Impacts of asymmetric hip rotation angle on gait biomechanics in patients with knee osteoarthritis

Abstract

Background: Knee Osteoarthritis (OA) is a highly prevalent age-related disease. The altered kinematic pattern of the knee joint as well as the adjacent joints affects to progression of knee OA. However, there is a lack of research on how asymmetry of the hip rotation angle affects the gait pattern in knee OA patients.

Research question: What are the impacts of asymmetric hip rotation range on gait biomechanical characteristics and do the gait patterns differ between patients with knee OA and healthy elderly people?

Methods: Twenty-nine female patients with knee OA and 15 healthy female elders as control group were enrolled in this study. The spatiotemporal parameters, kinematic and kinetic data during walking were measured using a three-dimensional motion capture system. The differences between knee OA and control group were analyzed using an independent t-test.

Results: The knee OA group exhibited a significant reduction in hip internal rotation range and internal/external rotation ratio on more affected side (p < 0.05). Significant differences were found in spatiotemporal parameters except to the step width. Significant reductions were also found in kinematic parameters (pelvic lateral tilt range, sagittal angle ranges in hip, knee and ankle, knee adduction mean angle). There were also significant differences in vertical ground reaction force and knee adduction moment (p < 0.05).

Conclusions: Knee OA patients have asymmetric hip rotation ranges. Especially limited hip internal rotation could lead to the reduction of pelvic lateral tilt, which may cause greater knee joint loading. Therefore, it is necessary to pay attention to recovery of hip rotation after knee surgery.

Keywords: Gait; Hip rotation; Knee adduction moment; Knee osteoarthritis; Pelvic lateral tilt.