Hyunwook Lee, Ashley N Buck, Cortney Armitano-Lago, Robert A Creighton, Ganesh M Kamath, Jeffrey T Spang, Xiaojuan Li, David Lalush, Jason R Franz, J Troy Blackburn, Brian Pietrosimone
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Forty-three participants with primary unilateral ACLR (17 ± 14 months post-ACLR) were categorized as high (≥ 25 kg/m<sup>2</sup>; n = 18) or normal (< 25 kg/m<sup>2</sup>; n = 25) BMI and performed an overground gait at self-selected speed. For biomechanical outcomes, we calculated the differences between first peak and midstance minimum (∆vGRF1) and between the second peak and midstance minimum (∆vGRF2). T1ρ relaxation time interlimb ratios (ILR), calculated as the T1ρ relaxation time in the ACLR relative to the uninjured limb, were calculated for the medial and lateral tibia and femur. Stepwise linear regressions were used to determine associations between biomechanical outcomes and T1ρ relaxation time ILR for each region of interest. Lesser ∆vGRF1 and ∆vGRF2 in the high-BMI group significantly associated with greater T1ρ relaxation time ILR for the medial femoral condyle (ΔR<sup>2</sup> = 0.28, p = 0.03; ΔR<sup>2</sup> = 0.25, p = 0.04, respectively) and tibial plateau (ΔR<sup>2</sup> = 0.55, p < 0.001; ΔR<sup>2</sup> = 0.25, p = 0.004, respectively). Aberrant limb-level loading, characterized by less dynamic limb loading, is linked to deleterious changes in tibiofemoral cartilage in ACLR patients with high BMI, suggesting that gait retraining may be more critical for ACLR with a BMI ≥ 25 kg/m<sup>2</sup>.</p>","PeriodicalId":16650,"journal":{"name":"Journal of Orthopaedic Research®","volume":" ","pages":""},"PeriodicalIF":2.1000,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Aberrant Gait Biomechanics Linked to Cartilage Changes After ACL Reconstruction in Those With High Body Mass Index.\",\"authors\":\"Hyunwook Lee, Ashley N Buck, Cortney Armitano-Lago, Robert A Creighton, Ganesh M Kamath, Jeffrey T Spang, Xiaojuan Li, David Lalush, Jason R Franz, J Troy Blackburn, Brian Pietrosimone\",\"doi\":\"10.1002/jor.26099\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>A history of anterior cruciate ligament reconstruction (ACLR) and high body mass index (BMI) are strong risk factors for incident knee osteoarthritis. Limited research has evaluated the interaction between ACLR and high BMI on limb-level loading and early deleterious changes in cartilage health. The purpose of this study was to separately investigate the association between vertical ground reaction force (vGRF) loading profiles during gait and tibiofemoral cartilage composition in ACLR patients with high and normal BMI. Forty-three participants with primary unilateral ACLR (17 ± 14 months post-ACLR) were categorized as high (≥ 25 kg/m<sup>2</sup>; n = 18) or normal (< 25 kg/m<sup>2</sup>; n = 25) BMI and performed an overground gait at self-selected speed. For biomechanical outcomes, we calculated the differences between first peak and midstance minimum (∆vGRF1) and between the second peak and midstance minimum (∆vGRF2). T1ρ relaxation time interlimb ratios (ILR), calculated as the T1ρ relaxation time in the ACLR relative to the uninjured limb, were calculated for the medial and lateral tibia and femur. Stepwise linear regressions were used to determine associations between biomechanical outcomes and T1ρ relaxation time ILR for each region of interest. Lesser ∆vGRF1 and ∆vGRF2 in the high-BMI group significantly associated with greater T1ρ relaxation time ILR for the medial femoral condyle (ΔR<sup>2</sup> = 0.28, p = 0.03; ΔR<sup>2</sup> = 0.25, p = 0.04, respectively) and tibial plateau (ΔR<sup>2</sup> = 0.55, p < 0.001; ΔR<sup>2</sup> = 0.25, p = 0.004, respectively). Aberrant limb-level loading, characterized by less dynamic limb loading, is linked to deleterious changes in tibiofemoral cartilage in ACLR patients with high BMI, suggesting that gait retraining may be more critical for ACLR with a BMI ≥ 25 kg/m<sup>2</sup>.