Mechanisms underpinning longitudinal increases in the knee adduction moment following arthroscopic partial meniscectomy

• Published in: Clinical biomechanics (Bristol) 2014-09, Vol.29 (8), p.892-897
• Main Authors: Hall, Michelle, Wrigley, Tim V, Metcalf, Ben R, Hinman, Rana S, Dempsey, Alasdair R, Mills, Peter M, Cicuttini, Flavia M, Lloyd, David G, Bennell, Kim L
• Format: Article
• Language: English
• Subjects: Adult; Arthroscopy - methods; Biomechanical Phenomena; Female; Gait; Humans; Knee; Knee Joint - surgery; Knee joint load; Longitudinal Studies; Male; Mechanism; Meniscectomy; Menisci, Tibial - surgery; Middle Aged; Movement; Osteoarthritis, Knee; Physical Medicine and Rehabilitation; Reproducibility of Results; Tibia; Walking
• ISSN: 0268-0033; 1879-1271
• DOI: 10.1016/j.clinbiomech.2014.07.002

Abstract Background Knee osteoarthritis is common following arthroscopic partial meniscectomy and a higher external peak knee adduction moment is believed to be a contributor. The peak knee adduction moment has been shown to increase over 2 years (from 3-months post-arthroscopic partial meniscectomy). The aim of this study was to evaluate mechanisms underpinning the increase in peak knee adduction moment over 2 years observed in people 3-months following arthroscopic partial meniscectomy. Methods Sixty-six participants with medial arthroscopic partial meniscectomy were assessed at baseline and again 2 years later. Parameters were evaluated at time of peak knee adduction moment as participants walked barefoot at their self-selected normal and fast pace for both time points. Findings For normal pace walking, an increase in frontal plane ground reaction force-to-knee lever arm accounted for 30% of the increase in peak knee adduction moment (B = 0.806 [95% CI 0.501–1.110], P < 0.001). For fast pace walking, an increase in the frontal plane ground reaction force magnitude accounted for 21% of the increase in peak knee adduction moment (B = 2.343 [95% CI 1.219–3.468], P < 0.001); with an increase in tibia varus angle accounting for a further 15% (B = 0.310 [95% CI 0.145–0.474], P < 0.001). Interpretation Our data suggest that an increase in lever arm and increase in frontal plane ground reaction force magnitude are contributors to the increased knee adduction moment observed over time in people following arthroscopic partial meniscectomy.