Proximal Gait Adaptations in Medial Knee OA

The purpose of this study was to examine interlimb differences in gait kinematics and kinetics in patients with symptomatic medial knee OA. The main objective was to identify hip joint movement strategies that might lower the knee adduction moment and also compensate for decreased knee flexion during weight acceptance. Gait analysis was performed on 32 patients with moderate medial compartment knee CA. Kinetic and kinematic data were calculated and side-to-side comparisons made. Radiographs were used to identify frontal plane alignment. No interlimb difference in the peak knee adduction moment was found (p=0.512), whereas a greatly reduced hip adduction moment was seen on the involved side (p < 0.001.) during the early part of stance. The involved limb flexed significantly less and hip and knee flexion moments were smaller compared to the uninvolved side. Gait adaptations involving a lateral sway of the trunk may successfully lead to relatively lower ipsilateral knee adduction moments, and would further be reflected by a lower adduction moment at the hip. Subjects did not compensate for less knee flexion by any dynamic means, and likely experience a resulting higher joint impact. These gait adaptations may have implications with respect to development of weakness of the ipsilateral hip musculature and progression of multiarticular OA. (C) 2008 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 27:78-83, 2009