PrEOA Knee

PrE-OA Knee

Concurrent validity and reliability of a semi-automated approach to measuring the MRI morphology

Blaney TC, Ronsky JL, Macri EM, Jaremko JL, Kuntze G, Pakdel A, Whittaker JL, Emery CA

Proc Inst Mech Eng H. May 2022 (Online ahead of print)


Who participated in this study?

76 youth who experienced a sport-related knee injury 3-10 years prior to imaging and 76 uninjured individuals of similar age, sex, and sport.

When did this study occur?

2013-2018

Why did we do this research?

To describe the development and evaluation of a semi-automated software for measuring knee joint architecture using MRI.

What did we find?

When compared to previously reported methods, the software provides an alternative measurement approach for measuring large numbers of geometric features of the tibiofemoral and patellofemoral joints from MR studies.

Publication


Does a history of youth sport-related knee injury still impact accelerometer-measured levels of PA

Toomey CM, Whittaker JL, Doyle-Baker PK, Emery CA

Phys Ther Sport. March 2022 (Online ahead of print)


Who participated in this study?

42 individuals 3-12 years following youth sport-related knee injury and 43 uninjured individuals of similar age, sex, and sport.

When did this study occur?

2015-2017

Why did we do this research?

To examine accelerometer-measured physical activity in individuals with a knee injury history and controls. To examine the association of moderate to vigorous physical activity with self-reported and performance measures of knee function.

What did we find?

Moderate to vigorous physical activity is lower in youth and young adults with a history of sport-related knee injury compared to uninjured controls. Participants with previous injury spent more time in light activity physical activity compares to uninjured controls. All participants met recommended weekly physical activity criteria.

Publication


Vertical Drop Jump Biomechanics of Patients With a 3- to 10-Year History of Youth Sport-Related ACLR

Kuntze G, Nettel-Aguirre A, Lorenzen KN, Küpper J, Ronsky JL, Whittaker JL, Emery CA

Orthop J Sports Med December 2021


Who participated in this study?

48 patients with a history on ACLR and 48 uninjured age-, sex-, and sport-matched controls.

When did this study occur?

2013-2017

Why did we do this research?

To investigate the difference in vertical drop jump biomechanics between individuals with a 3-10 year history of youth sport-related anterior cruciate ligament reconstruction and uninjured individuals.

What did we find?

Individuals with a 3-10 year history of anterior cruciate ligament reconstruction demonstrated biomechanics that may be associated with knee motion control challenges.

Publication


What Does the Future Hold?

Le CY, Toomey CM, Emery CA, Whittaker JL

Int J Environ Res Public Health. June 2021


Who participated in this study?

124 individuals 3-12 years following youth sport-related knee injury and 129 uninjured age-, sex-, and sport-matched controls.

When did this study occur?

2013-2017

Why did we do this research?

To assess health-related quality of life 3-12 years following youth sport-related knee injury.

What did we find?

Knee injury was associated with poorer condition specific health-related quality of life, but not generic health-related quality of life 3-12 years post injury.

Publication


Knee Injury and Osteoarthritis Outcome Score (KOOS) Responder Criteria and Minimal Detectable Change

Toomey CM, Whittaker JL, Palacios-Derflingher L, Emery CA

J Clin Med. February 2021


Who participated in this study?

124 participants who suffered a youth sport-related knee injury 3-12 years previously and 129 participants with similar age, sex and sport characteristics.

When did this study occur?

Participants were recruited between 2013 and 2017 for their initial visit. They were invited to repeat testing annually for 2 subsequent visits.

Why did we do this research?

To evaluate the associations of intra-articular knee injury history type with two types of Knee Injury and Osteoarthritis Outcome Score criteria to define painful or symptomatic knee.

What did we find?

A high proportion of individuals with a 3-12-year history of different types if intra-articular knee injury were experiencing significant pain. 9-18% met the criteria for a symptomatic knee. Over a 1-4 year follow-up, at least one Knee Injury and Osteoarthritis Outcome Score sub-scale worsened for 36% of injured participants.

Publication


Classification of gait muscle activation patterns according to knee injury history

Mohr M, von Tscharner V, Emery CA, Nigg BM

Hum Mov Sci May 2019


Who participated in this study?

 34 participants who suffered a sport-related knee injury 3-12 years previously and 37 uninjured participants matched for age, sex and sport

When did this study occur?

August 2016-October 2017

Why did we do this research?

To characterize the abnormal muscle activity from electromyograms of five leg muscles

What did we find?

