Armaghan Mahmoudian1, Jaap H van Dieen2, Sjoerd M Bruijn3, Isabel Ac Baert4, Gert S Faber5, Frank P Luyten6, Sabine Mp Verschueren7. 1. Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven, Belgium. Electronic address: armaghan.mahmoudian@gmail.com. 2. MOVE Research Institute Amsterdam, Faculty of Human Movement Sciences, VU University Amsterdam, The Netherlands. Electronic address: j.van.dieen@vu.nl. 3. MOVE Research Institute Amsterdam, Faculty of Human Movement Sciences, VU University Amsterdam, The Netherlands; Department of Orthopedics, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, PR China. Electronic address: s.m.bruijn@gmail.com. 4. Department of Health Care, Artesis University College of Antwerp, Belgium. Electronic address: isabel.baert@uantwerpen.be. 5. MOVE Research Institute Amsterdam, Faculty of Human Movement Sciences, VU University Amsterdam, The Netherlands. Electronic address: gertfaber.sci@gmail.com. 6. Department of Development & Regeneration, Skeletal Biology and Engineering Research Center, KU Leuven, Belgium. Electronic address: frank.luyten@uzleuven.be. 7. Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven, Belgium. Electronic address: sabine.verschueren@faber.kuleuven.be.
Abstract
BACKGROUND: Varus thrust, defined as an abrupt increase of the knee varus angle during weight-bearing in gait, has been shown to be present in patients with moderate to severe knee osteoarthritis and is considered to be one of the risk factors for progression of symptomatic medial knee osteoarthritis. We evaluated the presence and magnitude of varus thrust and its relation with the Knee Adduction Moment in women with early medial knee osteoarthritis, and compared it to that in a group of controls and in a group of subjects with established medial knee osteoarthritis. METHODS: Twenty-seven women with early medial knee osteoarthritis, 20 women with established medial knee osteoarthritis and 24 asymptomatic controls were evaluated. Varus thrust was estimated as an increase of the knee varus angle during the weight-bearing phase of gait at self-selected speed, assessed by 3D motion analysis. FINDINGS: Varus thrust was significantly higher in both early and established osteoarthritis groups compared to the control group (P<0.001), but not different between osteoarthritis groups. While the knee adduction moments were higher than controls only in the established osteoarthritis group, the magnitude of varus thrust was significantly correlated with the second peak knee adduction moment. INTERPRETATION: Higher varus thrust was found both in early and established stages of knee osteoarthritis, suggesting that problems with dynamic stabilization of the knee are present early in the development of knee osteoarthritis. This highlights the necessity of considering dynamic alignment in rehabilitation already in the early stages of the disease.
BACKGROUND: Varus thrust, defined as an abrupt increase of the knee varus angle during weight-bearing in gait, has been shown to be present in patients with moderate to severe knee osteoarthritis and is considered to be one of the risk factors for progression of symptomatic medial knee osteoarthritis. We evaluated the presence and magnitude of varus thrust and its relation with the Knee Adduction Moment in women with early medial knee osteoarthritis, and compared it to that in a group of controls and in a group of subjects with established medial knee osteoarthritis. METHODS: Twenty-seven women with early medial knee osteoarthritis, 20 women with established medial knee osteoarthritis and 24 asymptomatic controls were evaluated. Varus thrust was estimated as an increase of the knee varus angle during the weight-bearing phase of gait at self-selected speed, assessed by 3D motion analysis. FINDINGS: Varus thrust was significantly higher in both early and established osteoarthritis groups compared to the control group (P<0.001), but not different between osteoarthritis groups. While the knee adduction moments were higher than controls only in the established osteoarthritis group, the magnitude of varus thrust was significantly correlated with the second peak knee adduction moment. INTERPRETATION: Higher varus thrust was found both in early and established stages of knee osteoarthritis, suggesting that problems with dynamic stabilization of the knee are present early in the development of knee osteoarthritis. This highlights the necessity of considering dynamic alignment in rehabilitation already in the early stages of the disease.
Authors: Leena Sharma; Alison H Chang; Rebecca D Jackson; Michael Nevitt; Kirsten C Moisio; Marc Hochberg; Charles Eaton; C Kent Kwoh; Orit Almagor; Jane Cauley; Joan S Chmiel Journal: Arthritis Rheumatol Date: 2017-11 Impact factor: 10.995
Authors: Kerry E Costello; Samantha Eigenbrot; Alex Geronimo; Ali Guermazi; David T Felson; Jim Richards; Deepak Kumar Journal: Clin Biomech (Bristol, Avon) Date: 2020-11-11 Impact factor: 2.063