title: Are the kinematics of the knee joint altered during the loading response phase of gait in individuals with concurrent knee osteoarthritis and complaints of joint instability? A dynamic stereo X-ray study.
abstract: BACKGROUND
  Joint instability has been suggested as a risk factor for knee osteoarthritis and a cause of significant functional decline in those with symptomatic disease. However, the relationship between altered knee joint mechanics and self-reports of instability in individuals with knee osteoarthritis remains unclear.
  
  
  METHODS
  Fourteen subjects with knee osteoarthritis and complaints of joint instability and 12 control volunteers with no history of knee disease were recruited for this study. Dynamic stereo X-ray technology was used to assess the three-dimensional kinematics of the knee joint during the loading response phase of gait.
  
  
  RESULTS
  Individuals with concurrent knee osteoarthritis and joint instability demonstrated significantly reduced flexion and internal/external rotation knee motion excursions during the loading response phase of gait (P<0.01), while the total abduction/adduction range of motion was increased (P<0.05). In addition, the coronal and transverse plane alignment of the knee joint at initial contact was significantly different (P<0.05) for individuals with concurrent knee osteoarthritis and joint instability. However, the anteroposterior and mediolateral tibiofemoral joint positions at initial contact and the corresponding total joint translations were similar between groups during the loading phase of gait.
  
  
  CONCLUSIONS
  The rotational patterns of tibiofemoral joint motion and joint alignments reported for individuals with concurrent knee osteoarthritis and joint instability are consistent with those previously established for individuals with knee osteoarthritis. Furthermore, the findings of similar translatory tibiofemoral motion between groups suggest that self-reports of episodic joint instability in individuals with knee osteoarthritis may not necessarily be associated with adaptive alterations in joint arthrokinematics.
authors.affiliation: Department of Physical Therapy, Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15260, USA. Farrokhi@pitt.edu
authors.forename: Shawn
authors.initials: S
authors.lastname: Farrokhi
authors.forename: Scott
authors.initials: S
authors.lastname: Tashman
authors.forename: Alexandra B
authors.initials: AB
authors.lastname: Gil
authors.forename: Brian A
authors.initials: BA
authors.lastname: Klatt
authors.forename: G Kelley
authors.initials: GK
authors.lastname: Fitzgerald
mesh_terms: D000368:Aged; D005260:Female; D005684:Gait; D020233:Gait Disorders, Neurologic / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D020370:Osteoarthritis, Knee / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D016059:Range of Motion, Articular; D014057:Tomography, X-Ray Computed / Q000379:methods*
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