TY - JOUR
T1 - Exploring relationships among multi-disciplinary assessments for knee joint health in service members with traumatic unilateral lower limb loss
T2 - a two-year longitudinal investigation
AU - Wasser, Joseph G.
AU - Hendershot, Brad D.
AU - Acasio, Julian C.
AU - Dodd, Lauren D.
AU - Krupenevich, Rebecca L.
AU - Pruziner, Alison L.
AU - Miller, Ross H.
AU - Goldman, Stephen M.
AU - Valerio, Michael S.
AU - Senchak, Lien T.
AU - Murphey, Mark D.
AU - Heltzel, David A.
AU - Fazio, Michael G.
AU - Dearth, Christopher L.
AU - Hager, Nelson A.
N1 - Funding Information:
This work was supported, in part, by the Center for Rehabilitation Sciences Research, of the Uniformed Services University of the Health Sciences (awards HU0001-11-1-0004 and HU0001-15-2-0003), and the Extremity Trauma and Amputation Center of Excellence (award HU0001-20-2-0038).
Funding Information:
The authors acknowledge Emilia-Marie Jaskot, BS for her contributions to project management and coordination. The authors do not have any conflicts of interest to note. The views expressed in this manuscript are those of the authors and do not necessarily reflect the official policies of the Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Uniformed Services University of the Health Sciences, the U.S. Departments of the Army, Navy, Air Force, Defense, nor the U.S. Government. Identifying specific products or instrumentation is considered an integral part of the scientific endeavor and does not constitute an endorsement or implied endorsement on the part of the authors, Department of Defense, or any component agency.
Publisher Copyright:
© 2023, This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.
PY - 2023/12
Y1 - 2023/12
N2 - Motivated by the complex and multifactorial etiologies of osteoarthritis, here we use a comprehensive approach evaluating knee joint health after unilateral lower limb loss. Thirty-eight male Service members with traumatic, unilateral lower limb loss (mean age = 38 yr) participated in a prospective, two-year longitudinal study comprehensively evaluating contralateral knee joint health (i.e., clinical imaging, gait biomechanics, physiological biomarkers, and patient-reported outcomes); seventeen subsequently returned for a two-year follow-up visit. For this subset with baseline and follow-up data, outcomes were compared between timepoints, and associations evaluated between values at baseline with two-year changes in tri-compartmental joint space. Upon follow-up, knee joint health worsened, particularly among seven Service members who presented at baseline with no joint degeneration (KL = 0) but returned with evidence of degeneration (KL ≥ 1). Joint space narrowing was associated with greater patellar tilt (r[12] = 0.71, p = 0.01), external knee adduction moment (r[13] = 0.64, p = 0.02), knee adduction moment impulse (r[13] = 0.61, p = 0.03), and CTX-1 concentration (r[11] = 0.83, p = 0.001), as well as lesser KOOSSport and VR-36General Health (r[16] = − 0.69, p = 0.01 and r[16] = − 0.69, p = 0.01, respectively). This longitudinal, multi-disciplinary investigation highlights the importance of a comprehensive approach to evaluate the fast-progressing onset of knee osteoarthritis, particularly among relatively young Service members with lower limb loss.
AB - Motivated by the complex and multifactorial etiologies of osteoarthritis, here we use a comprehensive approach evaluating knee joint health after unilateral lower limb loss. Thirty-eight male Service members with traumatic, unilateral lower limb loss (mean age = 38 yr) participated in a prospective, two-year longitudinal study comprehensively evaluating contralateral knee joint health (i.e., clinical imaging, gait biomechanics, physiological biomarkers, and patient-reported outcomes); seventeen subsequently returned for a two-year follow-up visit. For this subset with baseline and follow-up data, outcomes were compared between timepoints, and associations evaluated between values at baseline with two-year changes in tri-compartmental joint space. Upon follow-up, knee joint health worsened, particularly among seven Service members who presented at baseline with no joint degeneration (KL = 0) but returned with evidence of degeneration (KL ≥ 1). Joint space narrowing was associated with greater patellar tilt (r[12] = 0.71, p = 0.01), external knee adduction moment (r[13] = 0.64, p = 0.02), knee adduction moment impulse (r[13] = 0.61, p = 0.03), and CTX-1 concentration (r[11] = 0.83, p = 0.001), as well as lesser KOOSSport and VR-36General Health (r[16] = − 0.69, p = 0.01 and r[16] = − 0.69, p = 0.01, respectively). This longitudinal, multi-disciplinary investigation highlights the importance of a comprehensive approach to evaluate the fast-progressing onset of knee osteoarthritis, particularly among relatively young Service members with lower limb loss.
UR - https://www.scopus.com/pages/publications/85178173031
U2 - 10.1038/s41598-023-48662-9
DO - 10.1038/s41598-023-48662-9
M3 - Article
C2 - 38040780
AN - SCOPUS:85178173031
SN - 2045-2322
VL - 13
JO - Scientific Reports
JF - Scientific Reports
IS - 1
M1 - 21177
ER -