Injury-related adaptations of lower extremity muscle activation are sex-specific. Higher quadriceps and lower hamstring activity in previously injured females.

Publication


Quadriceps-hamstrings intermuscular coherence during single-leg squatting

Mohr M, von Tscharner V, Whittaker JL, Emery CA, Nigg BM

Hum Mov Sci May 2019


Who participated in this study?

34 participants who suffered a sport-related knee injury 3-12 years previously and 37 uninjured participants matched for age, sex and sport

When did this study occur?

August 2016-October 2017

Why did we do this research?

To determine the degree of co-contraction during single-leg squatting. To assess the influence of sex and self-reported knee complaints

What did we find?

60-90% of tested legs showed significant quadriceps-hamstrings gamma-band coherence during squatting. Females showed a higher coherence than males. Injury history was associated with reduced coherence in males but not females.

Publication


CCL22 is a biomarker of cartilage injury and plays a functional role in chondrocyte apoptosis

Ren G, Whittaker JL, Leonard C, De Rantere D, Pang DSJ, Salo P, Fritzler M, Kapoor M, de Koning APJ, Jaremko JL, Emery CA, Krawetz RJ

Cytokine March 2019


Who participated in this study?

76 individuals with a sport-related intra-articular knee injury sustained 3-10 years previously and 76 uninjured age-, sex- and sport-matched controls.

When did this study occur?

2013-2017

Why did we do this research?

To determine if knee joint injury is associated with systemic inflammation. To determine if systemic inflammation is related to knee pain and joint structure.

What did we find?

Cytokine association networks differed significantly between study groups. No significant associations were found between networks and KOOS Pain or MRI-defined osteoarthritis. CCL22 may be an early factor in onset/pathogenic process of cartilage degeneration and/or related to pain osteoarthritis.

Publication


Serum cartilage oligomeric matrix protein (COMP) expression in individuals

Laudon J, Whittaker JL, Ren G, Jaremko JL, Emery CA, Krawetz RJ

Osteoarthritis Cartilage February 2019


Who participated in this study?

85 individuals with a sport-related intra-articular knee injury sustained 3-10 years previously and 85 uninjured age-, sex- and sport-matched controls.

When did this study occur?

2013-2015

Why did we do this research?

To investigate the relationship between youth sport-realted intra-articular knee injury and COMP, a biomarker of cartilage turnover.

What did we find?

Serum COMP levels were greater in injured males compared to matched controls. When controlling for Fat Mass Index, no differences in COMP were found. A unique COMP fragmentation pattern was observed in injured vs uninjured participants.

Publication


Health-related Outcomes after a Youth Sport-related Knee Injury

Whittaker JL, Toomey CM, Nettel-Aguirre A, Jaremko JL, Doyle-Baker PK, Woodhouse LJ, Emery CA

Med Sci Sports Exerc February 2019


Who participated in this study?

100 individuals with a sport-related intra-articular knee injury sustained 3-10 years previously and 100 uninjured age-, sex- and sport-matched controls.

When did this study occur?

2013-2016

Why did we do this research?

To examine the association between youth sport-related knee injury and various clinical, physiological, behavioural and functional health-related outcomes.

What did we find?

Injured individuals demonstrate, on average, more negative health-related outcomes consistent with future osteoarthritis. These negative outcomes differ by sex and time since injury.

Publication


A qualitative investigation of the attitudes and beliefs about physical activity

Ezzat AM, Brussoni M, Whittaker JL, Emery CA

Phys Ther Sport July 2018


Who participated in this study?

20 young adults who sustained an intra-articular knee injury 3-10 years previous

When did this study occur?

June 2013-March 2014

Why did we do this research?

To understand the influence of injury experience on current attitudes and beliefs about physical activity and developing post-traumatic osteoarthritis

What did we find?

There were 4 key themes: Acceptance, Resiliency and Determination, Knee Confidence, and Athletic Identity. By addressing knee confidence and providing education on physical activity options and long-term joint health, health may be improved,

Publication


Knee confidence in youth and young adults at risk of post-traumatic osteoarthritis

Ezzat AM, Whittaker JL, Toomey C, Doyle-Baker PK, Brussoni M, Emery CA

J Sci Med Sport July 2018


Who participated in this study?

100 individuals with a sport-related intra-articular knee injury sustained 3-10 years previously and 100 uninjured age-, sex- and sport-matched controls

When did this study occur?

2013-2017

Why did we do this research?

