title: Asymmetry of the knee extension deficit in standing affects weight-bearing distribution in patients with bilateral end-stage knee osteoarthritis.
abstract: OBJECTIVE
  The aim of this study was to evaluate weight-bearing distribution in patients with bilateral end-stage knee osteoarthritis (OA) and to clarify the gait parameters affecting the weight-bearing distribution during both standing and walking using gait analysis.
  
  
  METHODS
  Twenty-five patients (averaged 71 years) with symptomatic bilateral end-stage medial knee OA participated in this study. They performed relaxed standing, placing one foot on a force plate and thereafter, level walking. First, knee resultant force was calculated on bilateral knees during standing. The knees in each patient were divided into Higher and Lower force side for the definition of dominant side limb. Second, gait parameters in each subject were compared between both sides.
  
  
  RESULTS
  Each patient had large weight-bearing asymmetry, though passive range of motion, subjective pain level, femorotibial angle and radiographic disease severities were not significantly different between both sides. In standing, knees on Higher force side were significantly extended (11.2 ± 6.5°) than on Lower force side (14.4 ± 7.3°, P = 0.0086). Similarly, knees on Higher force side were also significantly extended at heel strike during gait. Besides, peak values of extension moment, knee adduction moment, knee adduction moment impulse and vertical force during gait were significantly greater on Higher force side.
  
  
  CONCLUSIONS
  Ability to extend the knee in standing was considered to be an essential factor to decide loading condition. It is clinically important to examine the ability to extend the knee in standing when considering loading asymmetry during gait in patients with bilateral knee OA.
  
  
  METHODS
  III.
authors: Department of Orthopedic Surgery, Keio University, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan, kharatoh@yahoo.co.jp.
authors: Kengo
authors: K
authors: Harato
authors: Takeo
authors: T
authors: Nagura
authors: Hideo
authors: H
authors: Matsumoto
authors: Toshiro
authors: T
authors: Otani
authors: Yoshiaki
authors: Y
authors: Toyama
authors: Yasunori
authors: Y
authors: Suda
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001696:Biomechanical Phenomena; D005260:Female; D005684:Gait / Q000502:physiology; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000503:physiopathology*; D011187:Posture; D016059:Range of Motion, Articular; D016138:Walking; D016474:Weight-Bearing / Q000502:physiology
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