Munsch Amanda E, Evans-Pickett Alyssa, Davis-Wilson Hope, Pietrosimone Brian, Rauch Carly M, Roth Joshua D, Franz Jason R
Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Chapel Hill, NC.
Department of Exercise and Sport Science, UNC Chapel Hill, Chapel Hill, NC.
Med Sci Sports Exerc. 2025 Apr 1;57(4):849-856. doi: 10.1249/MSS.0000000000003607. Epub 2024 Nov 18.
Individuals with anterior cruciate ligament reconstruction (ACLR) often walk with a less dynamic vertical ground reaction force (vGRF), exemplified by a reduced first peak vGRF and elevated midstance vGRF compared with uninjured controls. However, the mechanism by which altered limb loading affects actual tibial plateau contact forces during walking remains unclear.
Our purpose was to use musculoskeletal simulation to evaluate the effects of first peak vGRF biofeedback on bilateral tibiofemoral contact forces relevant to the development of post-traumatic osteoarthritis in 20 individuals with ACLR. We hypothesized that reduced first peak vGRF would produce less dynamic tibial plateau contact forces during walking in individuals with ACLR.
As the pivotal outcome from this study, and in support of our hypothesis, we found that less dynamic vGRF profiles in individuals with ACLR-observations that have associated in prior studies with more cartilage breakdown serum biomarkers and reduced proteoglycan density-are accompanied by less dynamic tibiofemoral joint contact forces during walking.
We conclude that more sustained limb-level loading, a phenotype that associates with worse knee joint health outcomes after ACLR and was prescribed herein using biofeedback, alters the loading profile and magnitude of force applied to tibiofemoral cartilage.
前交叉韧带重建（ACLR）患者行走时的垂直地面反作用力（vGRF）动态变化通常较小，与未受伤的对照组相比，表现为首次峰值vGRF降低和支撑中期vGRF升高。然而，行走过程中肢体负荷改变影响实际胫骨平台接触力的机制仍不清楚。
我们的目的是使用肌肉骨骼模拟来评估首次峰值vGRF生物反馈对20名ACLR患者双侧胫股接触力的影响，这些接触力与创伤后骨关节炎的发展相关。我们假设，ACLR患者行走时首次峰值vGRF降低会产生较小的动态胫骨平台接触力。
作为本研究的关键结果，并支持我们的假设，我们发现ACLR患者动态vGRF曲线较小——先前研究表明，这些观察结果与更多的软骨分解血清生物标志物和蛋白聚糖密度降低有关——同时行走时胫股关节接触力的动态变化也较小。
我们得出结论，更持续的肢体水平负荷，一种与ACLR后更差的膝关节健康结果相关的表型，本文中通过生物反馈进行设定，会改变施加于胫股软骨的负荷曲线和力的大小。
