title: Association of baseline knee sagittal dynamic joint stiffness during gait and 2-year patellofemoral cartilage damage worsening in knee osteoarthritis.
abstract: Knee sagittal dynamic joint stiffness (DJS) describes the biomechanical interaction between change in external knee flexion moment and flexion angular excursion during gait. In theory, greater DJS may particularly stress the patellofemoral (PF) compartment and thereby contribute to PF osteoarthritis (OA) worsening. We hypothesized that greater baseline knee sagittal DJS is associated with PF cartilage damage worsening 2 years later.
  
  
  
  Participants all had OA in at least one knee. Knee kinematics and kinetics during gait were recorded using motion capture systems and force plates. Knee sagittal DJS was computed as the slope of the linear regression line for knee flexion moments vs angles during the loading response phase. Knee magnetic resonance imaging (MRI) scans were obtained at baseline and 2 years later. We assessed the association between baseline DJS and baseline-to-2-year PF cartilage damage worsening using logistic regression with generalized estimating equations (GEE).
  
  
  
  Our sample had 391 knees (204 persons): mean age 64.2 years (SD 10.0); body mass index (BMI) 28.4 kg/m2(5.7); 76.5% women. Baseline knee sagittal DJS was associated with baseline-to-2-year cartilage damage worsening in the lateral (OR = 5.35, 95% CI: 2.37-12.05) and any PF (OR = 2.99, 95% CI: 1.27-7.04) compartment. Individual components of baseline DJS (i.e., change in knee moment or angle) were not associated with subsequent PF disease worsening.
  
  
  
  Capturing the concomitant effect of knee kinetics and kinematics during gait, knee sagittal DJS is a potentially modifiable risk factor for PF disease worsening.
authors.affiliation: Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. Electronic address: hsini@northwestern.edu.
authors.forename: A H
authors.initials: AH
authors.lastname: Chang
authors.affiliation: Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. Electronic address: jchmiel@northwestern.edu.
authors.forename: J S
authors.initials: JS
authors.lastname: Chmiel
authors.affiliation: Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. Electronic address: o-almagor@northwestern.edu.
authors.forename: O
authors.initials: O
authors.lastname: Almagor
authors.affiliation: Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, Boston, MA, USA. Electronic address: guermazi@bu.edu.
authors.forename: A
authors.initials: A
authors.lastname: Guermazi
authors.affiliation: Department of Radiology, NorthShore University HealthSystem, Evanston, IL, USA. Electronic address: p-prasad2@northwestern.edu.
authors.forename: P V
authors.initials: PV
authors.lastname: Prasad
authors.affiliation: Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. Electronic address: k-moisio@northwestern.edu.
authors.forename: K C
authors.initials: KC
authors.lastname: Moisio
authors.affiliation: Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. Electronic address: laura.belisle@northwestern.edu.
authors.forename: L
authors.initials: L
authors.lastname: Belisle
authors.affiliation: Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. Electronic address: y-zhang3@northwestern.edu.
authors.forename: Y
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. Electronic address: k-hayes@northwestern.edu.
authors.forename: K
authors.initials: K
authors.lastname: Hayes
authors.affiliation: Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. Electronic address: l-sharma@northwestern.edu.
authors.forename: L
authors.initials: L
authors.lastname: Sharma
mesh_terms: D002358:Cartilage, Articular / Q000473:pathology* / Q000503:physiopathology; D018450:Disease Progression; D005260:Female; D005684:Gait / Q000502:physiology; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D057071:Patellofemoral Joint / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D011446:Prospective Studies
keywords: Cartilage; Gait; Imaging; Knee osteoarthritis; Magnetic resonance; Patellofemoral joint