Affiliation:
1. Hokkaido University
2. Hakodate Orthopedic Clinic
3. National Institute of Technology, Hakodate College
4. Future University Hakodate
5. Hokkaido University Hospital
Abstract
Abstract
Background
During progression of knee osteoarthritis (KOA), coronal, sagittal, and horizontal biomechanical parameters are dramatically altered. The purpose of this study is to assess the three-dimensional knee joint biomechanics and trunk posture according to KOA severity.
Methods
Seventy-five patients (95 knees) with medial knee osteoarthritis and 19 young healthy controls (38 knees) were enrolled in this study. The Kellgren-Lawrence classification was used for radiographic evaluation. There were 20 patients with 24 knees with grade 2, 25 with 28 knees with grade 3, and 30 with 43 knees with grade 4. All patients walked at a self-selected speed using an optical motion capture system. Additionally, six-degrees-of-freedom kinematics of the knee joint were calculated using the point cluster technique. The three moment components of the knee joint were calculated using inverse dynamics.
Results
In grade 2 KOA, the relative contribution of knee adduction moment (KAM) increased significantly, and that of knee flexion moment (KFM) decreased at the first peak of total joint moment prior to significant progression of varus knee deformity. Grade 3 KOA showed significant exacerbation of varus knee deformity and increased KA. Maximum knee extension angle decreased and trunk flexion increased during gait in grade 4 KOA.
Conclusions
We showed that kinetic conversion occurred in grade 2 KOA prior to varus deformity appearance as in grade 3. Knee flexion contracture and trunk flexion during gait occurred in grade 4 KOA. The relative contribution of KAM increased significantly, and that of KFM decreased prior to progression of varus knee deformity.
Trial registration:
Not applicable
Publisher
Research Square Platform LLC