title: A longitudinal study of impact and early stance loads during gait following arthroscopic partial meniscectomy.
abstract: People following arthroscopic partial medial meniscectomy (APM) are at increased risk of developing knee osteoarthritis. High impact loading and peak loading early in the stance phase of gait may play a role in the pathogenesis of knee osteoarthritis. This was a secondary analysis of longitudinal data to investigate loading-related indices at baseline in an APM group (3 months post-surgery) and a healthy control group, and again 2 years later (follow-up). At baseline, 82 participants with medial APM and 38 healthy controls were assessed, with 66 and 23 re-assessed at follow-up, respectively. Outcome measures included: (i) heel strike transient (HST) presence and magnitude, (ii) maximum loading rate, (iii) peak vertical force (Fz) during early stance. At baseline, maximum loading rate was lower in the operated leg (APM) and non-operated leg (non-APM leg) compared to controls (p ≤ 0.03) and peak Fz was lower in the APM leg compared to non-APM leg (p ≤ 0.01). Over 2 years, peak Fz increased in the APM leg compared to the non-APM leg and controls (p ≤ 0.01). Following recent APM, people may adapt their gait to protect the operated knee from excessive loads, as evidenced by a lower maximum loading rate in the APM leg compared to controls, and a reduced peak Fz in the APM leg compared to the non-APM leg. No differences at follow-up may suggest an eventual return to more typical gait. However, the increase in peak Fz in the APM leg may be of concern for long-term joint health given the compromised function of the meniscus.
authors.affiliation: Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, VIC, Australia.
authors.forename: Michelle
authors.initials: M
authors.lastname: Hall
authors.affiliation: Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, VIC, Australia.
authors.forename: Tim V
authors.initials: TV
authors.lastname: Wrigley
authors.affiliation: Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, VIC, Australia.
authors.forename: Ben R
authors.initials: BR
authors.lastname: Metcalf
authors.affiliation: Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, VIC, Australia.
authors.forename: Rana S
authors.initials: RS
authors.lastname: Hinman
authors.affiliation: Centre for Musculoskeletal Research, Griffith Health Institute, Griffith University, Gold Coast Campus, QLD, Australia; School of Psychology and Exercise Science, Murdoch University, Perth, WA, Australia.
authors.forename: Alasdair R
authors.initials: AR
authors.lastname: Dempsey
authors.affiliation: Centre for Musculoskeletal Research, Griffith Health Institute, Griffith University, Gold Coast Campus, QLD, Australia.
authors.forename: Peter M
authors.initials: PM
authors.lastname: Mills
authors.affiliation: Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
authors.forename: Flavia M
authors.initials: FM
authors.lastname: Cicuttini
authors.affiliation: Centre for Musculoskeletal Research, Griffith Health Institute, Griffith University, Gold Coast Campus, QLD, Australia.
authors.forename: David G
authors.initials: DG
authors.lastname: Lloyd
authors.affiliation: Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, VIC, Australia. Electronic address: k.bennell@unimelb.edu.au.
authors.forename: Kim L
authors.initials: KL
authors.lastname: Bennell
mesh_terms: D000328:Adult; D001182:Arthroscopy; D016022:Case-Control Studies; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008592:Menisci, Tibial / Q000503:physiopathology* / Q000601:surgery*; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000503:physiopathology; D011184:Postoperative Period; D016474:Weight-Bearing
keywords: Impact loading; Medial meniscectomy