Individuals With Knee Osteoarthritis and Symmetrical Total Joint Moment Exhibit Bilateral Gait Characteristics...

Interlimb asymmetries may influence contralateral knee osteoarthritis (OA) progression, yet research remains unclear. This study examined whether patient-reported outcomes and knee biomechanics differ between individuals with knee OA exhibiting symmetrical versus asymmetrical knee loading. Forty-three individuals with knee OA were dichotomized into symmetrical (≤14% asymmetry; n = 19) and asymmetrical (>14% asymmetry; n = 24) groups based on total joint moment symmetry indices. Participants completed the Knee Injury and Osteoarthritis Outcome Score and Intermittent and Constant Osteoarthritis Pain questionnaires. Three-dimensional kinematics and kinetics were collected during walking at a self-selected speed. Independent t tests and statistical parametric mapping examined between-group differences in patient-reported outcomes and biomechanical measures. Individuals with symmetrical knee loading had worse Knee Injury and Osteoarthritis Outcome Score activities of daily living scores (P = .041) than those with asymmetrical loading. Individuals with symmetrical knee loading exhibited less knee extension moment during late stance (P = .031) and lower knee adduction moment range in their affected knee compared with asymmetrical loaders. Individuals with symmetrical knee loading walked with lower knee flexion angles (P = .011), less midstance unloading (P = .011), and lower peak knee flexion moment (P < .001) in their contralateral knee compared with asymmetrical loaders. Symmetrical knee loading was associated with affected and contralateral knee biomechanics that were consistent with more severe knee OA and worse functional outcomes.