Changes in knee joint load indices from before to 12 months after arthroscopic partial meniscectomy: a prospective cohort study. Thorlund, J. B.; Holsgaard-Larsen, A.; Creaby, M. W.; Jørgensen, G. M.; Nissen, N.; Englund, M.; and Lohmander, L. S. 24(7):1153--1159.
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OBJECTIVE: Patients undergoing arthroscopic partial meniscectomy (APM) are at increased risk of knee osteoarthritis (OA). Meniscal damage and/or surgery may alter knee joint loading to increase OA risk. We investigated changes in knee joint loading following medial APM surgery, compared with the contra-lateral leg. METHODS: We estimated indices of knee joint loading (external peak knee adduction moment (KAM), KAM impulse and peak knee flexion moment (KFM)) normalized to body size (i.e., body mass (BM) and height (HT)) using 3D gait analysis in 23 patients (17 men, mean (SD) 46.2 (6.4) years, BMI 25.8 (3.4) kg/m(2)) without radiographic knee OA before and 12 months after medial APM. Static alignment was assessed by radiography and self-reported outcomes by Knee injury and Osteoarthritis Outcome Score (KOOS). RESULTS: Peak KAM and KAM impulse increased in the APM leg compared to the contra-lateral leg from before to 12 months after surgery (change difference: 0.38 Nm/BM*HT% 95% CI 0.01 to 0.76 (P = 0.049) and 0.20 Nm*s/BM*HT% 95% CI 0.10 to 0.30 (P \textless 0.001)). Patients self-reported improvements on all KOOS subscales (KOOS pain improvement: 22.8 95% CI 14.5 to 31.0 (P \textless 0.01)). CONCLUSIONS: A relative increase in indices of medial compartment loading was observed in the leg undergoing APM compared with the contra-lateral leg from before to 12 months after surgery. This increase may contribute to the elevated risk of knee OA in these patients. Randomized trials including a non-surgical control group are needed to determine if changes in joint loading following APM are caused by surgery or by changes in symptoms.
@article{thorlund_changes_2016,
	title = {Changes in knee joint load indices from before to 12 months after arthroscopic partial meniscectomy: a prospective cohort study.},
	volume = {24},
	issn = {1522-9653},
	doi = {10.1016/j.joca.2016.01.987},
	shorttitle = {Changes in knee joint load indices from before to 12 months after arthroscopic partial meniscectomy},
	abstract = {{OBJECTIVE}: Patients undergoing arthroscopic partial meniscectomy ({APM}) are at increased risk of knee osteoarthritis ({OA}). Meniscal damage and/or surgery may alter knee joint loading to increase {OA} risk. We investigated changes in knee joint loading following medial {APM} surgery, compared with the contra-lateral leg.
{METHODS}: We estimated indices of knee joint loading (external peak knee adduction moment ({KAM}), {KAM} impulse and peak knee flexion moment ({KFM})) normalized to body size (i.e., body mass ({BM}) and height ({HT})) using 3D gait analysis in 23 patients (17 men, mean ({SD}) 46.2 (6.4) years, {BMI} 25.8 (3.4) kg/m(2)) without radiographic knee {OA} before and 12 months after medial {APM}. Static alignment was assessed by radiography and self-reported outcomes by Knee injury and Osteoarthritis Outcome Score ({KOOS}).
{RESULTS}: Peak {KAM} and {KAM} impulse increased in the {APM} leg compared to the contra-lateral leg from before to 12 months after surgery (change difference: 0.38 Nm/{BM}*{HT}\% 95\% {CI} 0.01 to 0.76 (P = 0.049) and 0.20 Nm*s/{BM}*{HT}\% 95\% {CI} 0.10 to 0.30 (P {\textless} 0.001)). Patients self-reported improvements on all {KOOS} subscales ({KOOS} pain improvement: 22.8 95\% {CI} 14.5 to 31.0 (P {\textless} 0.01)).
{CONCLUSIONS}: A relative increase in indices of medial compartment loading was observed in the leg undergoing {APM} compared with the contra-lateral leg from before to 12 months after surgery. This increase may contribute to the elevated risk of knee {OA} in these patients. Randomized trials including a non-surgical control group are needed to determine if changes in joint loading following {APM} are caused by surgery or by changes in symptoms.},
	pages = {1153--1159},
	number = {7},
	journaltitle = {Osteoarthritis and cartilage / {OARS}, Osteoarthritis Research Society},
	shortjournal = {Osteoarthr. Cartil.},
	author = {Thorlund, J. B. and Holsgaard-Larsen, A. and Creaby, M. W. and Jørgensen, G. M. and Nissen, N. and Englund, M. and Lohmander, L. S.},
	date = {2016-07},
	pmid = {26836286},
	keywords = {Arthroscopy, Biomechanics, Joint load, Knee adduction moment, Meniscectomy, Osteoarthritis}
}
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