Hip and knee joint rotations differ between patients with medial and lateral knee osteoarthritis: Gait analysis of 30 patients and 15 controls

Abstract

The motions and moments in the hip and knee in female patients on the waiting list for knee prosthesis surgery with medial (n ¼ 15) or lateral (n ¼ 15) osteoarthritis (OA) were compared with a control group (n ¼ 15). We hypothesized that not only the kinematics and kinetics of the knee but also of the hip would differ between patients the medial and lateral groups. At midstance, patients with lateral OA showed slightly (28) more maximal (peak) adduction ( p ¼ 0.015) of the hip joint and patients with medial OA had 78 more abduction (p < 0.001) than did controls. In patients with lateral OA, the femur was positioned in about 78 more maximum external rotation (p ¼ 0.001), but femur position did not differ between medial OA and controls ( p ! 0.8). There was a tendency to higher internal hip rotation moment in lateral OA compared to controls ( p ¼ 0.021). The maximum values of the internal knee abduction moments were 52% higher in medial OA ( p ¼ 0.005) and 63% lower in lateral OA ( p < 0.001) compared to controls. Cases with medial OA had 98 more, whereas those with lateral OA had 68 less external tibial rotation than controls (medial vs. lateral OA, p ¼ 0.001). We found an association between presence of lateral OA of the knee and the biomechanics of the hip joint. It remains to be evaluated if the changed biomechanics of the hip joint is a reason for development of lateral OA or an observation that is a result of this disease. ß

Lower extremity walking mechanics of young individuals with asymptomatic varus knee alignment

“…Furthermore, Weidow and colleagues reported less hip adduction in individuals with medial knee OA compared to asymptomatic controls. 15 However, individuals with less severe medial knee OA ambulate with similar hip adduction moments as healthy controls, 12 suggesting that those with mild disease have sufficiently strong hip abductor musculature to counterbalance the hip adduction moment. This was likely the case for both groups in the present study, as all subjects were young and healthy.…”

“…12,15,18 Healthy older adults also demonstrate this pattern compared to younger individuals. 28 In the current study, the varus individuals demonstrated similar sagittal plane peak hip angles and moments in late stance in comparison to the normal group.…”

“…12,13 Patients with symptomatic medial knee OA often stiffen their knees to reduce the demands on the quadriceps muscles and diminish pain. 8,12,[14][15][16][17][18] Reduced hip extension angles and moments have also been noted. Stiffer gait patterns lead to greater vertical ground reaction force load rates as well.…”

Improvements in hip- and pelvic motion for patients with osseointegrated trans-femoral prostheses

“…Eighteen reflective spherical markers were attached to the skin over bony landmarks (acromion, 12th thoracic vertebra, sacrum, anterior superior iliac spine, lateral knee joint line, proximal to the superior border of the patella, tibial tubercle, heel, lateral malleolus, and between the second and third metatarsals) [13]. The markers were placed bilaterally.…”

Medial knee joint loading increases in those who respond to hyaluronan injection for medial knee osteoarthritis

“…5 Comparison of people with knee OA to healthy groups have shown differences in gait kinematics, kinetics, and muscle activation patterns. [6][7][8][9][10][11][12] These differences are hypothesized to occur as people attempt to avoid pain, to lessen joint forces through the deteriorating cartilage, or because of feelings of joint instability.…”