Towards understanding long-term cartilage degeneration: The role of passive joint laxity and active joint instability in pathological knee kinematics

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Instability of the knee joint is thought to be a precursor to osteoarthritis (OA) due to excessive rotation and shear movement within the joint. The relationship between static joint laxity and dynamic movement patterns remains unclear, but such knowledge is essential to understand the contribution of joint laxity towards osteoarthritic degeneration of the knee joint. If available, such understanding could allow a standard assessment metric for early recognition of joint degeneration to be attained. By specifically assessing the components of tibio-femoral motion that affect cartilage degeneration, it could also be possible to inform on preventive and therapeutical measures to target specific stabilisation of the joint for reducing the rate of osteoarthritic degeneration. The goal of this study is therefore to identify the components of passive joint laxity that best correlate with kinematic and kinetic parameters, and later to determine their role in the progression of gonarthrosis after knee injury. Through combining knowledge of the internal loading conditions within the knee joint with the measurement and identification of tibio-femoral shear and rotational movement during standardised activities of daily living using advanced motion analysis techniques, this project aims to elucidate the specific contribution of the mechanical aspects of anterior-posterior translation and rotational laxity of the joint towards the onset of gonarthrosis. This study therefore provides a key basis for 1) science based measures to prevent injury through specifically training joint stability, 2) assessing the requirement for surgical intervention, 3) guiding intra-operative strategies for joint stabilisation and 4) helping postoperative physiotherapy in targeting muscular components for strengthening and stabilisation.