Subject: ScienceDirect - Osteoarthritis and Cartilage : Lateral trunk lean explains variation in dynamic knee joint load in patients with medial compartment knee osteoarthritis

 doi:10.1016/j.joca.2007.10.017      

Copyright © 2007 Osteoarthritis Research Society International Published by Elsevier Ltd.

Lateral trunk lean explains variation in dynamic knee joint load in patients with medial compartment knee osteoarthritis

M.A. Hunt P.T., Ph.D., T.B. Birmingham P.T., Ph.D., D. Bryant Ph.D., I. Jones M.A., J.R. Giffin M.D., F.R.C.S.(C)., T.R. Jenkyn P.Eng., Ph.D. and A.A. Vandervoort Ph.D.

Wolf Orthopaedic Biomechanics Laboratory, Fowler Kennedy Sport Medicine Clinic, University of Western Ontario, London, Ontario, Canada

School of Physical Therapy, University of Western Ontario, London, Ontario, Canada

Department of Mechanical and Materials Engineering, University of Western Ontario, London, Ontario, Canada

Department of Orthopaedic Surgery, University of Western Ontario, London, Ontario, Canada

Received 29 June 2007;  accepted 29 October 2007.  Available online 21 February 2008. 

Summary

Objective

To test the hypothesis that selected gait kinematics, particularly lateral trunk lean, observed in patients with medial compartment knee osteoarthritis explain variation in dynamic knee joint load.

Method

In this cross-sectional observational study, 120 patients with radiographically confirmed varus gonarthrosis underwent three-dimensional gait analysis at their typical walking speed. We used sequential (hierarchical) linear regression to examine the amount of variance in dynamic knee joint load (external knee adduction moment) explained by static lower limb alignment (mechanical axis angle) and gait kinematics determined a priori based on their proposed effect on knee load (walking speed, toe-out angle, and lateral trunk lean angle).

Results

Approximately 50% of the variation in the first peak external knee adduction moment was explained by mechanical axis angle (25%), Western Ontario and McMaster Universities Osteoarthritis Index pain score (1%), gait speed (1%), toe-out angle (12%), and lateral trunk lean angle (13%). There was no confounding or interaction with Kellgren and Lawrence grade of severity.

Conclusions

Gait kinematics, particularly lateral trunk lean, explain substantial variation in dynamic knee joint load in patients with medial compartment knee osteoarthritis. While largely ignored in previous gait studies, the effect of lateral trunk lean should be considered in future research evaluating risk factors and interventions for progression of knee osteoarthritis.

Key words: Knee osteoarthritis; Gait; Knee adduction moment; Kinematics

Article Outline

Introduction

Materials and methods

Participants

Lower limb alignment

Gait analysis

Statistical analysis

Results

Discussion

Conflict of interest

Acknowledgements

References