Knee joint loading during sport specific movements following a meniscectomy
Traumatic meniscal injuries are common in sport and often occur as a result of twisting or shearing motion together with either a varus or valgus force directed to a flexed knee. Therefore, these injuries are more common in sports that require individuals to rapidly decelerate, change direction and land from a jump. Injuries to the meniscus are often difficult to treat owing to a poor blood supply, therefore surgical treatment to remove the damaged area (partial meniscectomy) is common. The meniscus aids in stabilising the knee, acting as a shock absorber and transmitting load. Damage to the meniscus is suggested to lead to altered knee mechanics leading to the initiation or acceleration of osteoarthritis (OA) development. Many athletic individuals who sustain a meniscal injury intend to return to sport following recovery from surgery. Previous research has focussed on walking or slow jogging and it is unclear how individuals load their knee during more demanding sport-specific tasks which could inform rehabilitation strategies.
Using instrumented three-dimensional technology, we examined knee loading during a range of sport-specific tasks such as running, changing direction and landing. Our findings demonstrated individuals off-loaded their knee during sport-specific tasks likely as a response to pain and fear of re-injury. The stiffer movement patterns observed to reduce knee loading in individuals following a meniscectomy is likely to offset the impact of the comprised meniscus and muscle weakness still present following surgery.
Footwear is considered an effective intervention for altering loading at the knee joint in individuals with knee OA. Athletes that return to sport are likely to continue in their given footwear. It is unclear the effect of commercially available footwear designs on knee loading. We sought to understand knee loading in individuals had undergone a meniscectomy when performing sport-specific tasks wearing commercially available footwear. The findings from this study will help future development of footwear interventions for these individuals. Our research examining individuals following a meniscectomy and footwear design has been in collaboration with the Manchester Institute of Health and Performance (mihp.co.uk)
Team: Dr Chelsea Starbuck, Miss Vanessa Walters, Dr Lee Herrington, Prof. Richard Jones