Ritzmann, Ramona, Paul, Jochen, Gasser, Juerg A, Kuch, Janine, Li, YUFEI, Honorio, Ines, Beretta-Picoli, Agnese, Doelemeyer, Arno, Meyer, Angelika, Hils, Lukas, Utzinger, Stephan, Heitner, Albrecht, Jacobi, Carsten and Centner, Christoph (2025) In vivo biomechanical correlates of gait and stair climbing are predictors of ex vivo cartilage quality in gonarthrotic patients. Journal of biomechanics.

Abstract

Objective: Previous evidence highlights the important role of knee joint malalignment and excessive joint moments for the development to knee osteoarthritis. To date most studies used X-ray imaging techniques to draw conclusions about cartilage quality. The present study aimed to systematically investigate the interrelationship between three-dimensional knee kinematics during walking and stair climbing and ex-vivo electromechanical cartilage quality in patients with end-stage knee osteoarthritis.
Methods: The prospective cohort study was conducted in 119 patients with end-stage knee OA. Patients scheduled for total knee arthroplasty surgery underwent radiographic assessment and biomechanical analysis in gait and stair climbing assessing in vivo knee joint angles and moments during movement dynamics prior to surgery. After surgery, ex vivo electromechanical properties of the tibial cartilage as an indicator or cartilage damage were evaluated using Arthro-BST. Associations between medial and lateral tibia cartilage quality and biomechanical parameters and radiographic, knee joint malalignment or joint width space were assessed using linear regression modelling.
Results: Peak knee adduction angle was found to be a significant predictor of medial cartilage quality during walking (R2 = 22%, p < 0.001) and stair climbing (R2 = 13%, p < 0.001). During walking, knee flexion moment was found to be a strong predictor of medial (R2 = 9%, p = 0.002) and lateral cartilage quality (R2 = 12%, p < 0.001). Knee adduction angle as determined on the frontal X-ray was found to be a significant predictor of medial cartilage quality (R2 = 12%, p = 0.003). Knee adduction (R2 = 19%, p < 0.001) and abduction angles (R2 = 44%, p < 0.01) during x-ray was significantly associated with dynamic assessments during 3D kinematics. Medial joint space width significantly predicted medial tibial cartilage quality (R2 = 16%, p < 0.001).
Conclusion: This study provides a biological rationale for the use of biomechanical analysis as a potential candidate to supplement diagnostic options for OA. The results showed that biomechanical parameters such as varus malalignment during walking and stair climbing are significantly associated with tibial cartilage deterioration and contribute to a variance explanation of 13-22%. Given the predictive value of these non-invasive examinations, kinematic analysis could be included in the test battery for OA patients and help to detect cartilage damage in addition to other recognized markers and imaging techniques.
Keywords: biomechanics, ArthroBST, cartilage quality, varus, valgus
Translational potential
This prospective cohort study translates in vivo biomechanical values of gait and stair climbing as well as joint width and static malalignment of images to cartilage quality of the medial and lateral tibia plateau as determined ex vivo by ArthroBSTTM.

Item Type:	Article
Date Deposited:	04 Mar 2025 00:45
Last Modified:	04 Mar 2025 00:45
URI:	https://oak.novartis.com/id/eprint/54150