Brian Pietrosimone1, J Troy Blackburn2, Matthew S Harkey3, Brittney A Luc3, Anthony C Hackney4, Darin A Padua3, Jeffrey B Driban5, Jeffrey T Spang6, Joanne M Jordan7. 1. Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA brian@unc.edu. 2. Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA Department of Orthopaedics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. 3. Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. 4. Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, North Carolina, USA. 5. Division of Rheumatology, Tufts Medical School, Boston, Massachusetts, USA. 6. Department of Orthopaedics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. 7. Division of Rheumatology, Allergy, and Immunology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Abstract
BACKGROUND: Individuals who have sustained an anterior cruciate ligament (ACL) injury and undergo ACL reconstruction (ACLR) are at higher risk of developing knee osteoarthritis. It is hypothesized that altered knee loading may influence the underlying joint metabolism and hasten development of posttraumatic knee osteoarthritis. PURPOSE: To explore the associations between serum biomarkers of cartilage metabolism and peak vertical ground-reaction force (vGRF) and vGRF loading rate in the injured and uninjured limbs of individuals with ACLR. STUDY DESIGN: Descriptive laboratory study. METHODS: Patients with a history of a primary unilateral ACLR who had returned to unrestricted physical activity (N = 19) participated in the study. Resting blood was collected from each participant before completing 5 walking gait trials at a self-selected comfortable speed. Peak vGRF was extracted for both limbs during the first 50% of the stance phase of gait, and the linear vGRF loading rate was determined between heel strike and peak vGRF. Sera were assessed for collagen breakdown (collagen type II cleavage product [C2C]) and synthesis (collagen type II C-propeptide [CPII]), as well as aggrecan concentrations, via commercially available specific enzyme-linked immunosorbent assays. Pearson product-moment correlations (r) and Spearman rank-order correlations (ρ) were used to evaluate associations between loading characteristics and biomarkers of cartilage metabolism. RESULTS: Lower C2C:CPII ratios were associated with higher peak vGRF in the injured limb (ρ = -0.59, uncorrected P = .007). There were no significant associations between peak vGRF or linear vGRF loading rate and CPII, C2C, or aggrecan serum concentrations. CONCLUSION: Lower C2C:CPII ratios were associated with higher peak vGRF in the ACLR limb during gait, suggesting that higher peak loading in the ACLR limb is related to lower type II collagen breakdown relative to type II collagen synthesis. CLINICAL RELEVANCE: These data suggest that type II collagen synthesis may be higher relative to the amount of type II collagen breakdown in the ACLR limb with higher lower extremity loading. Future study should determine if metabolic compensations to increase collagen synthesis may affect the risk of developing osteoarthritis after ACLR.
BACKGROUND: Individuals who have sustained an anterior cruciate ligament (ACL) injury and undergo ACL reconstruction (ACLR) are at higher risk of developing knee osteoarthritis. It is hypothesized that altered knee loading may influence the underlying joint metabolism and hasten development of posttraumatic knee osteoarthritis. PURPOSE: To explore the associations between serum biomarkers of cartilage metabolism and peak vertical ground-reaction force (vGRF) and vGRF loading rate in the injured and uninjured limbs of individuals with ACLR. STUDY DESIGN: Descriptive laboratory study. METHODS:Patients with a history of a primary unilateral ACLR who had returned to unrestricted physical activity (N = 19) participated in the study. Resting blood was collected from each participant before completing 5 walking gait trials at a self-selected comfortable speed. Peak vGRF was extracted for both limbs during the first 50% of the stance phase of gait, and the linear vGRF loading rate was determined between heel strike and peak vGRF. Sera were assessed for collagen breakdown (collagen type II cleavage product [C2C]) and synthesis (collagen type II C-propeptide [CPII]), as well as aggrecan concentrations, via commercially available specific enzyme-linked immunosorbent assays. Pearson product-moment correlations (r) and Spearman rank-order correlations (ρ) were used to evaluate associations between loading characteristics and biomarkers of cartilage metabolism. RESULTS: Lower C2C:CPII ratios were associated with higher peak vGRF in the injured limb (ρ = -0.59, uncorrected P = .007). There were no significant associations between peak vGRF or linear vGRF loading rate and CPII, C2C, or aggrecan serum concentrations. CONCLUSION: Lower C2C:CPII ratios were associated with higher peak vGRF in the ACLR limb during gait, suggesting that higher peak loading in the ACLR limb is related to lower type II collagen breakdown relative to type II collagen synthesis. CLINICAL RELEVANCE: These data suggest that type II collagen synthesis may be higher relative to the amount of type II collagen breakdown in the ACLR limb with higher lower extremity loading. Future study should determine if metabolic compensations to increase collagen synthesis may affect the risk of developing osteoarthritis after ACLR.
Authors: Brian Pietrosimone; Richard F Loeser; J Troy Blackburn; Darin A Padua; Matthew S Harkey; Laura E Stanley; Brittney A Luc-Harkey; Veronica Ulici; Stephen W Marshall; Joanne M Jordan; Jeffery T Spang Journal: J Orthop Res Date: 2017-03-02 Impact factor: 3.494
Authors: Sandra J Shultz; Randy J Schmitz; Kenneth L Cameron; Kevin R Ford; Dustin R Grooms; Lindsey K Lepley; Gregory D Myer; Brian Pietrosimone Journal: J Athl Train Date: 2019-08-28 Impact factor: 2.860
Authors: Jacob J Capin; Ryan Zarzycki; Naoaki Ito; Ashutosh Khandha; Celeste Dix; Kurt Manal; Thomas S Buchanan; Lynn Snyder-Mackler Journal: J Orthop Res Date: 2019-05-20 Impact factor: 3.494
Authors: Amy R Lane; Matthew S Harkey; Hope C Davis; Brittney A Luc-Harkey; Laura Stanley; Anthony C Hackney; J Troy Blackburn; Brian Pietrosimone Journal: J Athl Train Date: 2019-03-04 Impact factor: 2.860
Authors: Kevin A Taylor; Amber T Collins; Lauren N Heckelman; Sophia Y Kim; Gangadhar M Utturkar; Charles E Spritzer; William E Garrett; Louis E DeFrate Journal: J Biomech Date: 2018-11-01 Impact factor: 2.712
Authors: Elizabeth Wellsandt; Ashutosh Khandha; Jacob Capin; Thomas S Buchanan; Lynn Snyder-Mackler Journal: J Orthop Res Date: 2020-03-20 Impact factor: 3.494
Authors: Steven Pfeiffer; Matthew S Harkey; Laura E Stanley; J Troy Blackburn; Darin A Padua; Jeffrey T Spang; Stephen W Marshall; Joanne M Jordan; Randy Schmitz; Daniel Nissman; Brian Pietrosimone Journal: Arthritis Care Res (Hoboken) Date: 2018-07-04 Impact factor: 4.794
Authors: H C Davis; B A Luc-Harkey; M K Seeley; J Troy Blackburn; B Pietrosimone Journal: Osteoarthritis Cartilage Date: 2019-01-18 Impact factor: 6.576
Authors: Steven A Garcia; Scott R Brown; Mary Koje; Chandramouli Krishnan; Riann M Palmieri-Smith Journal: J Orthop Res Date: 2021-06-14 Impact factor: 3.494