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. 2023 Sep 13;15(1):110.
doi: 10.1186/s13102-023-00726-z.

The association between tibial torsion, knee flexion excursion and foot progression during gait in people with knee osteoarthritis: a cross-sectional study

Chen Huang  1 , Ping-Keung Chan  2 , Kwong-Yuen Chiu  2 , Chun-Hoi Yan  2 , Shun-Shing Yeung  3 , Christopher Wai-Keung Lai  4 , Aaron Kam-Lun Leung  1 , Siu Ngor Fu  5
Affiliations

The association between tibial torsion, knee flexion excursion and foot progression during gait in people with knee osteoarthritis: a cross-sectional study

Chen Huang et al. BMC Sports Sci Med Rehabil. .

Abstract

Background: Lower limb malalignment is associated with gait kinematics, but there is limited information on the relationship between gait kinematics and tibial torsion in individuals with knee osteoarthritis (OA). This study aimed to investigate possible associations between tibial torsion and early stance kinematics during gait in people with mild and moderate medial knee OA.

Methods: Forty-seven participants (age: 62.1 ± 6.0 years; female/male: 37/10) diagnosed with medial knee OA were recruited from a regional hospital. Thirty of them had mild and seventeen had moderate knee OA. Lower limb alignment including tibial torsion and valgus/varus alignment were assessed by an EOS biplaner X-ray system with participants in weight-bearing position. Lower limb kinematics during gait was captured using the Vicon motion analysis system. The associations were estimated by partial Pearson correlation coefficient test.

Results: Our results indicated that external tibial torsion was related to early stance knee flexion excursion in participants with moderate knee OA (r = -0.58, p = 0.048), but not in participants with mild knee OA (r = 0.34, p = 0.102). External tibial torsion was associated with external foot progression angle (r = 0.48, p = 0.001), and knee varus/valgus alignment was associated with knee flexion excursion (r = -0.39, p = 0.010) in all participants.

Conclusions: Both horizontal and frontal lower limb alignments were associated with knee flexion excursion at early stance of gait cycle in participants with medial knee OA. The distal rotational profile of lower limb would likely affect knee motion in sagittal plane. It implies that people with moderate knee OA could possibly benefit from correction of rotational alignment of lower limb.

Keywords: Gait kinematics; Knee osteoarthritis; Osteoarthritis; Tibial torsion.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Scatter plot of relationship between knee flexion excursion and tibial torsion (A mild OA, B moderate OA)
See this image and copyright information in PMC

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References

    1. James SL, Abate D, Abate KH, Abay SM, Abbafati C, Abbasi N, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the global burden of disease study 2017. The Lancet. 2018;392(10159):1789–1858. doi: 10.1016/S0140-6736(18)32279-7. - DOI - PMC - PubMed
    1. Silverwood V, Blagojevic-Bucknall M, Jinks C, Jordan J, Protheroe J, Jordan K. Current evidence on risk factors for knee osteoarthritis in older adults: a systematic review and meta-analysis. Osteoarthritis Cartilage. 2015;23(4):507–515. doi: 10.1016/j.joca.2014.11.019. - DOI - PubMed
    1. Tanamas S, Hanna FS, Cicuttini FM, Wluka AE, Berry P, Urquhart DM. Does knee malalignment increase the risk of development and progression of knee osteoarthritis? A systematic review. Arthritis Care Res. 2009;61(4):459–467. doi: 10.1002/art.24336. - DOI - PubMed
    1. Dixon SJ, Hinman RS, Creaby MW, Kemp G, Crossley KM. Knee joint stiffness during walking in knee osteoarthritis. Arthritis Care Res. 2010;62(1):38–44. doi: 10.1002/acr.20012. - DOI - PubMed
    1. Heiden TL, Lloyd DG, Ackland TR. Knee joint kinematics, kinetics and muscle co-contraction in knee osteoarthritis patient gait. Clin Biomech. 2009;24(10):833–841. doi: 10.1016/j.clinbiomech.2009.08.005. - DOI - PubMed

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