While there is some research investigating whole foods or diets that are easily understood and accessible to patients with osteoarthritis, specific nutrients or nutraceuticals are more commonly identified. Unfortunately, guidelines and evidence surrounding individual nutrients, extracts, and nutraceuticals are conflicting and are more difficult to interpret and implement for patients with osteoarthritis. The purpose of this umbrella review is to provide a comprehensive understanding of the existing evidence of whole foods and dietary patterns effects on osteoarthritis-related outcomes to inform evidence-based recommendations for healthcare professionals and identify areas where more research is warranted. A literature search identified relevant systematic reviews/meta-analyses using five databases from inception to May 2022. Five systematic reviews/meta-analyses were included in the current umbrella review. Most evidence supported the Mediterranean diet improving osteoarthritis-related outcomes (e.g., pain, stiffness, inflammation, biomarkers of cartilage degeneration). There was little to no evidence supporting the effects of fruits and herbs on osteoarthritis-related outcomes; however, there was some suggestion that specific foods could potentiate symptom improvement through antioxidative mechanisms. The overall lack of homogeneity between the studies limits the conclusions that can be made and highlights the need for quality research that can identify consumer-accessible foods to improve osteoarthritis-related symptoms.

The purpose of this study was to compare gait biomechanics between limbs and to matched uninjured controls (i.e., sex, age, and body mass index) preoperatively and at 2, 4, 6, and 12 months following primary unilateral anterior cruciate ligament reconstruction (ACLR). Functional mixed effects models were used to identify differences in gait biomechanics throughout the stance phase between the a) ACLR limb and uninvolved limb, b) ACLR limb and controls, and c) uninvolved limb and controls. Compared with the uninvolved limb, the ACLR limb demonstrated lesser knee extension moment (KEM; within 8–37% range of stance) during early stance as well as lesser knee flexion moment (KFM; 45–84%) and greater knee flexion angle (KFA; 43–90%) during mid‐ to late stance at all timepoints. Compared with controls, the ACLR limb demonstrated lesser vertical ground reaction force (vGRF; 5–26%), lesser KEM (7–47%), and lesser knee adduction moment (KAM; 12–35%) during early stance as well as greater vGRF (39–63%) and greater KFA (34–95%) during mid‐ to late stance at all timepoints. Compared with controls, the uninvolved limb demonstrated lesser KFA (1–56%) and lesser KEM (12–54%) during early to mid‐stance at all timepoints. While gait becomes more symmetrical over the first 12 months post‐ACLR, the ACLR and uninvolved limbs both demonstrate persistent aberrant gait biomechanics compared to controls. Biomechanical waveforms throughout stance can be generally described as less dynamic following ACL injury and ACLR compared with uninjured controls.

For persons with osteoarthritis (OA), nutrition education may facilitate weight and OA symptom management. The primary aim of this study was to determine preferred OA-related nutritional and weight management topics and their preferred delivery modality. The secondary aim was to determine whether there is a disconnect between what patients want to know about nutrition and OA management and what information health-care professionals (HCPs) are providing to patients. The Osteoarthritis Action Alliance surveyed individuals with OA to identify their preferences, categorized in 4 domains: 1) strategies for weight management and a healthy lifestyle; 2) vitamins, minerals, and other supplements; 3) foods or nutrients that may reduce inflammation; and 4) diets for weight loss. HCPs were provided these domains and asked which topics they discussed with patients with OA. Both groups were asked to select currently utilized or preferred formats of nutritional resources. Survey responses from 338 individuals with OA and 104 HCPs were included. The highest preference rankings in each domain were: 1) foods that make OA symptoms worse (65%), foods and nutrients to reduce inflammation (57%), and healthy weight loss (42%); 2) glucosamine (53%), vitamin D (49%), and omega-3 fatty acids (45%); 3) spices and herbs (65%), fruits and vegetables (58%), and nuts (40%); and 4) Mediterranean diet (21%), low-carbohydrate diet (18%), and fasting or intermittent fasting (15%). There was greater than 20% discrepancy between interests reported by individuals with OA and discussions reported by HCPs on: weight loss strategies, general information on vitamins and minerals, special dietary considerations for other conditions, mindful eating, controlling caloric intake or portion sizes, and what foods worsen OA symptoms. Most respondents preferred to receive nutrition information in a passive format and did not want information from social media messaging. There is disparity between the nutrition education content preferred by individuals with OA (which often lacks empirical support) and evidence-based topics being discussed by HCPs. HCPs must communicate evidence-based management of joint health and OA symptoms in patient-preferred formats. This study explored the information gap between what individuals with OA want to know and what HCPs believe they need to know.

