Asymmetry of the knee extension deficit in standing affects weight-bearing distribution in patients with bilateral end-stage knee osteoarthritis

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• 作者：Kengo Harato (1) (2)
  Takeo Nagura (1)
  Hideo Matsumoto (1)
  Toshiro Otani (1)
  Yoshiaki Toyama (1)
  Yasunori Suda (1)
  
• 关键词：End ; stage knee osteoarthritis ; Weight ; bearing distribution ; Gait analysis ; Standing ; Extension deficit
• 刊名：Knee Surgery, Sports Traumatology, Arthroscopy
• 出版年：2014
• 出版时间：November 2014
• 年：2014
• 卷：22
• 期：11
• 页码：2608-2613
• 全文大小：307 KB
• 参考文献：1. Andriacchi TP, Galante JO, Fermier RW (1982) The influence of total knee-replacement design on walking and stair-climbing. J Bone Joint Surg Am 64:1328-335
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  10. Harato K, Nagura T, Matsumoto H, Otani T, Toyama Y, Suda Y (2008) A gait analysis of simulated knee flexion contracture to elucidate knee-spine syndrome. Gait Posture 28:687-92 CrossRef
  11. Harato K, Nagura T, Matsumoto H, Otani T, Toyama Y, Suda Y (2010) Extension limitation in standing affects weight-bearing asymmetry after unilateral total knee arthroplasty. J Arthroplasty 25:225-29 CrossRef
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  14. Henriksen M, Simonsen EB, Alkjaer T, Lund H, Graven-Nielsen T, Danneskiold-Sams?e B, Bliddal H (2006) Increased joint loads during walking–a consequence of pain relief in knee osteoarthritis. Knee 13:445-50 CrossRef
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• 作者单位：Kengo Harato (1) (2)
  Takeo Nagura (1)
  Hideo Matsumoto (1)
  Toshiro Otani (1)
  Yoshiaki Toyama (1)
  Yasunori Suda (1)
  
  1. Department of Orthopedic Surgery, Keio University, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan
  2. Department of Orthopedic Surgery, Kawasaki Municipal Kawasaki Hospital, 12-1, Shinkawadouri, Kawasakiku, Kawasaki, Kanagawa Prefecture, 210-0013, Japan
  
• ISSN：1433-7347

文摘

Purpose 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. Level of evidence III.