The knee adduction moment during gait in subjects with knee osteoarthritis is more closely correlated with static alignment than radiographic disease severity, toe out angle and pain

Hurwitz, Debra E.; Ryals, A. B.; Case, John P.; Block, Joel A.; Andriacchi, Thomas P.

doi:10.1016/s0736-0266(01)00081-x

Cited by 481 publications

(429 citation statements)

References 15 publications

Supporting

Mentioning

374

Contrasting

Unclassified

Order By: Relevance

“…The magnitude of knee adduction moment is influenced by the magnitude of the ground reaction force, the moment arm, and the mass and acceleration of lower limb segments (Fig. 4) [12,22]. Peak knee adduction moment represents the maximum load differential between the medial and lateral compartment during one gait cycle.…”

Section: Gait Analysismentioning

confidence: 99%

Do Laterally Wedged Insoles or Valgus Braces Unload the Medial Compartment of the Knee in Patients With Osteoarthritis?

Duivenvoorden¹,

Raaij

Horemans³

et al. 2015

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background The results of conservative treatment of knee osteoarthritis (OA) are generally evaluated in epidemiological studies with clinical outcome measures as primary outcomes. Biomechanical evaluation of orthoses shows that there are potentially beneficial biomechanical changes to joint loading; however, evaluation in relation to clinical outcome measures in longitudinal studies is needed. Questions/purposes We asked (1) is there an immediate effect on gait in patients using a laterally wedged insole or valgus knee brace; (2) is there a late (6 weeks) effect; and (3) is there a difference between subgroups within each group with respect to patient compliance, body mass index, and OA status? Methods This was a secondary analysis of data from a previous randomized controlled trial of patients with early medial knee OA. A total of 91 patients were enrolled in that trial, and 73 (80%) completed it after 6 months. Of the enrolled patients, 80 (88%) met prespecified inclusion criteria for analysis in the present study. The patients were randomized to an insole or brace. Gait was analyzed with and without wearing the orthosis (insole or brace) at baseline and after 6 weeks. Measurements were taken of the knee adduction moment, ground reaction force, moment arm, walking speed, and toe-out angle. Data were analyzed with regression analyses based on an intention-to-treat principle. Results A mean reduction of 4% (± 10) (95% confidence interval [CI], À0.147 to À0.03, p = 0.003) of the peak knee adduction moment and 4% (± 13) (95% CI, À0.009 to À0.001, p = 0.01) of the moment arm at baseline was observed in the insole group when walking with an insole was compared with walking without an insole. A mean reduction of 1% (± 10) (95% CI, À0.002 to À0.001, p = 0.001) of the peak knee adduction moment and no reduction of the moment arm were measured after 6 weeks.

show abstract

Section: Gait Analysismentioning

confidence: 99%

Do Laterally Wedged Insoles or Valgus Braces Unload the Medial Compartment of the Knee in Patients With Osteoarthritis?

Duivenvoorden¹,

Raaij

Horemans³

et al. 2015

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

show abstract

“…Numerous variables have been studied regarding their usefulness for predicting the progression of knee OA (Table 4) [13,15,23,35,47]; however, amid conflicting reports, few predictive variables have strong supporting evidence [51]. We found that the radiographic medial knee JS and the peak knee adduction angle were the best predictors of knee pain in our study; and that these variables accounted for approximately three-quarters of the model variance (r 2 = 0.73).…”

Section: Discussionmentioning

confidence: 52%

Are Joint Structure and Function Related to Medial Knee OA Pain? A Pilot Study

Zifchock

Kirane

Hillstrom

2011

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background Although the severity of knee osteoarthritis (OA) usually is assessed using different measures of joint structure, function, and pain, the relationships between these measures are unclear. Purpose Therefore, we: (1) examined the relationships between the measures of knee structure (flexion-extension range of motion, radiographic tibiofemoral angle, and medial joint space), function (Knee Osteoarthritis Outcome Scores [KOOS], peak adduction angle, and moment), and pain (visual analog scale [VAS]); and (2) identified variables that best predicted knee pain. Methods We assessed 15 patients with medial knee OA using VAS pain, KOOS questionnaire, 3-D gait analysis, and radiographic examination. Parameter relationships were assessed using Pearson correlation, and variables most predictive of knee pain were determined using a stepwise multiple regression. Results Subjective measurements correlated (|r| C 0.54) with one another, as did most of the objective measurements (|r| C 0.56) except for adduction moment which did not correlate with any variable. All variables correlated (|r| [ 0.54) with VAS knee pain except peak adduction moment. Medial joint space and peak adduction angle best predicted knee pain, accounting for approximately threequarters of the model variance (r 2 = 0.73).

show abstract

“…Gait alterations are often seen in people with knee OA during walking, which have been suggested to be an attempt to reduce pain and joint load (21,41). People with knee OA typically walk more slowly and with a reduced knee ROM during early stance, as well as a reduced total knee ROM, compared to asymptomatic control subjects (20,21).…”

Section: Discussionmentioning

confidence: 99%

Association between skeletal muscle inflammatory markers and walking pattern in people with knee osteoarthritis

Levinger

Caldow

Feller

et al. 2011

Arthritis Care & Research

View full text Add to dashboard Cite

Objective. Patients with knee osteoarthritis (OA) are characterized by increased muscle inflammation and altered gait. We investigated the association between proinflammatory mediators in the vastus lateralis and physical function and gait in patients with knee OA. Methods. Nineteen patients with knee OA underwent gait analysis, assessment of self-reported pain and physical function (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC]), and a muscle biopsy that was taken during their knee replacement surgery. Muscle was analyzed for cellular protein inflammatory mediators, interleukin-6, monocyte chemotactic protein 1 (MCP-1), p65 NF-B, signal transducer and activator of transcription 3 (STAT-3), and JNK-1. Sagittal plane knee function, including early stance knee range of motion (ROM) and knee sagittal plane impulse, was measured using a motion analysis system. Pearson's correlation was used to assess relationships between selected variables. Results. Significant positive correlations were found between MCP-1 and self-perceived stiffness, physical function, and the total WOMAC score (P < 0.05). MCP-1 was also negatively correlated with early stance knee ROM (r ‫؍‬ ؊0.52, P ‫؍‬ 0.023). Reduced velocity was associated with elevated levels of p65 NF-B and STAT-3 (P < 0.05). Knee sagittal plane impulse was negatively correlated with JNK-1 (P ‫؍‬ 0.02), indicating reduction in knee impulse with an increased level of JNK-1. Conclusion. Increased levels of several proinflammatory mediators were correlated with altered knee function during walking as well as greater physical disability and slower gait velocity. Identification of the cellular and molecular mechanisms associated with muscle inflammation is important to better understand the underlying mechanism responsible for altered gait and function in patients with knee OA.

show abstract

The knee adduction moment during gait in subjects with knee osteoarthritis is more closely correlated with static alignment than radiographic disease severity, toe out angle and pain

Cited by 481 publications

References 15 publications

Do Laterally Wedged Insoles or Valgus Braces Unload the Medial Compartment of the Knee in Patients With Osteoarthritis?

Do Laterally Wedged Insoles or Valgus Braces Unload the Medial Compartment of the Knee in Patients With Osteoarthritis?

Are Joint Structure and Function Related to Medial Knee OA Pain? A Pilot Study

Association between skeletal muscle inflammatory markers and walking pattern in people with knee osteoarthritis

Contact Info

Product

Resources

About