Derek Rutherford1, Lindsey Buckingham2, Janice Moreside3, Ivan Wong4, Glen Richardson5. 1. School of Physiotherapy, Faculty of Health, Dalhousie University, Halifax, NS B3H 4R2, Canada; School of Biomedical Engineering, Faculty of Engineering, Dalhousie University, Halifax, NS B3H 4R2, Canada. Electronic address: djr@dal.ca. 2. School of Physiotherapy, Faculty of Health, Dalhousie University, Halifax, NS B3H 4R2, Canada. 3. School of Physiotherapy, Faculty of Health, Dalhousie University, Halifax, NS B3H 4R2, Canada; School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, NS B3H 4R2, Canada. Electronic address: JMoreside@dal.ca. 4. Department of Surgery, Division of Orthopaedics, Nova Scotia Health Authority, Halifax, NS B3H 3G1, Canada. Electronic address: iw@drivanwong.com. 5. Department of Surgery, Division of Orthopaedics, Nova Scotia Health Authority, Halifax, NS B3H 3G1, Canada. Electronic address: Glen.Richardson@nshealth.ca.
Abstract
BACKGROUND: Knee function is impaired in individuals with moderate hip osteoarthritis. How this extends to those undergoing total hip arthroplasty is unknown despite the common requirement for knee arthroplasty in this population. The study purpose was to determine whether sagittal plane knee joint movements and quadriceps and hamstring activation patterns differ between individuals with either moderate or severe unilateral hip osteoarthritis, and between ipsilateral and contralateral knees. METHODS: 20 individuals with moderate osteoarthritis and 20 with severe osteoarthritis were recruited. Sagittal knee motion and surface electromyograms from the hamstrings and quadriceps were collected during treadmill walking at a self-selected speed. Principal component analysis captured amplitude and temporal sagittal plane motion and EMG waveform features. Student's t-tests and Analysis of Variance determined between group differences and within/between group leg differences. FINDINGS: The severe groups' contralateral knee was in greater flexion at initial contact and demonstrated a movement profile of a longer stance phase (p < 0.001). The severe group had reduced sagittal plane knee motion (p < 0.0001); more so in the ipsilateral knee (p < 0.0001). The severe group had greater hamstring (p = 0.009) and quadriceps activation (p < 0.001) overall, specifically mid-stance quadriceps bilaterally (p = 0.002). Ipsilateral sagittal plane knee motion was reduced in both groups. Compared with those with moderate osteoarthritis, individuals with severe osteoarthritis walk with reduced sagittal plane knee motion bilaterally, suggesting prolonged contralateral stance, and elevated mid-stance hamstring and quadriceps activation. INTERPRETATION: Altered kinematics and muscle activity could contribute to a greater mechanical demand on the contralateral knee in those with more severe hip osteoarthritis.
BACKGROUND: Knee function is impaired in individuals with moderate hip osteoarthritis. How this extends to those undergoing total hip arthroplasty is unknown despite the common requirement for knee arthroplasty in this population. The study purpose was to determine whether sagittal plane knee joint movements and quadriceps and hamstring activation patterns differ between individuals with either moderate or severe unilateral hip osteoarthritis, and between ipsilateral and contralateral knees. METHODS: 20 individuals with moderate osteoarthritis and 20 with severe osteoarthritis were recruited. Sagittal knee motion and surface electromyograms from the hamstrings and quadriceps were collected during treadmill walking at a self-selected speed. Principal component analysis captured amplitude and temporal sagittal plane motion and EMG waveform features. Student's t-tests and Analysis of Variance determined between group differences and within/between group leg differences. FINDINGS: The severe groups' contralateral knee was in greater flexion at initial contact and demonstrated a movement profile of a longer stance phase (p < 0.001). The severe group had reduced sagittal plane knee motion (p < 0.0001); more so in the ipsilateral knee (p < 0.0001). The severe group had greater hamstring (p = 0.009) and quadriceps activation (p < 0.001) overall, specifically mid-stance quadriceps bilaterally (p = 0.002). Ipsilateral sagittal plane knee motion was reduced in both groups. Compared with those with moderate osteoarthritis, individuals with severe osteoarthritis walk with reduced sagittal plane knee motion bilaterally, suggesting prolonged contralateral stance, and elevated mid-stance hamstring and quadriceps activation. INTERPRETATION: Altered kinematics and muscle activity could contribute to a greater mechanical demand on the contralateral knee in those with more severe hip osteoarthritis.
Authors: Jesse C Christensen; David L Quammen; Justin H Rigby; Cory L Christiansen; Jennifer E Stevens-Lapsley Journal: Clin Biomech (Bristol, Avon) Date: 2021-07-21 Impact factor: 2.034