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Limb Underloading in Walking Transmits Less Dynamic Knee Joint Contact Forces after Anterior Cruciate Ligament Reconstruction.
Medicine & Science in Sports & Exercise ( IF 4.1 ) Pub Date : 2024-11-18 , DOI: 10.1249/mss.0000000000003607
Amanda E Munsch,Alyssa Evans-Pickett,Hope Davis-Wilson,Brian Pietrosimone,Carly M Rauch,Joshua D Roth,Jason R Franz

INTRODUCTION Individuals with anterior cruciate ligament reconstruction (ACLR) often walk with a less dynamic vertical ground reaction force (vGRF), exemplified by a reduced first peak vGRF and elevated midstance vGRF compared to uninjured controls. However, the mechanism by which altered limb loading affects actual tibial plateau contact forces during walking remains unclear. METHODS Our purpose was to use musculoskeletal simulation to evaluate the effects of first peak vertical ground reaction force (vGRF) biofeedback on bilateral tibiofemoral contact forces relevant to the development of post-traumatic osteoarthritis (OA) in 20 individuals with ACLR. We hypothesized that reduced first peak vGRF would produce less dynamic tibial plateau contact forces during walking in individuals with ACLR. RESULTS As the pivotal outcome from this study, and in support of our hypothesis, we found that less dynamic vGRF profiles in individuals with ACLR - observations that have associated in prior studies with more cartilage breakdown serum biomarkers and reduced proteoglycan density - are accompanied by less dynamic tibiofemoral joint contact forces during walking. CONCLUSION We conclude that more sustained limb-level loading, a phenotype that associates with worse knee joint health outcomes following ACLR and was prescribed herein using biofeedback, alters the loading profile and magnitude of force applied to tibiofemoral cartilage.

中文翻译:


前交叉韧带重建后,行走中的肢体负重传递的动态膝关节接触力较小。



引言 前交叉韧带重建 (ACLR) 患者通常行走时动态垂直地面反作用力 (vGRF) 较低,与未受伤的对照组相比,第一峰值 vGRF 降低和中部 vGRF 升高就是例证。然而,改变的肢体负荷影响行走过程中实际胫骨平台接触力的机制仍不清楚。方法 我们的目的是使用肌肉骨骼模拟来评估第一峰值垂直地面反作用力 (vGRF) 生物反馈对 20 例 ACLR 患者创伤后骨关节炎 (OA) 发展相关的双侧胫股骨接触力的影响。我们假设降低的第一个峰值 vGRF 会在 ACLR 个体行走时产生较少的动态胫骨平台接触力。结果作为这项研究的关键结果,并支持我们的假设,我们发现 ACLR 个体的动态 vGRF 谱较低 - 在先前的研究中与更多的软骨分解血清生物标志物和蛋白多糖密度降低相关的观察结果 - 伴随着动态的胫股关节接触力在行走时。结论 我们得出结论,更持续的肢体水平负荷,一种与 ACLR 后膝关节健康结果较差相关的表型,在本文中使用生物反馈规定,改变了施加在胫股软骨上的负荷曲线和力的大小。
更新日期:2024-11-18
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