Experimental Evaluation of Computationally Predicted Changes in Knee Loads Resulting From Medial Thrust Gait

2012 ◽  
Author(s):  
Allison L. Hall ◽  
Jonathan P. Walter ◽  
Thor F. Besier ◽  
Amy Silder ◽  
Scott L. Delp ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Experimental Evaluation ◽  
Treatment Strategies ◽  
Medial Compartment ◽  
Gait Patterns ◽  
Medial Knee ◽  
Knee Oa ◽  
Non Invasive ◽  
Gait Modification

Abnormal loading of the medial compartment of the knee is believed to be a contributing factor to the development of medial compartment knee osteoarthritis (OA) [1]. Treatment strategies for patients with medial knee OA include both invasive (i.e., surgery) and non-invasive (e.g., gait modification) options. A variety of modified gait patterns have been proposed as non-invasive treatments for patients with medial knee OA.

Changes in Medial Knee Contact Force Through Gait Modification

2012 ◽  
Author(s):  
Allison L. Hall ◽  
Thor F. Besier ◽  
Amy Silder ◽  
Scott L. Delp ◽  
Darryl D. D’Lima ◽  
...  
Keyword(s):  
Contact Force ◽  
Treatment Strategies ◽  
Medial Compartment ◽  
Knee Adduction Moment ◽  
Medial Knee ◽  
Non Invasive ◽  
Trunk Sway ◽  
Invasive Method ◽  
Gait Modification ◽  
External Knee Adduction Moment

The development of medial knee osteoarthritis (OA) has been attributed to overloading of the medial compartment articular cartilage [1]. Therefore, treatment strategies are often focused on reducing medial compartment loads. Gait modification represents a non-invasive method for achieving this goal. Previous studies have shown that a variety of gait modifications (e.g., toeing out, increased medial-lateral trunk sway, walking with medialized knees (i.e., medial thrust gait)) are effective in reducing the external knee adduction moment [e.g., 2–4]. Although the external knee adduction moment is often used as a surrogate measure of medial compartment force, a recent study showed that reductions in the external knee adduction moment do not guarantee reductions in medial compartment force [5]. Therefore, direct measurements of changes in medial contact force are important for determining the effectiveness of gait modifications.

scholarly journals Association of Varus Thrust With Pain and Stiffness and Activities of Daily Living in Patients With Medial Knee Osteoarthritis

2016 ◽  
Vol 96 (2) ◽  
pp. 167-175 ◽  
Author(s):  
Naoto Fukutani ◽  
Hirotaka Iijima ◽  
Takahiko Fukumoto ◽  
Daisuke Uritani ◽  
Eishi Kaneda ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Predictor Variable ◽  
Cross Sectional Study ◽  
Sensitivity Analyses ◽  
Varus Alignment ◽  
Cross Sectional ◽  
Medial Knee ◽  
Knee Oa

Background Increasing evidence highlights potential associations between varus thrust and health domains associated with knee osteoarthritis (OA). Objective The aim of this study was to investigate the association between varus thrust and 2 subcategories—“pain and stiffness” and “activities of daily living (ADL)”—of the Japanese Knee Osteoarthritis Measure (JKOM). Design This was a cross-sectional study. Methods In total, 296 outpatients with knee OA visiting orthopedic clinics were enrolled. The inclusion criteria were age ≥50 years, medial knee OA and Kellgren-Lawrence (K/L) grade ≥1 in one or both knees, and the ability to walk independently. Standard posterior-anterior knee radiographs were measured for varus alignment. Participants were video recorded while walking and were evaluated for the presence or absence of varus thrust. Pain and stiffness of the knee joint and ADL were evaluated using the JKOM. Multivariate regressions (outcomes: pain and stiffness and ADL; predictor variable: varus thrust) were performed. Results Varus thrust was present in 46 (16.2%) of 284 patients. Multivariate regression analyses demonstrated that varus thrust is independently associated with pain and stiffness, adjusted for age, sex, body mass index, K/L grade, and varus alignment (β=.17, P=.005). However, the association between varus thrust and ADL was not significant (β=.11, P=.058). Based on sensitivity analyses, including participants of K/L grade 1 had little influence on this analysis. Limitations Only 16.2% of participants had a varus thrust. Moreover, a cause-effect relationship between varus thrust and pain and stiffness remains unknown due to the cross-sectional design of this study. Conclusions Varus thrust was associated with pain and stiffness in patients with medial knee OA. However, the association between varus thrust and ADL did not reach significance.

scholarly journals A Positive Association Between Foot Posture Index and Medial Compartment Knee Osteoarthritis in Moroccan People

