2015 ISAKOS Biennial Congress ePoster #1132

Gait Knee Kinematic Alterations in Medial Osteoarthritis – 3D Assesement

Dafina Bytyqi, PhD, Prishtina, Kosovo ALBANIA
Bujar Shabani, MD, PhD, Prishtina, Kosovo KOSOVO
Sebastien Lustig, MD, PhD, Lyon, Rhône Alpes FRANCE
Laurence Cheze, Prof.,, Lyon, Rhone-Alpes FRANCE
Philippe Noel Neyret, MD, PhD, Prof., Lyon La Tour De Salvagny FRANCE

Laboratoire de Biomécanique et Mécanique des Chocs' Universite Claude Bernard, LYON 1, Lyon, Rhone Alpes, FRANCE

FDA Status Not Applicable

Summary: Gait differences that appear with knee OA included decreased stance phase knee extension and decreased swing phase flexion angles, decreased internal rotation and increased adduction angles.

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Abstract:

Background

Knee osteoarthritis (OA) is a common cause of functional disability, the medial compartment being the most affected. Patients with osteoarthritis (OA) tend to modify spatial and temporal parameters during walking to reduce the pain and knee joint moments. Although the kinematic changes in the sagittal plane of OA patients have been elucidated, very few studies have analyzed changes in the frontal and horizontal planes.Therefore the aim of this study was to investigate in vivo three dimensional knee kinematics in patients suffering from knee OA during walking.

Material And Methods

30 patients with medial knee OA and a control group with age- matched subjects were prospectively collected for this study. All subjects were examined with KneeKG system while walking on a treadmill at a self-selected speed. The KneeKG is composed of passive motion sensors fixed on the validated knee harness, an infrared motion capture system (Polaris Spectra camera, Northern Digital Inc.), and a computer equipped with the Knee3DTM software suite (Emovi, Inc.). In each trial, we calculated the angular displacements of flexion/extension, abduction/adduction, and external/internal tibial rotation.Statistical analyze was performed to determine differences between knee OA group and control group.

Results

The patients with knee OA had a reduced extension during stance phase (p<0.05;8.550 and 4.390 ,OA patients and control group, respectively) and a reduced flextion during push-off and initial swing phase (p<0.05; 41.90 and 49.360, OA patients and control group, respecively). The adduction angle was consistently greater at the OA patients (p<0.05; 3.40 and -0.970, for OA and control group, respectively). The frontal laxity at OA patients was positively correlated with varus deformity(r=0.42, p<0.05). There was a significant difference (p<0.05) in the tibial rotation during the midstance phase; the OA patients retained a neutral position(-0.430) while control group presented internal tibial rotation (-2.220).

Conclusion

The reduction of extension suggests that in severe knee OA, patients do not use their quadriceps (i.e., quadricep avoidance gait pattern) to absorb the impact during the loading phase of gait. Larger adduction angle found in our study may be the result of the larger lever arm magnitudes exhibited in knees with medial OA. OA patients actively avoided internal rotation to decrease the load in medial compartement thereby decrease pain.
Weight-bearing kinematics in medial OA knees differ from normal knee kinematics. Gait differences that appear with knee OA included decreased stance phase knee extension and decreased swing phase flexion angles, decreased internal rotation and increased adduction angles.
These data will be taken in consideration in a further study that evaluates the kinematic outcomes of the patients after total knee replacement.