</p>\",\"PeriodicalId\":16650,\"journal\":{\"name\":\"Journal of Orthopaedic Research®\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2025-05-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Orthopaedic Research®\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/jor.26099\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Orthopaedic Research®","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/jor.26099","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
摘要
前交叉韧带重建(ACLR)史和高体重指数(BMI)是发生膝骨关节炎的重要危险因素。有限的研究评估了ACLR和高BMI对肢水平负荷和软骨健康早期有害变化之间的相互作用。本研究的目的是分别研究高BMI和正常BMI的ACLR患者步态中垂直地反力(vGRF)负荷谱与胫股软骨组成之间的关系。43名原发性单侧ACLR患者(ACLR后17±14个月)被分类为高(≥25 kg/m2;N = 18)或normal (2;n = 25) BMI,并以自行选择的速度进行地面步态。对于生物力学结果,我们计算了第一个峰值和中间最小值(∆vGRF1)以及第二个峰值和中间最小值(∆vGRF2)之间的差异。计算胫骨和股骨内侧和外侧的T1ρ松弛时间相对于未损伤肢体的肢体间比(ILR),计算ACLR中T1ρ松弛时间。采用逐步线性回归来确定每个感兴趣区域的生物力学结果与T1ρ松弛时间ILR之间的关系。高bmi组较小的∆vGRF1和∆vGRF2与较大的T1ρ松弛时间显著相关(ΔR2 = 0.28, p = 0.03;ΔR2 = 0.25, p = 0.04)和胫骨高原(ΔR2 = 0.55, p 2 = 0.25, p = 0.004)。异常肢水平负荷,以较少的动态肢负荷为特征,与高BMI的ACLR患者胫骨股骨软骨的有害变化有关,这表明步态再训练可能对BMI≥25 kg/m2的ACLR更为重要。
Aberrant Gait Biomechanics Linked to Cartilage Changes After ACL Reconstruction in Those With High Body Mass Index.
A history of anterior cruciate ligament reconstruction (ACLR) and high body mass index (BMI) are strong risk factors for incident knee osteoarthritis. Limited research has evaluated the interaction between ACLR and high BMI on limb-level loading and early deleterious changes in cartilage health. The purpose of this study was to separately investigate the association between vertical ground reaction force (vGRF) loading profiles during gait and tibiofemoral cartilage composition in ACLR patients with high and normal BMI. Forty-three participants with primary unilateral ACLR (17 ± 14 months post-ACLR) were categorized as high (≥ 25 kg/m2; n = 18) or normal (< 25 kg/m2; n = 25) BMI and performed an overground gait at self-selected speed. For biomechanical outcomes, we calculated the differences between first peak and midstance minimum (∆vGRF1) and between the second peak and midstance minimum (∆vGRF2). T1ρ relaxation time interlimb ratios (ILR), calculated as the T1ρ relaxation time in the ACLR relative to the uninjured limb, were calculated for the medial and lateral tibia and femur. Stepwise linear regressions were used to determine associations between biomechanical outcomes and T1ρ relaxation time ILR for each region of interest. Lesser ∆vGRF1 and ∆vGRF2 in the high-BMI group significantly associated with greater T1ρ relaxation time ILR for the medial femoral condyle (ΔR2 = 0.28, p = 0.03; ΔR2 = 0.25, p = 0.04, respectively) and tibial plateau (ΔR2 = 0.55, p < 0.001; ΔR2 = 0.25, p = 0.004, respectively). Aberrant limb-level loading, characterized by less dynamic limb loading, is linked to deleterious changes in tibiofemoral cartilage in ACLR patients with high BMI, suggesting that gait retraining may be more critical for ACLR with a BMI ≥ 25 kg/m2.
期刊介绍:
The Journal of Orthopaedic Research is the forum for the rapid publication of high quality reports of new information on the full spectrum of orthopaedic research, including life sciences, engineering, translational, and clinical studies.