2014 ◽  
Vol 8 (1) ◽  
pp. 96-99 ◽  
Author(s):  
Abourazzak F.E ◽  
Kadi N ◽  
Azzouzi H ◽  
Lazrak F ◽  
Najdi A ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Medial Compartment ◽  
Control Group ◽  
Flat Foot ◽  
Pes Cavus ◽  
Foot Posture Index ◽  
Posture Index ◽  
Knee Oa ◽  
Significant Difference ◽  
Foot Posture

Objectives : To compare foot posture in people with and without medial compartment knee osteoarthritis (OA), and to assess association between its abnormalities and medial compartment knee OA. Methods : We compared the foot posture of patients with clinically and radiographically-confirmed medial compartment knee OA and asymptomatic healthy controls using the foot posture index (FPI), navicular height, and the medial arch. Results : We included 100 patients and 80 asymptomatic controls. The mean age of patients was 59 ± 7 (44-76) years and 48 ± 9 (28-60) years in the control (p=0.06). Patients group have more pronated foot for FPI (1.50 ± 2.68 vs 0.72 ± 2.63; p=0.05), more flat foot (42% vs 22%; p=0.03), and less pes cavus than the control group (58% vs 77%; p=0.004). However, there was no significant difference between the groups in the navicular height (3.90 ± 0.85 cm vs 4.00 ± 0.76 cm; p=0.41). In multivariate statistical analysis, after adjusting for age and body mass index, pronated foot in FPI (OR=1.22, 95%IC= [1.06-1.40], p=0.005), and pes cavus (OR=0.32, 95%IC= [0.11-0.93], p=0.03) had a significant correlation with the knee osteoarthritis. Conclusion : Pronated foot posture and flat foot are significantly associated with medial compartment knee osteoarthritis.

scholarly journals RADIOLOGICAL ASSESSMENT OF KNEE JOINT WIDTH DIFFERENCES IN OLDER ADULTS WITH SYMPTOMATIC MEDIAL KNEE OSTEOARTHRITIS

2021 ◽  
Author(s):  
SAMWON YOON ◽  
YOUNGJOO CHA ◽  
HYUNSIK YOON ◽  
KYOUNGTAE KIM ◽  
ILBONG PARK ◽  
...  
Keyword(s):  
Older Adults ◽  
Knee Joint ◽  
Knee Osteoarthritis ◽  
Joint Space Width ◽  
Lower Limbs ◽  
Unaffected Side ◽  
Medial Knee ◽  
Knee Oa ◽  
Affected Side ◽  
Significant Difference

Knee osteoarthritis (OA) is a degenerative articular disease. The knee joint space width (JSW) is used for grading the severity of knee OA. However, there is a lack of research on differences in the widths of knee joints between both lower limbs in unilateral OA. The purpose of this research was to examine the radiological difference in the affected knee joint and contralateral knee joint by analyzing unilateral older adults with medial knee OA using both knees’ JSW differences. Twenty-five subjects with unilateral medial knee OA participated. X-ray radiographs were used to assess knee JSW, and the paired [Formula: see text]-test was performed to assess the knee joint gap width between the affected side and the unaffected side in the respective medial and lateral sides. The independent [Formula: see text]-test compared the differences between the lateral and medial knee JSWs on the affected side and unaffected side. The paired [Formula: see text]-test did not show a significant difference in the medial and lateral knee JSW on the affected side compared to the unaffected side ([Formula: see text]; 0.11). Meanwhile, the independent [Formula: see text]-test revealed a significant difference between the affected and unaffected sides ([Formula: see text]). This study showed no significant changes in affected knee JSWs compared to unaffected sides, but the difference between the lateral and medial JSWs was significant between the knees affected and unaffected by OA in the older adults with medial knee OA.

Muscle Forces May Explain Paradoxical Knee Loads During Different Gait Patterns

2010 ◽  
Author(s):  
Jonathan P. Walter ◽  
Darryl D. D’Lima ◽  
Benjamin J. Fregly
Keyword(s):  
Disease Progression ◽  
Medial Compartment ◽  
Knee Adduction Moment ◽  
Gait Patterns ◽  
Common Assumption ◽  
Clinical Disorder ◽  
Surrogate Measure ◽  
Gait Modification ◽  
External Knee Adduction Moment

Medial compartment knee osteoarthritis is a common clinical disorder [1] in which the articular cartilage in the medial compartment progressively deteriorates. To slow disease progression without surgical intervention, researchers have proposed gait modifications to offload the medial compartment. Since knee medial contact force (MCF) cannot be measured non-invasively in vivo, researchers have identified the external knee adduction moment (KAM) as a surrogate measure that is easy to calculate [2]. A common assumption has been that reducing the peak KAM will result in a corresponding reduction in peak MCF. While the magnitude of the peak KAM has been correlated with disease severity and rate of disease progression [3,4], it is not clear that reduction of this external load via gait modification will always result in a decrease in internal MCF.

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