Proximal gait adaptations in medial knee OA

Area of Science:

• Biomechanics
• Orthopedics
• Kinesiology

Background:

• Medial knee osteoarthritis (OA) significantly impacts gait biomechanics.
• Understanding interlimb kinematic and kinetic differences is crucial for managing OA progression.
• Hip joint strategies may influence knee loading and compensatory movements.

Purpose of the Study:

• To investigate interlimb differences in gait kinematics and kinetics in patients with medial knee OA.
• To identify hip joint movement strategies aimed at reducing the knee adduction moment.
• To assess compensation for decreased knee flexion during the weight-acceptance phase.

Main Methods:

• Gait analysis was conducted on 32 patients with moderate medial compartment knee OA.
• Kinetic and kinematic data were collected for side-to-side comparisons.
• Frontal plane alignment was assessed using radiographs.

Main Results:

• No significant interlimb difference was found in the peak knee adduction moment (p = 0.512).
• A significantly reduced hip adduction moment was observed on the involved limb during early stance (p < 0.001).
• The involved limb demonstrated significantly less knee flexion and smaller hip/knee flexion moments compared to the uninvolved limb.

Conclusions:

• Lateral trunk sway may reduce ipsilateral knee adduction moments, reflected by lower hip adduction moments.
• Patients did not dynamically compensate for reduced knee flexion, likely leading to higher joint impact.
• These gait adaptations may contribute to ipsilateral hip muscle weakness and multiarticular OA progression.