data. The purpose of this study was to develop a methodology for generating subject-specific finite element models of porcine tibiofemoral joints that was robust and valid over multiple different constraint scenarios. Computational model predictions of two knees were compared to experimental studies on corresponding specimens loaded under several different constraint scenarios using a custom designed experimental rig, with variations made to the femoral flexion angle and level of tibial freedom. For both in vitro specimens, changing the femoral flexion angle had a marked effect on the contact distribution observed experimentally. With the tibia fixed, the majority of the contact region shifted to the medial plateau as flexion was increased. This did not occur when the tibia was free to displace and rotate in response to applied load. These trends in contact distribution across the medial and lateral plateaus were replicated in the computational models. In an additional model with the meniscus removed, contact pressures were elevated by a similar magnitude to the increase seen when the meniscus was removed experimentally. Overall, the models were able to capture specimen-specific trends in contact distribution under a variety of different loads, providing the potential to investigate subject-specific outcomes for knee interventions.
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Trad Z, Barkaoui A, Chafra M, Tavares JMR. Finite element analysis of the effect of high tibial osteotomy correction angle on articular cartilage loading. Proc Inst Mech Eng H 2018; 232:553-564. [PMID: 29683374 DOI: 10.1177/0954411918770706] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Osteoarthritis is a globally common disease that imposes a considerable ongoing health and economic burden on the socioeconomic system. As more and more biomechanical factors have been explored, malalignment of the lower limb has been found to influence the load distribution across the articular surface of the knee joint substantially. In this work, a three-dimensional finite element analysis was carried out to investigate the effect of varying the high tibial osteotomy correction angle on the stress distribution in both compartments of the human knee joint. Thereafter, determine the optimal correction angle to achieve a balanced loading between these two compartments. The developed finite element model was validated against experimental and numerical results. The findings of this work suggest that by changing the correction angle from 0° to 10° valgus, high tibial osteotomy shifted the mechanical load from the affected medial compartment to the lateral compartment with intact cartilage. The Von Mises and the shear stresses decreased in the medial compartment and increased in the lateral compartment. Moreover, a balanced stress distribution between the two compartments as well as the desired alignment were achieved under a valgus hypercorrection of 4.5° that significantly unloads the medial compartment, loads the lateral compartment and arrests the progression of osteoarthritis. After comparing the achieved results against the ones of previous studies that explored the effects of the high tibial osteotomy correction angle on either clinical outcomes or biomechanical outcomes, one can conclude that the findings of this study agree well with the related clinical data and recommendations found in the literature.
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Affiliation(s)
- Zahra Trad
- 1 LR-11-ES19 Laboratoire de Mécanique Appliquée et Ingénierie (LR-MAI), Ecole Nationale d'Ingénieurs de Tunis, Université de Tunis El Manar, Tunis, Tunisie
| | - Abdelwahed Barkaoui
- 1 LR-11-ES19 Laboratoire de Mécanique Appliquée et Ingénierie (LR-MAI), Ecole Nationale d'Ingénieurs de Tunis, Université de Tunis El Manar, Tunis, Tunisie
| | - Moez Chafra
- 2 Laboratoire de Systèmes et de Mécanique Appliquée (LASMAP-EPT), Ecole Polytechnique de Tunisie, Université de Carthage, La Marsa, Tunisie
| | - João Manuel Rs Tavares
- 3 Instituto de Ciência e Inovação em Engenharia Mecânica e Engenharia Industrial, Departamento de Engenharia Mecânica, Faculdade de Engenharia, Universidade do Porto, Porto, Portugal
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Luczkiewicz P, Daszkiewicz K, Witkowski W, Chróścielewski J, Ferenc T, Baczkowski B. The influence of a change in the meniscus cross-sectional shape on the medio-lateral translation of the knee joint and meniscal extrusion. PLoS One 2018; 13:e0193020. [PMID: 29447236 PMCID: PMC5814050 DOI: 10.1371/journal.pone.0193020] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 02/02/2018] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE The purpose of this study was to evaluate the influence of a change in the meniscus cross sectional shape on its position and on the biomechanics of a knee joint. METHODS One main finite element model of a left knee joint was created on the basis of MRI images. The model consisted of bones, articular cartilages, menisci and ligaments. Eight variants of this model with an increased or decreased meniscus height were then prepared. Nonlinear static analyses with a fixed flexion/extension movement for a compressive load of 1000 N were performed. The additional analyses for those models with a constrained medio-lateral relative bone translation allowed for an evaluation of the influence of this translation on a meniscus external shift. RESULTS It was observed that a decrease in the meniscus height caused a decrease in the contact area, together with a decrease in the contact force between the flattened meniscus and the cartilage. For the models with an increased meniscus height, a maximal value of force acting on the meniscus in a medio-lateral direction was obtained. The results have shown that the meniscus external shift was approximately proportional to the meniscus slope angle, but that relationship was modified by a medio-lateral relative bone translation. It was found that the translation of the femur relative to the tibia may be dependent on the geometry of the menisci. CONCLUSIONS The results have suggested that a change in the meniscus geometry in the cross sectional plane can considerably affect not only the meniscal external shift, but also the medio-lateral translation of the knee joint as well as the congruency of the knee joint.
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MESH Headings
- Adult
- Biomechanical Phenomena
- Cartilage, Articular/anatomy & histology
- Cartilage, Articular/diagnostic imaging
- Cartilage, Articular/physiology
- Female
- Finite Element Analysis
- Humans
- Imaging, Three-Dimensional
- Knee Joint/anatomy & histology
- Knee Joint/diagnostic imaging
- Knee Joint/physiology
- Magnetic Resonance Imaging
- Menisci, Tibial/anatomy & histology
- Menisci, Tibial/diagnostic imaging
- Menisci, Tibial/physiology
- Models, Anatomic
- Models, Biological
- Stress, Mechanical
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Affiliation(s)
- Piotr Luczkiewicz
- II Clinic of Orthopaedics and Kinetic Organ Traumatology, Medical University of Gdansk, Gdansk, Poland
- * E-mail:
| | - Karol Daszkiewicz
- Department of Mechanics of Materials, Faculty of Civil and Environmental Engineering, Gdansk University of Technology, Gdansk, Poland
| | - Wojciech Witkowski
- Department of Mechanics of Materials, Faculty of Civil and Environmental Engineering, Gdansk University of Technology, Gdansk, Poland
| | - Jacek Chróścielewski
- Department of Mechanics of Materials, Faculty of Civil and Environmental Engineering, Gdansk University of Technology, Gdansk, Poland
| | - Tomasz Ferenc
- Department of Mechanics of Materials, Faculty of Civil and Environmental Engineering, Gdansk University of Technology, Gdansk, Poland
| | - Boguslaw Baczkowski
- II Clinic of Orthopaedics and Kinetic Organ Traumatology, Medical University of Gdansk, Gdansk, Poland
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