title: Impulse-forces during walking are not increased in patients with knee osteoarthritis.
abstract: BACKGROUND
  Impulsive forces in the knee joint have been suspected to be a co-factor in the development and progression of knee osteoarthritis. We thus evaluated the impulsive sagittal ground reaction forces (iGRF), shock waves and lower extremity joint kinematics at heel strike during walking in knee osteoarthritis (OA) patients and compared them to those in healthy subjects.
  
  
  METHODS
  We studied 9 OA patients and 10 healthy subjects using three-dimensional gait analyses concentrated on the heel strike. Impulse GRF (iGRF) was measured together with peak accelerations (PA) at the tibial tuberosity and sacrum. Sagittal lower extremity joint angles at heel strike were extracted from the gait analyses. As OA is painful and pain might alter movement strategies, the patient group was also evaluated following pain relief by intraarticular lidocaine injections.
  
  
  RESULTS
  The two groups showed similar iGRF, similar tibial and sacral PA, and similar joint angles at heel strike. Following pain relief, the OA patients struck the ground with more extended hip and knee joints and lower tibial PA compared to the painful condition. Although such changes occurred after pain relief, all parameters were within their normal ranges.
  
  
  CONCLUSIONS
  OA patients and healthy subjects show similar impulse-forces and joint kinematics at heel strike. Following pain relief in the patient group, changes in tibial PA and in hip and knee joint angles were observed but these were still within the normal range. Our findings make us question the hypothesis that impulse-forces generated at heel strike during walking contribute to progression of OA.
authors.affiliation: The Parker Institute, Frederiksberg Hospital. Frederiksberg, DK-2000. Denmark. parker@fh.hosp.dk
authors.forename: Marius
authors.initials: M
authors.lastname: Henriksen
authors.forename: Erik B
authors.initials: EB
authors.lastname: Simonsen
authors.forename: Thomas
authors.initials: T
authors.lastname: Graven-Nielsen
authors.forename: Hans
authors.initials: H
authors.lastname: Lund
authors.forename: Bente
authors.initials: B
authors.lastname: Danneskiold-Samsøe
authors.forename: Henning
authors.initials: H
authors.lastname: Bliddal
mesh_terms: D000368:Aged; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage; D001696:Biomechanical Phenomena; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D007270:Injections, Intra-Articular; D007719:Knee Joint / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000503:physiopathology*; D010146:Pain / Q000188:drug therapy; D016059:Range of Motion, Articular / Q000502:physiology; D016138:Walking / Q000502:physiology*
chemical_list: D018712:Analgesics, Non-Narcotic; D000779:Anesthetics, Local