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Acoustic Emissions as a Non-invasive Biomarker of the Structural Health of the Knee

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Abstract

The longitudinal assessment of joint health is a long-standing issue in the management of musculoskeletal injuries. The acoustic emissions (AEs) produced by joint articulation could serve as a biomarker for joint health assessment, but their use has been limited by a lack of mechanistic understanding of their creation. In this paper, we investigate that mechanism using an injury model in human lower-limb cadavers, and relate AEs to joint kinematics. Using our custom joint sound recording system, we recorded the AEs from nine cadaver legs in four stages: at baseline, after a sham surgery, after a meniscus tear, and post-meniscectomy. We compare the resulting AEs using their b-values. We then compare joint anatomy/kinematics to the AEs using the X-ray reconstruction of moving morphology (XROMM) technique. After the meniscus tear the number and amplitude of the AE peaks greatly increased from baseline and sham (b-value = 1.33 ± 0.15; p < 0.05). The XROMM analysis showed a close correlation between the minimal inter-joint distances (0.251 ± 0.082 cm during extension, 0.265 ± .003 during flexion, at 145°) and a large increase in the AEs. This work provides key insight into the nature of joint AEs, and details a novel technique and analysis for recording and interpreting these biosignals.

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References

  1. Ahmed, A. M., and D. L. Burke. In-vitro measurement of static pressure distribution in synovial joints. J. Biomech. Eng. 105(3):216–225, 1983.

    Article  CAS  Google Scholar 

  2. American Academy of Orthopaedic Surgeons. Information About Musculoskeletal Conditions. 3 Nov. 2015.

  3. Bai, B., H. Shun, Z. X. Yin, Z. W. Liao, and N. Chen. Changes of contact pressure in patellofemoral joint after meniscectomies. Int. Orthop. J. 36:987–991, 2012.

    Article  Google Scholar 

  4. Blodgett, W. Auscultation of the knee joint. Boston Med. Surg. J. 146(3):63–66, 1902.

    Article  Google Scholar 

  5. Boll, S. Suppression of acoustic noise in speech using spectral subtraction. IEEE Trans. Acoust. Speech Signal Process. 27(2):113–120, 1979.

    Article  Google Scholar 

  6. Brainerd, E. L., D. B. Baier, S. M. Gatesy, T. L. Hedrick, K. A. Metzger, S. L. Gilbert, and J. J. Crisco. X-ray reconstruction of moving morphology (XROMM): precision, accuracy and applications in comparative biomechanics research. J. Exp. Zool. 313(5):262–279, 2010.

    Google Scholar 

  7. Coluccino, L., C. Peres, R. Gottardi, P. Bianchini, A. Diaspro, and L. Ceseracciu. Anisotropy in the viscoelastic response of knee meniscus cartilage. J. Appl. Biomater. 15(1):77–83, 2017.

    Google Scholar 

  8. Dehaven, K. E. Diagnosis of acute knee injuries with hemarthrosis. Am. J. Sports Med. 8(1):9–14, 1980.

    Article  CAS  Google Scholar 

  9. Englund, M., E. M. Roos, and L. S. Lohmander. Impact of type of meniscal tear on radiographic and symptomatic knee osteoarthritis. Arthritis Rheum. 48(8):2178–2187, 2003.

    Article  CAS  Google Scholar 

  10. Fairbank, T. J. Knee joint changes after meniscectomy. J. Bone Joint Surg. 30(4):664–670, 1948.

    Article  Google Scholar 

  11. Fukubayashi, T., and H. Kurosawa. The contact area and pressure distribution pattern of the knee. Acta Orthop. Scand. 51(1–6):871–879, 1980.

    Article  CAS  Google Scholar 

  12. Guilak, F., B. Fermor, F. J. Keefe, V. B. Kraus, S. A. Olson, D. S. Pisetsky, and J. B. Weinberg. The role of biomechanics and inflammation in cartilage injury and repair. Clin. Orthop. Relat. Res. 423:17–26, 2004.

    Article  Google Scholar 

  13. Gutenberg, B., and C. F. Richter. Seismicity of the Earth and Associated Phenomena. New York: Hafner Publishing Company, p. 310, 1965.

    Google Scholar 

  14. Henry, S., R. Mascarenhas, D. Kowalchuk, B. Forsythe, J. J. Irrgang, and C. D. Harner. Medial meniscus tear morphology and chondral degeneration of the knee: is there a relationship? Arthroscopy 28(8):1124–1134, 2012.

    Article  Google Scholar 

  15. Hersek, S., M. B. Pouyan, C. N. Teague, M. N. Sawka, M. L. Millard-Stafford, G. F. Kogler, and O. T. Inan. Acoustic emission analysis by unsupervised graph mining: a novel biomarker of knee health status. IEEE Trans. Biomed. Eng. 65(6):1291–1300, 2018.

    Article  Google Scholar 

  16. Hootman, J. M., C. G. Helmick, K. E. Barbour, K. A. Theis, and M. A. Boring. Updated projected prevalence of self-reported doctor-diagnosed arthritis, 2015–2040. Arthritis Rheumatol. 68:1582–1587, 2016.

    Article  Google Scholar 

  17. Jeong, H. K., D. Whittingslow, and O. T. Inan. b-Value: a potential biomarker for assessing knee joint health using acoustic emission sensing. IEEE Sens. Lett. 2:4, 2018.

