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research-article

Evaluation of the effect of bariatric surgery-induced weight loss on knee gait and cartilage degeneration

[+] Author and Article Information
Mimmi K. Liukkonen

Department of Applied Physics, University of Eastern Finland, POB 1627, Kuopio FI-70211, Finland
mimmi.liukkonen@uef.fi

Mika E. Mononen

Department of Applied Physics, University of Eastern Finland, POB 1627, Kuopio FI-70211, Finland
mika.mononen@uef.fi

Paavo Vartiainen

Department of Applied Physics, University of Eastern Finland, POB 1627, Kuopio FI-70211, Finland
paavo.vartiainen@uef.fi

Päivi Kaukinen

Institute of Clinical Medicine, University of Eastern Finland, POB 1627, Kuopio FI-70211, Finland, Department of Physical and Rehabilitation Medicine, Kuopio University Hospital, POB 100, Kuopio FI-70029, Finland
paivi.kaukinen@kuh.fi

Timo Bragge

Charles River Discovery Research Services, Microkatu 1, FI-70210 Kuopio
timo.bragge@gmail.com

Juha-Sampo Suomalainen

Department of Clinical Radiology, University of Eastern Finland, POB 1627, Kuopio FI-70211, Finland
juha-sampo.suomalainen@kuh.fi

Markus K.H. Malo

Department of Applied Physics, University of Eastern Finland, POB 1627, Kuopio FI-70211, Finland
markus.malo@uef.fi

Sari Venesmaa

Department of Surgery, University of Eastern Finland, POB 1627, Kuopio FI-70211, Finland, Department of Gastrointestinal Surgery, Kuopio University Hospital, POB 100, Kuopio FI-70029, Finland
sari.venesmaa@kuh.fi

Pirjo Käkelä

Department of Surgery, University of Eastern Finland, POB 1627, Kuopio FI-70211, Finland; Department of Gastrointestinal Surgery, Kuopio University Hospital, POB 100, Kuopio FI-70029, Finland
pirjo.kakela@kuh.fi

Jussi Pihlajamäki

Department of Public Health and Clinical Nutrition, University of Eastern Finland, POB 1627, Kuopio FI-70211, Finland, Clinical Nutrition and Obesity Center, Kuopio University Hospital, POB 100, Kuopio FI-70029, Finland
jussi.pihlajamaki@kuh.fi

Pasi A. Karjalainen

Department of Applied Physics, University of Eastern Finland, POB 1627, Kuopio FI-70211, Finland
pasi.karjalainen@uef.fi

Jari P. Arokoski

Department of Physical and Rehabilitation Medicine, Helsinki University Hospital, POB 349, Helsinki FI-00029, Finland, University of Helsinki, POB 3, Helsinki FI-00014, Finland
jari.arokoski@hus.fi

Rami Korhonen

Department of Applied Physics, University of Eastern Finland, POB 1627, Kuopio FI-70211, Finland, Diagnostic Imaging Centre, Kuopio University Hospital, POB 100, Kuopio FI-70029, Finland
rami.korhonen@uef.fi

1Corresponding author.

ASME doi:10.1115/1.4038330 History: Received May 11, 2017; Revised October 24, 2017

Abstract

The objective of the study was to investigate the effect of bariatric surgery-induced weight loss on knee gait and cartilage degeneration in osteoarthritis by combining magnetic resonance imaging, gait analysis, finite element modeling and cartilage degeneration algorithm. Gait analyses were performed for obese subjects before and one-year after the bariatric surgery. Finite element models were created before and after weight loss for those subjects who had not 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 osteoarthritis. The average weight loss was 25.7±11.0kg corresponding to a 9.2±3.9kg/m2 decrease in 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, also increased degeneration levels could 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 and knee compartment. Simulation results also suggest that prediction of cartilage degeneration is subject-specific and depend highly on the altered gait loading, not just the patient's weight.

Copyright (c) 2017 by ASME
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