title: Three-dimensional dynamic analysis of knee joint during gait in medial knee osteoarthritis using loading axis of knee.
abstract: We recently developed a new method for three-dimensional evaluation of mechanical factors affecting knee joint in order to help identify factors that contribute to the progression of knee osteoarthritis (KOA). This study aimed to verify the clinical validity of our method by evaluating knee joint dynamics during gait. Subjects were 41 individuals (14 normal knees; 8 mild KOAs; 19 severe KOAs). The positions of skin markers attached to the body were captured during gait, and bi-planar X-ray images of the lower extremities were obtained in standing position. The positional relationship between the markers and femorotibial bones was determined from the X-ray images. Combining this relationship with gait capture allowed for the estimation of relative movement between femorotibial bones. We also calculated the point of intersection of loading axis of knee on the tibial proximal surface (LAK point) to analyze knee joint dynamics. Knee flexion range in subjects with severe KOA during gait was significantly smaller than that in those with normal knees (p=0.011), and knee adduction in those with severe KOA was significantly larger than in those with mild KOA (p<0.000). LAK point was locally loaded on the medial compartment of the tibial surface as KOA progressed, with LAK point of subjects with severe KOA rapidly shifting medially during loading response. Local loading and medial shear force were applied to the tibial surface during stance phase as medial KOA progressed. Our findings suggest that our method is useful for the quantitative evaluation of mechanical factors that affect KOA progression.
authors.affiliation: Niigata Institute for Health and Sports Medicine, 67-12 Seigorou, Chuoh-ku, Niigata, Japan. Electronic address: k.nishino@ken-supo.jp.
authors.forename: Katsutoshi
authors.initials: K
authors.lastname: Nishino
authors.affiliation: Department of Health and Sports, Faculty of Health Sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata, Japan.
authors.forename: Go
authors.initials: G
authors.lastname: Omori
authors.affiliation: Department of Orthopaedic Surgery, Ninouji Spa Hospital, 452 Toramaru, Shibata-shi, Niigata, Japan.
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Koga
authors.affiliation: Department of Health Sciences, Niigata University School of Medicine, 2-746 Asahimachi-dori, Chuoh-ku, Niigata, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Kobayashi
authors.affiliation: Department of Health Sciences, Niigata University School of Medicine, 2-746 Asahimachi-dori, Chuoh-ku, Niigata, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Sakamoto
authors.affiliation: Department of Mechanical Engineering, Faculty of Engineering Niigata University, 2-8050 Ikarashi, Nishi-ku, Niigata, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Tanabe
authors.affiliation: Niigata Institute for Health and Sports Medicine, 67-12 Seigorou, Chuoh-ku, Niigata, Japan.
authors.forename: Masaei
authors.initials: M
authors.lastname: Tanaka
authors.affiliation: Niigata Institute for Health and Sports Medicine, 67-12 Seigorou, Chuoh-ku, Niigata, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Arakawa
mesh_terms: D000328:Adult; D000368:Aged; D001696:Biomechanical Phenomena / Q000502:physiology; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D021621:Imaging, Three-Dimensional; D007719:Knee Joint / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D011187:Posture / Q000502:physiology; D059869:Radiostereometric Analysis; D012016:Reference Values; D013977:Tibia / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D014057:Tomography, X-Ray Computed; D016474:Weight-Bearing / Q000502:physiology*; D055815:Young Adult
keywords: Gait; Kinematics; Kinetics; Knee osteoarthritis; Loading axis of knee