Details

Autor(en) / Beteiligte

• Teoli, Anthony

Titel

The Impact of Loading and Physical Activity Measures on Outcomes in Patients with Knee Osteoarthritis, and Implant Survivorship in Patients Following Knee Arthroplasty

Ort / Verlag

ProQuest Dissertations & Theses

Erscheinungsjahr

2023

Link zum Volltext

• ProQuest

Quelle

ProQuest Dissertations & Theses A&I

Beschreibungen/Notizen

• Obesity, quadriceps muscle weakness and joint injury play a role in knee osteoarthritis (OA) pathogenesis through the creation of an abnormal loading environment at the knee. Better understanding these relationships can fill knowledge gaps and inform treatment strategies. Moreover, physical activity (PA) and sports participation recommendations following unicompartmental (UKA) and total knee arthroplasty (TKA) are mainly based on expert consensus. An overview of the literature on the topic is needed. Lastly, sensitivity to physical activity (SPA) is an approach to assess pain in response to PA. A better understanding of the merits and limitations of SPA measures in patients with knee OA is needed. Therefore, the goals of this thesis were: 1) to better understand how joint loading during walking relates to knee OA severity, 2), to better understand how measures of adiposity relate to knee OA severity, 3) to describe the literature examining the impact of PA level and sports participation on implant integrity and failure in patients post UKA and TKA, and 4) to evaluate the merits and limitations of SPA measures and their prognostic value in patients with knee OA. This was achieved via four manuscripts.First, a cross-sectional study examined relationships between knee joint moments during gait and tibiofemoral cartilage thickness in patients with non-traumatic (n = 22) and post-traumatic knee OA (n = 19) (Chapter 3). A higher knee adduction moment impulse was associated with a lower medial-to-lateral cartilage thickness ratio. A higher late stance knee extension moment was associated with greater medial femoral condyle cartilage thickness and medial-to-lateral cartilage thickness. These relationships differed between groups, suggesting that the influence of knee loading on articular cartilage may differ between these OA subtypes.Next, a cross-sectional study examined whether vastus medialis (VM) intramuscular fat relates to OA severity and quadriceps muscle strength in patients with non-traumatic (n = 22) and post-traumatic knee OA (n = 19) (Chapter 4). VM intramuscular fat was positively associated with body mass index, but not OA severity or group. Higher VM intramuscular fat was also associated with reduced quadriceps muscle torque. It is unclear whether this is due to VM intramuscular fat or other factors, such as diet and physical inactivity.Then, a scoping review summarized the literature examining the impact of PA level and sports participation on implant integrity and failure in patients post UKA and TKA (Chapter 5). Five databases were searched, articles were screened by two reviewers, and extracted data were summarized using descriptive analysis. Eighteen studies met inclusion criteria. Following UKA (n = 5), no studies reported a deleterious effect of PA level or sports participation on implant integrity or failure.