Aberrant gait biomechanics in individuals with anterior cruciate ligament reconstruction (ACLR) are linked to posttraumatic osteoarthritis (PTOA) development, indicating a need to normalize gait biomechanics to prevent PTOA. Anterior cruciate ligament reconstruction individuals walk slower than uninjured controls and slower speeds are associated with aberrant gait biomechanics. Yet, it is unclear if increasing walking speed normalizes gait biomechanics post-ACLR. Purpose: To determine the effect of acutely increasing walking speed on gait biomechanics in ACLR individuals compared with their habitual speed and uninjured matched-controls. Methods: Gait biomechanics were collected on 30 ACLR individuals (20 females; age, 22.0 ± 4.2 yr; body mass index, 24.0 ± 3.0 kg·m⁻²) at their habitual speed and at 1.3 m·s⁻¹, a speed similar to controls, and 30 uninjured matched-controls (age: 21.9 ± 3.8, body mass index: 23.6 ± 2.5) at their habitual speed. Functional waveform analyses compared biomechanics between: i) walking at habitual speed vs 1.3 m·s⁻¹ in ACLR individuals; and ii) ACLR individuals at 1.3 m·s⁻¹ vs controls. Results: In the ACLR group, there were no statistically significant biomechanical differences between walking at habitual speed (1.18 ± 0.12 m·s⁻¹) and 1.3 m·s⁻¹ (1.29 ± 0.05 m·s⁻¹). Compared with controls (habitual speed: 1.34 ± 0.12 m·s⁻¹), the ACLR group while walking at 1.3 m·s⁻¹ exhibited smaller vertical ground reaction force (vGRF) during early and late stance (13–28, 78–90% stance phase), greater midstance vGRF (47–61%), smaller early-to-midstance knee flexion angle (KFA; 1–44%), greater mid-to-late stance KFA (68–73, 96–101%), greater internal knee abduction moment (69–101%), and smaller internal knee extension moment (4–51, 88–96%). Conclusions: Increasing walking speed to a speed similar to uninjured controls did not elicit significant changes to gait biomechanics, and ACLR individuals continued to demonstrate biomechanical profiles that are associated with PTOA development and differ from controls.

Context: Slower habitual walking speed and aberrant gait biomechanics are linked to clinically significant knee-related symptoms and articular cartilage composition changes linked to posttraumatic osteoarthritis after anterior cruciate ligament reconstruction (ACLR). Objectives: To (1) determine whether specific gait biomechanical variables can accurately identify individuals with clinically significant knee-related symptoms post-ACLR and (2) determine the corresponding threshold values, sensitivity, specificity, and odds ratios for each biomechanical variable. Design: Cross-sectional study. Setting: Laboratory. Patients or Other Participants: A total of 71 individuals (38 female, 33 male; age = 21 ± 4 years, height = 1.76 ± 0.11 m, mass = 75.38 ± 13.79 kg, time after primary unilateral ACLR = 6.2 ± 0.4 months). Main Outcome Measure(s): Three-dimensional motion capture of 5 overground walking trials was used to calculate discrete gait biomechanical variables of interest during stance phase (first and second peak vertical ground reaction force [vGRF], midstance minimum vGRF, peak internal knee-abduction and -extension moments, and peak knee-flexion angle), along with habitual walking speed. Previously established Knee Injury and Osteoarthritis Outcome Score cutoff scores were used to define patients with (ie, symptomatic; n = 51) and those without (ie, asymptomatic; n = 20) clinically significant knee-related symptoms. Separate receiver operating characteristic curves and respective areas under the curve (AUCs) were used to evaluate the capability of each biomechanical variable of interest to identify individuals with clinically significant knee-related symptoms. Results: Habitual walking speed (AUC = 0.66), vGRF at midstance (AUC = 0.69), and second peak vGRF (AUC = 0.76) demonstrated low to moderate accuracy for identifying individuals with clinically significant knee-related symptoms. Individuals who exhibited habitual walking speeds ≤ 1.27 m/s, midstance minimum vGRF ≥ 0.82 body weights, and second peak vGRF ≤ 1.11 body weights demonstrated 3.13, 6.36, and 9.57 times higher odds of experiencing clinically significant knee-related symptoms, respectively. Conclusions: Critical thresholds for gait variables may be used to identify individuals with increased odds of clinically significant knee-related symptoms and potential targets for future interventions.

A history of anterior cruciate ligament reconstruction (ACLR) and high body mass index (BMI) are strong risk factors for incident knee osteoarthritis. Limited research has evaluated the interaction between ACLR and high BMI on limb‐level loading and early deleterious changes in cartilage health. The purpose of this study was to separately investigate the association between vertical ground reaction force (vGRF) loading profiles during gait and tibiofemoral cartilage composition in ACLR patients with high and normal BMI. Forty‐three participants with primary unilateral ACLR (17 ± 14 months post‐ACLR) were categorized as high (≥ 25 kg/m²; n = 18) or normal (< 25 kg/m²; n = 25) BMI and performed an overground gait at self‐selected speed. For biomechanical outcomes, we calculated the differences between first peak and midstance minimum (∆vGRF1) and between the second peak and midstance minimum (∆vGRF2). T1ρ relaxation time interlimb ratios (ILR), calculated as the T1ρ relaxation time in the ACLR relative to the uninjured limb, were calculated for the medial and lateral tibia and femur. Stepwise linear regressions were used to determine associations between biomechanical outcomes and T1ρ relaxation time ILR for each region of interest. Lesser ∆vGRF1 and ∆vGRF2 in the high‐BMI group significantly associated with greater T1ρ relaxation time ILR for the medial femoral condyle (ΔR² = 0.28, p = 0.03; ΔR² = 0.25, p = 0.04, respectively) and tibial plateau (ΔR² = 0.55, p < 0.001; ΔR² = 0.25, p = 0.004, respectively). Aberrant limb‐level loading, characterized by less dynamic limb loading, is linked to deleterious changes in tibiofemoral cartilage in ACLR patients with high BMI, suggesting that gait retraining may be more critical for ACLR with a BMI ≥ 25 kg/m².