    Article  Google Scholar 

  18. Knörlein, B. J., D. B. Baier, S. M. Gatesy, J. D. Laurence-Chasen, and E. L. Brainerd. Validation of XMALab software for marker-based XROMM. J. Exp. Biol. 219(23):3701–3711, 2016.

    Article  Google Scholar 

  19. Krishnan, S. Adaptive time-frequency analysis of knee joint vibroarthrographic signals for noninvasive screening of articular cartilage pathology. IEEE Trans. Biomed. Eng. 47(6):773–783, 2000.

    Article  CAS  Google Scholar 

  20. Lee. T. F. Analysis of vibroarthrographic signals for knee osteoarthritis diagnosis. In: Proceeding 2012 6th International Conference Genetic Evolution Computing, 2012, pp. 223–228.

  21. Matsas, A., N. Taylor, and H. McBurney. Knee joint kinematics from familiarised treadmill walking can be generalised to overground walking in young unimpaired subjects. Gait & Posture 11(1):46–53, 2000.

    Article  CAS  Google Scholar 

  22. McDermott, I. D., and A. A. Amis. The consequences of meniscectomy. J. Bone Joint Surg. 88:1549–1556, 2006.

    Article  CAS  Google Scholar 

  23. Medvecky, M. J., and F. R. Noyes. Surgical approaches to the posteromedial and posterolateral aspects of the knee. J. Am. Acad. Orthop. Surg. 13(2):121–128, 2005.

    Article  Google Scholar 

  24. Perie, D., and M. C. Hobatho. In vivo determination of contact areas and pressure of the femorotibial joint using non-linear finite element analysis. Clin. Biomech. 13(6):394–402, 1998.

    Article  Google Scholar 

  25. Post, W. R., S. R. Akers, and V. Kish. Load to failure of common meniscal repair techniques: effects of suture technique and suture material. Arthroscopy 13(6):731–736, 1997.

    Article  CAS  Google Scholar 

  26. Rao, A. J., B. J. Erickson, G. L. Cvetanovich, A. B. Yanke, B. R. Bach, Jr, and B. J. Cole. The meniscus-deficient knee: biomechanics, evaluation, and treatment options. Orthop. J. Sports Med. 3(10):2325967115611386, 2015.

    Article  Google Scholar 

  27. Schumacher, Jr, H. R. Aspiration and injection therapies for joints. Arthritis Rheumatol. 49(3):413–420, 2003.

    Article  Google Scholar 

  28. Teague, C. N., S. Hersek, H. Toeryin, M. Millard-Stafford, M. Jones, G. Kogler, M. Sawka, and O. Inan. Novel methods for sensing acoustic emissions from the knee for wearable joint health assessment. IEEETrans. Biomed. Eng. 63(8):1581–1590, 2016.

    Article  Google Scholar 

  29. Torry, M. R., M. J. Decker, R. W. Viola, D. O’Connor, and J. R. Steadman. Intra-articular knee joint effusion induces quadriceps avoidance gait patterns. Clin. Biomech. 15(3):147–159, 2000.

    Article  CAS  Google Scholar 

  30. Woolf, A. D., and K. Akesson. Understanding the burden of musculoskeletal conditions. BMJ 322:1079–1080, 2001.

    Article  CAS  Google Scholar 

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Acknowledgments

The authors thank Professor Young-Hui Chang and his Comparative Neuromechanics Lab at the Georgia Institute of Technology for lending expertise on the imaging and XROMM tracking portion of this project.

Funding

This work was supported by the National Institutes of Health, National Institute of Biomedical Imaging and Bioengineering, Grant No. 1R01EB023808, as part of the NSF/NIH Smart and Connected Health Program.

Author contributions

DW served as the project lead and was involved in every part of its design, execution, and reporting. HJ was the lead data analyzer and assisted DW with the recording of the joint sounds. VG was involved in all aspects of the project, particularly the monitoring and execution of the articulations for proper sound recording. NK was the lead on the XROMM and imaging analysis portion of the project. GK conceived the original experimental cadaveric design model and provided clinical perspective on injuries to the knee. OI served as the principal investigator for the project, and was integral in the funding, managing, planning and execution of all aspects.

Competing interests

The authors have no competing financial interests to report.

Data availability

The authors will make the data available upon request.

Author information

Authors and Affiliations

  1. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA

    Daniel. C. Whittingslow, Nathan J. Kirkpatrick & Omer T. Inan

  2. Emory University School of Medicine, Atlanta, GA, USA

    Daniel. C. Whittingslow

  3. School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, USA

    Hyeon-Ki Jeong, Venu G. Ganti & Omer T. Inan

  4. School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, USA

    Geza F. Kogler

Authors
  1. Daniel. C. Whittingslow
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  2. Hyeon-Ki Jeong
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  3. Venu G. Ganti
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  4. Nathan J. Kirkpatrick
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  5. Geza F. Kogler
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  6. Omer T. Inan
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Corresponding author

Correspondence to Daniel. C. Whittingslow.

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Associate Editor Peter E. McHugh oversaw the review of this article.

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Whittingslow, D.C., Jeong, HK., Ganti, V.G. et al. Acoustic Emissions as a Non-invasive Biomarker of the Structural Health of the Knee. Ann Biomed Eng 48, 225–235 (2020). https://doi.org/10.1007/s10439-019-02333-x

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  • DOI: https://doi.org/10.1007/s10439-019-02333-x

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