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

膝关节的不稳定被认为是由于关节内过度旋转和剪切运动导致的骨关节炎（OA）的前兆。静态关节松弛和动态运动模式之间的关系尚不清楚，但这些知识对于了解关节松弛对膝关节骨关节炎变性的贡献至关重要。如果可用的话，这种理解可以允许获得用于早期识别关节退行性变的标准评估指标。通过专门评估影响软骨退化的胫股运动的组成部分，还可以提供预防和治疗措施，以针对特定的关节稳定，降低骨关节炎退化的发生率。因此，本研究的目的是确定被动关节松弛的组成部分，最相关的运动学和动力学参数，并随后确定其在膝关节损伤后膝关节病的进展中的作用。通过结合知识的内部负载条件下的膝关节与测量和识别的胫股剪切和旋转运动在标准化的日常生活活动，使用先进的运动分析技术，该项目旨在阐明的具体贡献的机械方面的前后平移和旋转松弛的关节对发病的膝关节。因此，本研究为以下方面提供了关键依据：1）通过专门训练关节稳定性来预防损伤的科学措施，2）评估手术干预的需求，3）指导关节稳定的术中策略，4）帮助术后物理治疗靶向肌肉成分以增强和稳定。

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.