Sex differences in knee joint loading: Cross-sectional study in geriatric population

Area of Science:

• Orthopedics
• Biomechanics
• Gerontology

Background:

• Sex differences in knee biomechanics are not well understood in geriatric populations.
• Knee osteoarthritis (OA) is prevalent in older adults, and biomechanical factors may influence its development.

Purpose of the Study:

• To investigate sex differences in knee joint biomechanics during gait in healthy older adults.
• To identify the determinants of these sex differences in knee biomechanics.

Main Methods:

• A cohort of 84 healthy older adults (42 males, 42 females) without knee OA was recruited.
• Three-dimensional motion capture and physical examinations were used to assess gait parameters, anthropometrics, and knee alignment.
• Multiple regression analysis identified determinants for sex differences in peak knee adduction moment (KAM).

Main Results:

• Females demonstrated a significantly higher peak KAM during gait compared to males (p=0.004).
• Females had a wider pelvis and narrower step width, while coronal knee alignment did not differ significantly between sexes.
• Narrow step width and a higher pelvic width/height ratio were significant determinants of higher peak KAM in females.

Conclusions:

• Sex differences in knee biomechanics exist in the geriatric population.
• Increased mechanical loading on the female knee, driven by gait patterns and pelvic structure, may contribute to OA development and progression.
• These findings highlight potential targets for interventions to mitigate OA risk in older women.