2025 ISAKOS Biennial Congress ePoster
Changes In Synovial Fluid Markers In Osteoarthritis Are Associated With Changes In Gait Biomechanics After High Tibial Osteotomy
Jenna Schulz, PT, PhD, London, ON CANADA
Trevor B. Birmingham, PT, PhD, London, Ontario CANADA
Holly Philpott, PhD, London CANADA
Codie Primeau, PT, PhD, London CANADA
Hayden Atkinson, MSc, London, Ontario CANADA
Kristyn M. Leitch, PhD, London, Ontario CANADA
J. Robert Giffin, MD, FRCSC, MBA, London, ON CANADA
Frank Beier, PhD, London CANADA
C. Thomas Appleton, MD, PhD, London CANADA
Western University, London, ON, CANADA
FDA Status Not Applicable
Summary
A biological response after high tibial osteotomy is associated with improvements in biomechanical measures, suggesting there is an ability to alter mechanobiological processes in patients with knee osteosarthritis.
ePosters will be available shortly before Congress
Abstract
Objective
Although mechanobiological processes are thought to be integral to knee osteoarthritis (OA) pathogenesis and potential interventions, it is unclear if altering gait mechanics can alter joint biology. Therefore, the objectives of the present study were to explore the associations between changes in knee synovial fluid biochemical markers and gait biomechanics after medial opening wedge high tibial osteotomy (HTO.
Methods
Twenty-six patients with medial compartment knee OA and varus alignment underwent three-dimensional gait analysis and synovial fluid aspiration before and one year after HTO. The top biomarkers that increased [endothelial growth factor (EGF), platelet derived growth factor (PDGF-BB) and fibroblast growth factor 2 (FGF-2)] and decreased [tumor necrosis factor-alpha (TNF-α) and interleukins (IL)-1 and -6)] after surgery were used to determine biological responder and non-responder groups. A series of mixed effects polynomial regression models were used to compare the external knee adduction moment (KAM) (outcome) between the responders and non-responders over 100% of stance (predictor) for each biomarker, adjusting for body mass index and radiographic stage of OA. The same analyses were repeated for the knee flexion moment (KFM).
Results
The responders in EGF, FGF-2, TNF-α and IL-1β had greater decreases in the KAM. The responders in EGF, PDGF-BB and IL-6 had greater increases in the KFM. The largest differences were observed for EGF, where the KAM differed between the responders and non-responders from 0-97% of stance, with the greatest decrease (unstandardized β [95% CI]) in the responder group occurring at 28% of stance ( 17.62 Nm [-20.08; -15.08]). For the KFM, there was a difference between the two groups for EGF from 62-86% of stance, with the greatest increase in the responder group occurring at 76% of stance (15.90 Nm [2.84; 28.96]).
Conclusions
The present results suggest a biological response after HTO that is associated with greater decreases in the KAM, and greater increases in the KFM, during walking. These findings are consistent with the ability to alter mechanobiological processes in patients with knee OA.