Gait mechanics in those with/without medial compartment knee osteoarthritis 5 years after anterior cruciate ligament reconstruction

摘要

The objective of the study was to evaluate differences in gait mechanics 5 years after unilateral anterior cruciate ligament reconstruction surgery, for non-osteoarthritic (n=24) versus osteoarthritic (n=9) subjects. For the involved knee, the osteoarthritic group demonstrated significantly lower peak knee flexion angles (non-osteoarthritic=24.3 +/- 4.6 degrees, osteoarthritic=19.1 +/- 2.9 degrees, p=0.01) and peak knee flexion moments (non-osteoarthritic=5.3 +/- 1.2% Body WeightxHeight, osteoarthritic=4.4 +/- 1.2% Body WeightxHeight, p=0.05). Differences in peak knee adduction moment approached significance, with a higher magnitude for the osteoarthritic group (non-osteoarthritic=2.4 +/- 0.8% Body WeightxHeight, osteoarthritic=2.9 +/- 0.5% Body WeightxHeight, p=0.09). Peak medial compartment joint load was evaluated using electromyography-informed neuromusculoskeletal modeling. Peak medial compartment joint load in the involved knee for the two groups was not different (non-osteoarthritic=2.4 +/- 0.4 Body Weight, osteoarthritic=2.3 +/- 0.6 Body Weight). The results suggest that subjects with dissimilar peak knee moments can have similar peak medial compartment joint load magnitudes. There was no evidence of inter-limb asymmetry for either group. Given the presence of inter-group differences (non-osteoarthritic vs. osteoarthritic) for the involved knee, but an absence of inter-limb asymmetry in either group, it may be necessary to evaluate how symmetry is achieved, over time, and to differentiate between good versus bad inter-limb symmetry, when evaluating knee gait parameters. (c) 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:625-633, 2017.