Effect of medial tibial torsion on the sagittal alignment of lower legs in patients with medial knee osteoarthritis

2012 ◽  
Vol 35 (3) ◽  
pp. 205-210 ◽  
Author(s):  
Atsushi Takahashi ◽  
Toshimi Aizawa ◽  
Takashi Aki ◽  
Mitsuhiro Kashiwaba ◽  
Masayuki Kamimura ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Sagittal Alignment ◽  
Tibial Torsion ◽  
Medial Knee ◽  
Medial Knee Osteoarthritis

scholarly journals Knee joint loadings are related to tibial torsional alignments in people with radiographic medial knee osteoarthritis

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0255008
Author(s):  
Chen Huang ◽  
Ping Keung Chan ◽  
Kwong Yuen Chiu ◽  
Chun Hoi Yan ◽  
Desmond Shun Shing Yeung ◽  
...  
Keyword(s):  
Knee Joint ◽  
Knee Osteoarthritis ◽  
Lower Limb ◽  
Knee Adduction Moment ◽  
Tibial Torsion ◽  
Cross Sectional ◽  
Medial Knee ◽  
Medial Knee Osteoarthritis ◽  
Tibiofemoral Rotation ◽  
Joint Loads

Torsional malalignment was detected in subjects with medial knee osteoarthritis (KOA) but few studies have reported the effect of torsional deformity on knee joint loads during walking. Therefore, this study examined the relationships between lower limb torsional alignments and knee joint loads during gait in people with symptomatic medial KOA using cross-sectional study design. Lower limb alignments including tibial torsion, tibiofemoral rotation and varus/valgus alignments in standing were measured by EOS low-dose bi-planar x-ray system in 47 subjects with mild or moderate KOA. The external knee adduction moment (KAM), flexion moment (KFM) and the KAM index which was defined as (KAM/ (KAM+KFM)*100) during walking were analyzed using a motion analysis system so as to estimate the knee loads. Results revealed externaltibial torsion was positively associated with KAM in subjects with moderate KOA (r = 0.59, p = 0.02) but not in subjects with mild KOA. On the contrary, significant association was found between knee varus/valgus alignment and KAM in the mild KOA group (r = 0.58, p<0.001) and a sign of association in the moderate KOA group (r = 0.47, p = 0.08). We concluded tibial torsion and knee varus/valgus mal-alignments would be associated with joint loading in subjects with moderate medial KOA during walking. Radiographic severity might need to be considered when using gait modification as a rehabilitation strategy for this condition.

scholarly journals A comparison between laterally wedged insoles and ankle-foot orthoses for the treatment of medial osteoarthritis of the knee: A randomized cross-over trial

2021 ◽  
pp. 026921552199363
Author(s):  
Martin Schwarze ◽  
Leonie P Bartsch ◽  
Julia Block ◽  
Merkur Alimusaj ◽  
Ayham Jaber ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Controlled Trial ◽  
Oxford Knee Score ◽  
Knee Adduction Moment ◽  
Osteoarthritis Of The Knee ◽  
Knee Score ◽  
Medial Knee ◽  
Medial Knee Osteoarthritis ◽  
Patient Reported ◽  
Angular Impulse

Objective: To compare biomechanical and clinical outcome of laterally wedged insoles (LWI) and an ankle-foot orthosis (AFO) in patients with medial knee osteoarthritis. Design: Single-centre, block-randomized, cross-over controlled trial. Setting: Outpatient clinic. Subjects: About 39 patients with symptomatic medial knee osteoarthritis. Interventions: Patients started with either LWI or AFO, determined randomly, and six weeks later changed to the alternative. Main measures: Change in the 1st maximum of external knee adduction moment (eKAM) was assessed with gait analysis. Additional outcomes were other kinetic and kinematic changes and the patient-reported outcomes EQ-5D-5L, Oxford Knee Score (OKS), American Knee Society Clinical Rating System (AKSS), Hannover Functional Ability Questionnaire – Osteoarthritis and knee pain. Results: Mean age (SD) of the study population was 58 (8) years, mean BMI 30 (5). Both aids significantly improved OKS (LWI P = 0.003, AFO P = 0.001), AKSS Knee Score (LWI P = 0.01, AFO P = 0.004) and EQ-5D-5L Index (LWI P = 0.001, AFO P = 0.002). AFO reduced the 1st maximum of eKAM by 18% ( P < 0.001). The LWI reduced both maxima by 6% ( P = 0.02, P = 0.03). Both AFO and LWI reduced the knee adduction angular impulse (KAAI) by 11% ( P < 0.001) and 5% ( P = 0.05) respectively. The eKAM (1st maximum) and KAAI reduction was significantly larger with AFO than with LWI ( P = 0.001, P = 0.004). Conclusions: AFO reduces medial knee load more than LWI. Nevertheless, no clinical superiority of either of the two aids could be shown.

