Does knee alignment influence gait in patients with severe knee osteoarthritis?
BACKGROUND
Patients with knee osteoarthritis present an altered gait pattern. Amongst many factors, the lower limb alignment (varus, valgus) has been identified as an important risk factor for the progression of knee osteoarthritis. Among the large number of studies on knee osteoarthritis gait, only a few have included patients with a valgus deformity. The aims of this study were to determine how knee alignment influences full-body gait in patients with knee osteoarthritis and if knee malalignment is associated with pain and functional capacity.


METHODS
Sixty patients with severe knee osteoarthritis scheduled for a total knee arthroplasty were included in this study. Twenty-six subjects were recruited as the control group. The spatio-temporal parameters, three-dimensional full-body kinematics, and lower body kinetics were evaluated during a comfortable gait and compared between the groups. Pain and function were assessed with the WOMAC questionnaire.


RESULTS
The full-body gait analysis demonstrated substantially different gait patterns and compensation mechanisms between the three groups. Patients with varus knee alignment significantly augmented their trunk movements in sagittal and frontal planes compared to patients with a valgus knee. In addition, patients with a valgus knee reported lower pain and lower functional deficits compared to patients with a varus knee.


CONCLUSIONS
We found that gait compensations were significantly influenced by lower limb alignment. These new insights related to different knee osteoarthritis gait patterns might help in the understanding of gait compensation behaviours prior to total knee arthroplasty and better manage the strategies of rehabilitation following surgery.
Willy Taillard Laboratory of Kinesiology, Geneva University Hospitals and Geneva University, Switzerland. kturcot@gmail.com
Katia
K
Turcot
Stéphane
S
Armand
Anne
A
Lübbeke
Daniel
D
Fritschy
Pierre
P
Hoffmeyer
Domizio
D
Suvà
D000368:Aged; D000704:Analysis of Variance; D018771:Arthralgia / Q000209:etiology* / Q000503:physiopathology; D001696:Biomechanical Phenomena; D017760:Bone Malalignment / Q000150:complications* / Q000503:physiopathology*; D005260:Female; D005684:Gait; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology*; D008297:Male; D020370:Osteoarthritis, Knee / Q000150:complications* / Q000503:physiopathology*; D010147:Pain Measurement; D012307:Risk Factors