To examine differences in knee confidence between individuals with a history of youth sport-related knee injury and uninjured controls

What did we find?

Injured participants had 5.0 and 7.5 times greater odds of being bothered by knee confidence than controls

Publication


Association between MRI-defined osteoarthritis, pain, function and strength

Whittaker JL, Toomey CM, Woodhouse LJ, Jaremko JL, Nettel-Aguirre A, Emery CA

Br J Sports Med July 2018


Who participated in this study?

73 individuals with a sport-related intra-articular knee injury sustained 3-10 years previously and 73 uninjured age-, sex- and sport-matched controls.

When did this study occur?

2013-2017

Why did we do this research?

To examine the association between MRI-defined osteoarthritis and self-reported and functional outcomes.

What did we find?

Injured participants had 10-fold greater odds of MRI-defined osteoarthritis than uninjured participants.

Publication


Differences in subchondral bone plate and cartilage thickness between women

Bhatla JL, Kroker A, Manske SL, Emery CA, Boyd SK

Osteoarthritis Cartilage July 2018


Who participated in this study?

15 women with unilateral ACL tears that had occurred more than 5 years ago and who had undergone ACL reconstruction, and 14 similarly-aged women who had not had a previous knee injury.

When did this study occur?

2017

Why did we do this research?

To assess if regions with differences in subchondral bone plate thickness have differences in cartilage thickness

What did we find?

Subchondral bone plate thickness differences are prominent following knee injury, but there are no significant difference in cartilage morphology.

Publication


Subchondral bone microarchitecture in ACL reconstructed knees of young women

Kroker A, Bhatla JL, Emery CA, Manske SL, Boyd SK

Bone June 2018


Who participated in this study?

15 women with reconstructed unilateral ACL tears and 14 healthy age-matched controls

When did this study occur?

2017

Why did we do this research?

To investigate how bone microarchitecture in ACL reconstructed knees differs from uninjured contralateral and healthy control knees

What did we find?

Differences in bone microarchitecture were primarily found in the femur. Lateral femur subchondral bone plate thickness was higher in reconstructed knees. Medial femoral trabecular bone mineral density was lower in reconstructed knees. There was no difference between contralateral knees and health controls.

Publication


Higher Fat Mass Is Associated With A History of Knee Injury in Youth Sport

Toomey CM, Whittaker JL, Nettle-Aguirre A, Reimer RA, Woodhouse LJ, Ghali B, Doyle-Baker PK, Emery CA

J Orthop Sports Phys Ther February 2017


Who participated in this study?

100 individuals with sport-related intra-articular knee injury sustained 3-10 years previously and 100 uninjured age-, sex- and sport-matched controls.

When did this study occur?

2013-2015

Why did we do this research?

To examine differences in adiposity, physical activity and cardiorespiratory fitness between youths with sport-related knee injury and uninjured controls.

What did we find?

Injured participants had higher Fat Mass Index and abdominal fat. Previous injury is significantly associated with increased Fat Mass Index. This increase is reduced in those who participated in higher physical activity or had a higher estimated maximum volume of oxygen.

Publication


The impact of previous knee injury on force plate and field-based measures of balance

Baltich J, Whittaker J, Von Tscharner V, Nettel-Aguirre A, Nigg BM, Emery C

Clin Biomech October 2015


Who participated in this study?

50 individuals with a sport-related intra-articular knee injury sustained 3-10 years previously and 50 uninjured age-, sex- and sport-matched controls.

When did this study occur?

2013-2014

Why did we do this research?

To examine the association between youth sport-related knee injury and balance.

What did we find?

Injured participants adjusted their position less frequently and demonstrated a larger magnitude of movement during single-limb stance compared to uninjured participants.

Publication


Outcomes associated with early post-traumatic osteoarthritis and other negative health consequences

Whittaker JL, Woodhouse LJ, Nettel-Aguirre A, Emery CA

Osteoarthritis Cartilage July 2015


Who participated in this study?

50 individuals with a sport-related intra-articular knee injury sustained 3-10 years previously and 50 uninjured age-, sex- and sport-matched controls

When did this study occur?

2013-2014

Why did we do this research?

To examine the association between youth sport-related knee injury and outcomes related to the development of post-traumatic osteoarthritis

What did we find?

Injured participants showed poorer Knee Osteoarthritis and Injury Outcome Score outcomes, were more likely to be overweight or obese, and scored lower during triple single-leg hop than uninjured participants.

Publications