scholarly journals Predictors of single-leg standing balance in individuals with medial knee osteoarthritis

2010 ◽  
Vol 62 (4) ◽  
pp. 496-500 ◽  
Author(s):  
Michael A. Hunt ◽  
Fiona J. McManus ◽  
Rana S. Hinman ◽  
Kim L. Bennell
Keyword(s):  
Knee Osteoarthritis ◽  
Standing Balance ◽  
Medial Knee ◽  
Medial Knee Osteoarthritis

scholarly journals Three‐month efficacy of three knee braces in the treatment of medial knee osteoarthritis in a randomized crossover trial

2020 ◽  
Vol 38 (10) ◽  
pp. 2262-2271
Author(s):  
Xavier Robert‐Lachaine ◽  
Yoann Dessery ◽  
Étienne L. Belzile ◽  
Sylvie Turmel ◽  
Philippe Corbeil
Keyword(s):  
Knee Osteoarthritis ◽  
Crossover Trial ◽  
Medial Knee ◽  
Medial Knee Osteoarthritis ◽  
Randomized Crossover Trial ◽  
Knee Braces

Effects of bilateral medial knee osteoarthritis on intra- and inter-limb contributions to body support during gait

2014 ◽  
Vol 47 (2) ◽  
pp. 445-450 ◽  
Author(s):  
Yen-Hung Liu ◽  
Ting-Ming Wang ◽  
I-Pin Wei ◽  
Tung-Wu Lu ◽  
Shih-Wun Hong ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Medial Knee ◽  
Medial Knee Osteoarthritis ◽  
Body Support

scholarly journals Medial Knee Osteoarthritis Treated by Insoles or Braces: A Randomized Trial

2010 ◽  
Vol 468 (7) ◽  
pp. 1926-1932 ◽  
Author(s):  
Tom M. van Raaij ◽  
Max Reijman ◽  
Reinoud W. Brouwer ◽  
Sita M. A. Bierma-Zeinstra ◽  
Jan A. N. Verhaar
Keyword(s):  
Knee Osteoarthritis ◽  
Randomized Trial ◽  
Medial Knee ◽  
Medial Knee Osteoarthritis

Higher dynamic medial knee load predicts greater cartilage loss over 12 months in medial knee osteoarthritis

2011 ◽  
Vol 70 (10) ◽  
pp. 1770-1774 ◽  
Author(s):  
Kim L Bennell ◽  
Kelly-Ann Bowles ◽  
Yuanyuan Wang ◽  
Flavia Cicuttini ◽  
Miranda Davies-Tuck ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Disease Progression ◽  
Cartilage Volume ◽  
Cartilage Defects ◽  
Medial Knee ◽  
Tibial Cartilage ◽  
Medial Knee Osteoarthritis ◽  
Structural Progression ◽  
The Relationship ◽  
Knee Load

ObjectiveMechanical factors, in particular increased medial knee joint load, are believed to be important in the structural progression of knee osteoarthritis. This study evaluated the relationship of medial knee load during walking to indices of structural disease progression, measured on MRI, in people with medial knee osteoarthritis.MethodsA longitudinal cohort design utilising a subset of participants (n=144, 72%) enrolled in a randomised controlled trial of lateral wedge insoles was employed. Medial knee load parameters including the peak knee adduction moment (KAM) and the KAM impulse were measured at baseline using three-dimensional gait analysis during walking. MRI at baseline and at 12 months was used to assess structural indices. Multiple regression with adjustment for covariates assessed the relationship between medial knee load parameters and the annual change in medial tibial cartilage volume. Binary logistic regression was used for the dichotomous variables of progression of medial tibiofemoral cartilage defects and bone marrow lesions (BML).ResultsA higher KAM impulse, but not peak KAM, at baseline was independently associated with greater loss of medial tibial cartilage volume over 12 months (β=29.9, 95% CI 6.3 to 53.5, p=0.01). No significant relationships were seen between medial knee load parameters and the progression of medial tibiofemoral cartilage defects or BML.ConclusionThis study suggests knee loading, in particular the KAM impulse, may be a risk factor for loss of medial tibial cartilage volume. As knee load is modifiable, load-modifying treatments may potentially slow disease progression.

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