Correlation between static limb alignment and peak knee adduction angle during gait is affected by subject pain in medial knee osteoarthritis.


Journal

The Knee
ISSN: 1873-5800
Titre abrégé: Knee
Pays: Netherlands
ID NLM: 9430798

Informations de publication

Date de publication:
Mar 2020
Historique:
received: 10 01 2019
revised: 23 10 2019
accepted: 13 11 2019
pubmed: 7 12 2019
medline: 4 11 2020
entrez: 7 12 2019
Statut: ppublish

Résumé

Although increases in knee adduction moment (KAM) and angle (KAA) during gait are considered key pathologies that produce mechanical overload in the medial compartment of knee osteoarthritis (OA), it is unclear how these pathologies are related to subjective pain. The purpose of this study was to examine how subjective pain is related to such pathologies. Gait analysis was performed in 31 participants with medial knee OA. The knees were classified into three groups based on Kellgren-Lawrence (KL) grade: early (0 and 1), moderate (2), and severe (3 and 4). Subjective pain was evaluated by the Western Ontario and McMaster Universities (WOMAC) osteoarthritis index pain score. The knees were classified into low- and high-pain groups based on the pain score. The WOMAC pain score did not correlate with either peak KAM or peak KAA. Although a positive correlation between static limb alignment and peak KAA was observed in the low-pain group, it was not observed in the high-pain group. Knee flexion angle at heel strike correlated negatively with the gap between static femorotibial angle and peak KAA in the high-pain group. Although a direct correlation between subjective pain and peak KAM or KAA was not observed, our results suggest a compensatory movement in the high-pain group of participants to reduce KAA increases in the early stance phase. Such movements would be one of the reasons why it is difficult to obtain a consistent relationship between subjective pain and load-related parameters.

Sections du résumé

BACKGROUND BACKGROUND
Although increases in knee adduction moment (KAM) and angle (KAA) during gait are considered key pathologies that produce mechanical overload in the medial compartment of knee osteoarthritis (OA), it is unclear how these pathologies are related to subjective pain. The purpose of this study was to examine how subjective pain is related to such pathologies.
METHODS METHODS
Gait analysis was performed in 31 participants with medial knee OA. The knees were classified into three groups based on Kellgren-Lawrence (KL) grade: early (0 and 1), moderate (2), and severe (3 and 4). Subjective pain was evaluated by the Western Ontario and McMaster Universities (WOMAC) osteoarthritis index pain score. The knees were classified into low- and high-pain groups based on the pain score.
RESULTS RESULTS
The WOMAC pain score did not correlate with either peak KAM or peak KAA. Although a positive correlation between static limb alignment and peak KAA was observed in the low-pain group, it was not observed in the high-pain group. Knee flexion angle at heel strike correlated negatively with the gap between static femorotibial angle and peak KAA in the high-pain group.
CONCLUSIONS CONCLUSIONS
Although a direct correlation between subjective pain and peak KAM or KAA was not observed, our results suggest a compensatory movement in the high-pain group of participants to reduce KAA increases in the early stance phase. Such movements would be one of the reasons why it is difficult to obtain a consistent relationship between subjective pain and load-related parameters.

Identifiants

pubmed: 31806512
pii: S0968-0160(19)30262-5
doi: 10.1016/j.knee.2019.11.008
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

348-355

Informations de copyright

Copyright © 2019 Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest The author(s) declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. This study was financially supported by Teijin Limited.

Auteurs

Kanako Kudo (K)

Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan.

Takeo Nagura (T)

Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan. Electronic address: nagura@z8.keio.jp.

Kengo Harato (K)

Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan.

Shu Kobayashi (S)

Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan.

Yasuo Niki (Y)

Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan.

Morio Matsumoto (M)

Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan.

Masaya Nakamura (M)

Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan.

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