articular cartilage

Effects of Transcutaneous Electrical Nerve Stimulation on Gait Kinetics in Individuals with Experimentally Induced Knee Joint Pain

Background: Knee joint pain (KJP) independently alters motor function and gait mechanics, and these alterations may accelerate chronic knee joint disease. While TENS restores motor function deficits, it is unclear whether TENS restores compensatory gait mechanics. The purpose was to examine the effects of KJP on lower-extremity joint moments, and the effects of TENS on the aforementioned variables. We hypothesized that KJP will result in altered gait patterns, and TENS will help restore these mechanical alterations. Methods: We randomly selected 15 subjects for the TENS group, after which subjects were matched for the placebo group. Subjects underwent 3 sessions (hypertonic, isotonic, control). A 20-gauge flexible catheter was inserted into the right infrapatellar fat pad, and an infusion pump infused a saline of 0.154 mL•min¯¹ for 50 min (total = 7.7 mL). A TENS protocol was set at a biphasic mode with 120 µs and 180 Hz for 20 min. To blind placebo treatment, subjects in the placebo group was told that an electrical stimulation had been set to sub-sensory level. High-speed video (240 Hz) and an instrumented treadmill (1200 Hz) were used for gait analysis. Functional analysis of variance were used to evaluate differences between groups over time for joint moments. The mean curve with 95% CIs is represented by polynomial functions, showing us the entire stance, rather than identifying discrete peak points. If 95% CIs did not cross zero, significant difference existed (P < 0.05). Discussion: KJP independently increase internal knee varus moments, which were consistent with previous finding using patients with osteoarthritic knee pain. These compensatory gait patterns may be a result of a pain-avoidance motor deficits strategies. Since observed patterns can create altered mechanical and biological stress patterns on articular surface, it may increase the risk of degenerative knee disease. However, attempting to reduce perceived pain and increase neuron activation through TENS can help overcome deficits in knee and hip joint moments.
Listed In: Biomechanics, Gait, Sports Science

Novel Synthetic Biolubricant Reduces Friction in Previously-Worn Cartilage Evaluated by Long-Duration Torsional Friction Test

During osteoarthritis (OA), the lubricity of synovial fluid (SF) decreases. Therefore, we synthesized a novel, 2MDa polymer biolubricant (“2M TEG”) designed to augment the lubricating properties of SF in OA. This study’s aims were 1) to compare the abilities of 2M TEG and bovine synovial fluid (BSF) to reduce the coefficient of friction (COF) for previously “worn” cartilage specimens during a long-duration, torsional, wear test, and 2) using the same regimen, examine the “reversibility” of 2M TEG’s lubricity relative to BSF. For both aims, each wear test consisted of subjecting mated, bovine osteochondral plug pairs to 10,080 rotations. To accomplish Aim 1, plug pairs were subjected to three sequential wear regimens (Wear 1-3). Wear 1&2 were used to progressively “wear” the cartilage, and Wear 3 was used to test the efficacy of either BSF (n=4) or 2M TEG (n=4) on “worn” cartilage. For Aim 2, three pairs were subjected to four sequential wear regimens, where the lubricants were BSF, BSF, 2M TEG, and BSF, respectively. The relative percent reduction in COF between Wear 3 and Wear 2 in Aim 1 was greatest for 2M TEG, followed by BSF. For Aim 2, the mean percent reduction in COF for Wear 3 relative to Wear 2 was almost exactly the same as the mean increase in COF for Wear 4 relative to Wear 3. By reducing the COF for worn cartilage in OA joints, synthetic biolubricants such as 2M TEG could help minimize further cartilage wear and ameliorate the progression of OA.
Listed In: Biomechanical Engineering, Biomechanics, Biotribology, Orthopedic Research

Biochemical markers of type II collagen degradation and synthesis are not associated with biomechanical variables in patients following ACL reconstruction.

This study investigated the association of serum C-propeptide (sCPII), urinary CTX-II (uCTX-II), and uCTX-II:sCPII with peak vertical ground reaction force (PVGRF) and quadriceps strength during jump-landing in patients with ACL reconstruction (ACLR). METHODS: twenty two patients with ACLR (Male=14, age=19.6 ± 4 yr) were tested 20 weeks after the surgery. Blood and urine samples were collected. sCPII and uCTX-II, biomarkers of articular degradation and synthesis respectively, were analyze using commercial ELISAs. Subjects performed 3 trials of a forward drop land and a drop vertical jump. Subjects started on a 20 cm step and landed on a force platform (AMTI). PVGRF was analyzed on the surgical side. Quadriceps strength (PKET) was assessed with an isokinetic dynamometer (60°/s). PVGRF and PKET were normalized to body weight (BW). Pearson’s correlation, with and without adjustment for age, was used to analyze associations among variables. RESULTS: Mean (± SD) log concentrations were 2.88 ± 0.19 and 3.32 ± 0.49 ng/mmol for sCPII and uCTX-II respectively; and for uCTXII:CPII was 1.16 ± 0.18. PVGRF was 3.2 BW ± 0.3 and 1.4 BW ± 0.3 for the forward drop land and drop vertical jump tasks, respectively; PKET was 0.92 BW ± 0.2. There were no significant correlations among variables (p≥0.2), except for a trend towards a positive correlation between PKET and uCTXII:sCPII (r = 406, p = .076). CONCLUSSIONS: Biomarkers of type II collagen metabolism were not associated with jump-landing forces. However, higher quadriceps strength may be associated with a shift in articular cartilage metabolism towards degradation.

Listed In: Biomechanics, Orthopedic Research, Physical Therapy, Sports Science