TY - JOUR A1 - Boeth, Heide A1 - Biesen, Robert A1 - Hollnagel, Jeremias A1 - Herrmann, Sandra A1 - Ehrig, Rainald A1 - Pelli, Lorenzo A1 - Taylor, William R. A1 - Duda, Georg A1 - Buttgereit, Frank T1 - Quantification of morning stiffness to assess disease activity and treatment effects in rheumatoid arthritis JF - Rheumatology N2 - Objectives The clinical parameter “morning stiffness” is widely used to assess the status of rheumatoid arthritis (RA), but its accurate quantitative assessment in a clinical setting has not yet been successful. This lack of individual quantification limits both personalized medication and efficacy evaluation in the treatment of RA. Methods We have developed a novel technology to assess passive resistance of the metacarpophalangeal (MCP) III joint (stiffness) and its Passive Range of Motion (PRoM). Within this pilot study, nineteen female postmenopausal RA patients and nine healthy controls were examined in the evening as well as in the morning of the following day. To verify the specificity of the biomechanical quantification, eleven patients with RA were assessed both prior to and ∼3 h after glucocorticoid therapy. Results While the healthy controls showed only minor changes between afternoon and morning, in RA patients mean±SD PRoM decreased significantly by 18 ± 22% and stiffness increased significantly by 20 ± 18% in the morning compared with the previous afternoon. We found a significant positive correlation between RA activity and biomechanical measures. Glucocorticoids significantly increased mean PRoM by 16 ± 11% and reduced mean stiffness by 23 ± 22%. Conclusion This technology allowed mechanical stiffness to be quantified in MCP joints, and has demonstrated high sensitivity in respect to disease status as well as medication effect in RA patients. Such non-invasive, low risk, and rapid assessment of biomechanical joint stiffness opens a novel avenue for judging therapy efficacy in patients with RA, and potentially also in other non-RA inflammatory joint diseases. Y1 - 2021 U6 - https://doi.org/10.1093/rheumatology/keab323 VL - 60 IS - 11 SP - 5282 EP - 5291 ER - TY - JOUR A1 - Trepczynski, Adam A1 - Kneifel, Paul A1 - Heyland, Mark A1 - Leskovar, Marko A1 - Moewis, Philippe A1 - Damm, Philipp A1 - Taylor, William R. A1 - Zachow, Stefan A1 - Duda, Georg T1 - Impact of the External Knee Flexion Moment on Patello-Femoral Loading Derived from in vivo Loads and Kinematics JF - Frontiers in Bioengineering and Biotechnology N2 - Anterior knee pain and other patello-femoral (PF) complications frequently limit the success of total knee arthroplasty as the final treatment of end stage osteoarthritis. However, knowledge about the invivo loading conditions at the PF joint remains limited, as no direct measurements are available. We hypothesised that the external knee flexion moment (EFM) is highly predictive of the PF contact forces during activities with substantial flexion of the loaded knee.Six patients (65-80 years, 67-101 kg) with total knee arthroplasty (TKA) performed two activities of daily living: sit-stand-sit and squat. Tibio-femoral (TF) contact forces were measured in vivo using instrumented tibial components, while synchronously internal TF and PF kinematics were captured with mobile fluoroscopy. The measurements were used to compute PF contact forces using patient specific musculoskeletal models. The relationship between the EFM and the PF contact force was quantified using linear regression.Mean peak TF contact forces of 1.97 to 3.24 times body weight (BW) were found while peak PF forces reached 1.75 to 3.29 times body weight (BW). The peak EFM ranged from 3.2 to 5.9 %BW times body height, and was a good predictor of the PF contact force (R^2 = 0.95 and 0.88 for sit-standsit and squat, respectively).The novel combination of in vivo TF contact forces and internal patellar kinematics enabled a reliable assessment of PF contact forces. The results of the regression analysis suggest that PF forces can be estimated based solely on the EFM from quantitative gait analysis. Our study also demonstrates the relevance of PF contact forces, which reach magnitudes similar to TF forces during activities of daily living. Y1 - 2024 U6 - https://doi.org/10.3389/fbioe.2024.1473951 VL - 12 ER -