Knee acoustic emission: a potential biomarker for quantitative assessment of joint ageing and degeneration.

Based on a single time-point study of 34 healthy and 19 osteoarthritic knees in three different age groups (early, middle and late adulthood), this paper reports the potential of knee acoustic emission as a biomarker to monitor joint ageing and degeneration. Measurements were made of short transient high frequency acoustic emission signals generated by knee joints under stress during repeated sit-stand-sit movements along with joint angle. A statistically significant feature profile was established using a four-phase model of sit-stand-sit movements and two waveform features. The four-phase movement model is derived from joint angle measurement during repeated sit-stand-sit movements, and it consists of the ascending-acceleration and ascending-deceleration phases in the sit-to-stand movement, followed by the descending-acceleration and descending-deceleration phases in the stand-to-sit movement. The two statistically significant waveform features are extracted from AE measurement during repeated sit-stand-sit movements, and they consist of the peak magnitude value and average signal level of each AE burst. In addition to the use of bilateral plots, statistical distributions and 2D colour histograms to visualise the differences and similarities among participants, use of principal component analysis showed not only distinct data clusters corresponding to participating groups, but also an age- and disease-related trajectory progressing from the early adulthood healthy group to the late adulthood healthy group followed by the middle adulthood osteoarthritic group to the late adulthood osteoarthritic group. Furthermore, this trajectory shows increasing areas for each data cluster, with a highly compact cluster for the early adulthood healthy group at one end and a widely spread cluster for the late adulthood osteoarthritic group at the other end. From these results, a strong basis is formed for further development of knee acoustic emission as a convenient and non-invasive biomarker for quantitative assessment of joint ageing and degeneration.

Exploratory study of a non-invasive method based on acoustic emission for assessing the dynamic integrity of knee joints.

The paper presents the development of a new measurement system based on acoustic emission (AE) for assessing the dynamic integrity of knee joints, and the evaluation of its efficacy, through an exploratory study using healthy and osteoarthritic knees. For the former, the paper describes the system implemented to acquire joint angle-based AE and the protocol developed to obtain repeatable results. For the latter, the paper reports significant differences between healthy and osteoarthritic knees using statistical analysis of AE occurrence and distribution of AE features in different movement phases. Osteoarthritic knees are found to produce 6-10 times more acoustic emissions than healthy knees, with amplitudes which can be 20 dB higher, and durations which can be 10 times longer. These findings lead to a visual representation method of AE feature profiles based on multidimensional density of AE hits per repeated movement and the use of principal component analysis for objective assessment of the clinical status of knee joints.