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Association Between Knee Load and Pain: Within-Patient, Between-Knees, Case-Control Study in Patients With Knee
Trevor B Birmingham1, Kendal A Marriott1, Kristyn M Leitch1
1University of Western Ontario, London, Ontario, Canada.
Arthritis Care & Research
|July 14, 2018
Summary
Knee loading significantly increases pain in osteoarthritis patients. Higher medial knee load, measured by knee adduction moment and impulse, strongly correlates with greater knee pain during walking.
Area of Science:
- Orthopedics
- Biomechanics
- Pain Management
Background:
- The link between knee loading and pain in knee osteoarthritis (KOA) is often considered weak.
- Previous studies may be confounded by patient-specific factors, questioning the true association.
Purpose of the Study:
- To clarify the relationship between dynamic knee load and pain in KOA patients.
- To minimize confounding by using a within-patient study design with knees discordant for pain.
Main Methods:
- 265 KOA patients with pain-discordant knees (530 knees total) participated.
- Pain was assessed before and after a 6-minute walk, followed by 3D gait analysis.
Main Results:
- Peak knee adduction moment and impulse (medial knee loading proxies) were linked to increased pain.
- Higher loading quartiles showed significantly greater odds of increased pain compared to the lowest quartile, even after adjusting for disease severity.
Conclusions:
- A strong association exists between medial knee load and increased knee pain during walking.
- Minimizing between-patient confounding reveals a significant link between knee loading and pain in KOA.
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