title: Differential knee joint loading patterns during gait for individuals with tibiofemoral and patellofemoral articular cartilage defects in the knee.
abstract: To determine compartment-specific loading patterns during gait, quantified as joint reaction forces (JRF), of individuals with knee articular cartilage defects (ACD) compared to healthy controls (HC).
  
  
  
  Individuals with ACDs and HC participated. Individuals with ACDs were divided into groups according to ACD location: PF (only a patellofemoral ACD), TF (only a tibiofemoral ACD), and MIX (both PF and TF ACDs). Participants underwent three-dimensional gait analysis at self-selected speed. TF joint reaction force (TF-JRF) was calculated using inverse dynamics. PF joint reaction force (PF-JRF) was derived from estimated quadriceps force (FQUAD) and knee flexion angle. Primary variables of interest were the PF- and TF-JRF peaks (body weight [×BW]). Related secondary variables (gait speed, quadriceps strength, knee function, activity level) were evaluated as covariates.
  
  
  
  First peak PF-JRF and TF-JRF were similar in the TF and MIX groups (0.75-1.0 ×BW, P = 0.6-0.9). Both peaks were also similar in the PF and HC groups (1.1-1.3 ×BW, P = 0.7-0.8), and higher than the TF and MIX groups (P = 0.004-0.02). For the second peak PF-JRF, only the HC group was higher than the TF group (P = 0.02). The PF group walked at a similar speed as the HC group; both groups walked faster than the TF and MIX groups (P < 0.001). With gait speed and quadriceps strength as covariates, no differences were observed in JRF peaks.
  
  
  
  The results suggest the presence of a TF ACD (TF and MIX groups), but not a PF ACD (PF group), may affect joint loading patterns during walking. Walking slower may be a protective gait modification to reduce load.
authors.affiliation: Department of Physical Therapy, University of Delaware, Newark, DE, USA.
authors.forename: L M
authors.initials: LM
authors.lastname: Thoma
authors.affiliation: School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, Columbus, OH, USA.
authors.forename: M P
authors.initials: MP
authors.lastname: McNally
authors.affiliation: School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, Columbus, OH, USA; Division of Physical Therapy, School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, Columbus, OH, USA; Department of Orthopedics, The Ohio State University, Columbus, OH, USA; Department of Mechanical and Aerospace Engineering, College of Engineering, The Ohio State University, Columbus, OH, USA.
authors.forename: A M
authors.initials: AM
authors.lastname: Chaudhari
authors.affiliation: Departments of Orthopedics, Family Medicine, Biomedical Engineering, University of Miami, Miami, FL, USA; UHealth Sports Medicine Institute, Miami, FL, USA.
authors.forename: T M
authors.initials: TM
authors.lastname: Best
authors.affiliation: OSU Sports Medicine, Columbus, OH, USA; Department of Orthopedics, The Ohio State University, Columbus, OH, USA.
authors.forename: D C
authors.initials: DC
authors.lastname: Flanigan
authors.affiliation: School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, Columbus, OH, USA; Department of Orthopedics, The Ohio State University, Columbus, OH, USA; Department of Mechanical and Aerospace Engineering, College of Engineering, The Ohio State University, Columbus, OH, USA.
authors.forename: R A
authors.initials: RA
authors.lastname: Siston
authors.affiliation: School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, Columbus, OH, USA; Division of Physical Therapy, School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, Columbus, OH, USA. Electronic address: Laura.Schmitt@osumc.edu.
authors.forename: L C
authors.initials: LC
authors.lastname: Schmitt
mesh_terms: D000293:Adolescent; D000328:Adult; D001696:Biomechanical Phenomena / Q000502:physiology; D002357:Cartilage Diseases / Q000503:physiopathology*; D002358:Cartilage, Articular / Q000503:physiopathology*; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D007719:Knee Joint / Q000502:physiology; D008297:Male; D053580:Muscle Strength / Q000502:physiology; D020370:Osteoarthritis, Knee / Q000503:physiopathology; D057071:Patellofemoral Joint / Q000502:physiology; D052097:Quadriceps Muscle / Q000502:physiology; D016059:Range of Motion, Articular / Q000502:physiology; D013977:Tibia / Q000502:physiology; D016138:Walking / Q000502:physiology; D055815:Young Adult
keywords: Biomechanics; Focal chondral defects; Gait analysis; Joint loading; Patellofemoral; Tibiofemoral