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J Biomech Eng. 2018 Apr 1;140(4). doi: 10.1115/1.4038330.

Evaluation of the Effect of Bariatric Surgery-Induced Weight Loss on Knee Gait and Cartilage Degeneration.

Author information

1
Department of Applied Physics, University of Eastern Finland, P.O. Box 1627, Kuopio FI-70211, Finland e-mail: .
2
Institute of Clinical Medicine, University of Eastern Finland, P.O. Box 1627, Kuopio FI-70211, Finland; Department of Physical and Rehabilitation Medicine, Kuopio University Hospital, P.O. Box 100, Kuopio FI-70029, Finland e-mail: .
3
Charles River Discovery Research Services, Microkatu 1, Kuopio FI-70210, Finland e-mail: .
4
Department of Clinical Radiology, University of Eastern Finland, P.O. Box 1627, Kuopio FI-70211, Finland e-mail: .
5
Department of Surgery, University of Eastern Finland, P.O. Box 1627, Kuopio FI-70211, Finland; Department of Gastrointestinal Surgery, Kuopio University Hospital, P.O. Box 100, Kuopio FI-70029, Finland e-mail: .
6
Department of Public Health and Clinical Nutrition, University of Eastern Finland, P.O. Box 1627, Kuopio FI-70211, Finland; Clinical Nutrition and Obesity Center, Kuopio University Hospital, P.O. Box 100, Kuopio FI-70029, Finland e-mail: .
7
Department of Physical and Rehabilitation Medicine, Helsinki University Hospital, P.O. Box 349, Helsinki FI-00029, Finland; University of Helsinki, P.O. Box 3, Helsinki FI-00014, Finland e-mail: .
8
Department of Applied Physics, University of Eastern Finland, P.O. Box 1627, Kuopio FI-70211, Finland; Diagnostic Imaging Centre, Kuopio University Hospital, P.O. Box 100, Kuopio FI-70029, Finland e-mail: .

Abstract

The objective of the study was to investigate the effects of bariatric surgery-induced weight loss on knee gait and cartilage degeneration in osteoarthritis (OA) by combining magnetic resonance imaging (MRI), gait analysis, finite element (FE) modeling, and cartilage degeneration algorithm. Gait analyses were performed for obese subjects before and one-year after the bariatric surgery. FE models were created before and after weight loss for those subjects who did not have severe tibio-femoral knee cartilage loss. Knee cartilage degenerations were predicted using an adaptive cartilage degeneration algorithm which is based on cumulative overloading of cartilage, leading to iteratively altered cartilage properties during OA. The average weight loss was 25.7±11.0 kg corresponding to a 9.2±3.9 kg/m2 decrease in body mass index (BMI). External knee rotation moment increased, and minimum knee flexion angle decreased significantly (p < 0.05) after weight loss. Moreover, weight loss decreased maximum cartilage degeneration by 5±23% and 13±11% on the medial and lateral tibial cartilage surfaces, respectively. Average degenerated volumes in the medial and lateral tibial cartilage decreased by 3±31% and 7±32%, respectively, after weight loss. However, increased degeneration levels could also be observed due to altered knee kinetics. The present results suggest that moderate weight loss changes knee kinetics and kinematics and can slow-down cartilage degeneration for certain patients. Simulation results also suggest that prediction of cartilage degeneration is subject-specific and highly depend on the altered gait loading, not just the patient's weight.

PMID:
29101403
DOI:
10.1115/1.4038330

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