Julien Clément1, Panagiota Toliopoulos2, Nicola Hagemeister3, François Desmeules2, Alexandre Fuentes4, Pascal-André Vendittoli5. 1. Hôpital Maisonneuve-Rosemont, Université de Montréal 5415 Boulevard de l'Assomption Montreal, Quebec, H1T 2M4, Canada; Laboratoire de recherche en imagerie orthopédique, École de technologie supérieure, Centre de recherche du CHUM, Tour Viger 900, rue St-Denis, local R11.322 Montreal, Quebec, H2X 0A9, Canada. 2. Hôpital Maisonneuve-Rosemont, Université de Montréal 5415 Boulevard de l'Assomption Montreal, Quebec, H1T 2M4, Canada. 3. Laboratoire de recherche en imagerie orthopédique, École de technologie supérieure, Centre de recherche du CHUM, Tour Viger 900, rue St-Denis, local R11.322 Montreal, Quebec, H2X 0A9, Canada. 4. Emovi, 201C-5795 de Gaspé, Montreal, Québec, H2S 2X3, Canada. 5. Hôpital Maisonneuve-Rosemont, Université de Montréal 5415 Boulevard de l'Assomption Montreal, Quebec, H1T 2M4, Canada. Electronic address: pa.vendittoli@me.com.
Abstract
BACKGROUND: Normal 3D knee kinematics during gait is still not well understood, especially regarding differences between women and men. RESEARCH QUESTION: The objective of the present study was to characterize 3D knee kinematics during gait in healthy women and men with a validated tool. METHODS: Knee kinematics was analysed with the KneeKG™ system in 90 healthy subjects (49 females and 41 males). 3D knee rotations were compared between women and men, and between right and left knees. Each subject underwent full-length weight-bearing x-rays. Correlations between abduction-adduction angles and lower-limb alignment measures on x-rays were assessed. RESULTS: In the frontal plane, 2.0-5.0° more abduction occurred in women compared to men (0.000 ≤ p ≤ 0.015) throughout the entire gait cycle. In the transverse plane, 2.4-3.7° more external tibial rotation was seen in women than in men (0.002 ≤ p ≤ 0.041) during the initial and mid-swing phases. No difference was found between the right and left knees. Low correlations (-0.52 ≤ r≤-0.41, p < 0.001) were observed between radiographic hip-knee-ankle angle (HKA) and abduction-adduction angles throughout the stance phase. SIGNIFICANCE: Kinematic differences between women and men in the frontal plane can be partly explained by their anatomical differences: women were less in varus than men (HKA of -0.8° vs. -2.6°, p < 0.001). Our study contributes to a better understanding of healthy 3D knee kinematics during gait and highlights the need for accounting of gender differences in future investigations. Better knowledge of natural knee kinematics will be helpful in assessing pathological gait patterns or determining the efficiency of conservative and surgical treatments to restore normal kinematics.
BACKGROUND: Normal 3D knee kinematics during gait is still not well understood, especially regarding differences between women and men. RESEARCH QUESTION: The objective of the present study was to characterize 3D knee kinematics during gait in healthy women and men with a validated tool. METHODS: Knee kinematics was analysed with the KneeKG™ system in 90 healthy subjects (49 females and 41 males). 3D knee rotations were compared between women and men, and between right and left knees. Each subject underwent full-length weight-bearing x-rays. Correlations between abduction-adduction angles and lower-limb alignment measures on x-rays were assessed. RESULTS: In the frontal plane, 2.0-5.0° more abduction occurred in women compared to men (0.000 ≤ p ≤ 0.015) throughout the entire gait cycle. In the transverse plane, 2.4-3.7° more external tibial rotation was seen in women than in men (0.002 ≤ p ≤ 0.041) during the initial and mid-swing phases. No difference was found between the right and left knees. Low correlations (-0.52 ≤ r≤-0.41, p < 0.001) were observed between radiographic hip-knee-ankle angle (HKA) and abduction-adduction angles throughout the stance phase. SIGNIFICANCE: Kinematic differences between women and men in the frontal plane can be partly explained by their anatomical differences: women were less in varus than men (HKA of -0.8° vs. -2.6°, p < 0.001). Our study contributes to a better understanding of healthy 3D knee kinematics during gait and highlights the need for accounting of gender differences in future investigations. Better knowledge of natural knee kinematics will be helpful in assessing pathological gait patterns or determining the efficiency of conservative and surgical treatments to restore normal kinematics.