Comparison of knee biomechanical characteristics during gait between patients with knee osteoarthritis and healthy individuals

Abstract

Objective: This study aim to quantify the differences in knee biomechanics during gait between knee osteoarthritis (KOA) patients and healthy individuals.

Methods: Twenty KOA patients (4 males and 16 females, 66.2 ± 7.7 years) and twenty controls (16 males and 4 females, 64.8 ± 5.4 years) were recruited for gait test using the motion capture system and force-platform system. The spatiotemporal parameters, knee kinematics and kinetics, and tibiofemoral contact force (TFCF) were calculated using an improved musculoskeletal model.

Results: KOA patients walked with reduced speed (48.6 %), stride length (32.9 %), stride height (33.0 %), time proportions of single-support phases (19.2 %), increased gait cycle time (31.0 %), time proportions of stance (8.5 %) and double-support phases (57.7-75.9 %). KOA patients had significant smaller peak flexion angle (29.1 %), flexion ROM (50.6 %) and peak flexion moment (90.2 %), greater peak adduction moment (KAM) (40.7 %), peak rotation moments (KRM) (50.0 %), KAM impulse (106.2 %) and KRM impulse (126.0 %). In proximodistal direction, greater medial TFCF impulse (238 %), total and medial first-peak TFCF (9.6 % and 15.2 %), and smaller lateral peak TFCF (33.3 %) and TFCF impulse (38.4 %) were found in KOA patients. Besides, significant differences were found in the total, medial and lateral peak TFCFs and TFCF impulses in mediolateral direction, and the medial and lateral TFCFs and TFCF impulses in anteroposterior direction.

Conclusions: Significant differences were found in the spatiotemporal parameters, knee kinematics and kinetics, and TFCF between the two groups. The results of this study have important implication for clinicians and rehabilitation physicians. These quantified biomechanical differences can provide data support for the personalized and quantified rehabilitation strategies, give suggestions for the exercises of KOA patients, help monitor disease, evaluate surgical treatment, and develop more effective preoperative planning and postoperative rehabilitation strategies.

Keywords: Gait analysis; Kinematics; Kinetics; Knee biomechanics; Knee osteoarthritis; Tibiofemoral contact force.

Fig. 1

Position of the reflective makers (A frontal view and B back view) and gait experiment (C).

Fig. 2

Comparison of the time proportion of each gait phase between patients with KOA and healthy individuals. Asterisk *** represent significance level at 0.001.

Fig. 3

Comparison of the knee angle-time curves (Ⅰ), peak angle and range of motion (ROM) (Ⅱ) between patients with KOA and healthy individuals in three anatomical planes, (A) knee flexion angle, (B) knee adduction angle and (C) knee internal rotation angle. Asterisk ** and *** represent significance level at 0.01 and 0.001 respectively.

Fig. 4

Comparison of the knee moment-time curves (Ⅰ), peak moment and moment impulse (Ⅱ) between patients with KOA and healthy individuals in three anatomical planes, (A) knee flexion moment, (B) knee adduction moment, (C) knee internal rotation moment. Asterisk ** and *** represent significance level at 0.01 and 0.001 respectively.

Fig. 5

Comparison of the tibiofemoral contact force-time curves (Ⅰ), peak force and force impulse (Ⅱ) between patients with KOA and healthy individuals in proximodistal (PD) direction, (A) total compartment, (B) medial compartment and (C) lateral compartment. Asterisk * and *** represent significance level at 0.05 and 0.001 respectively.

Fig. 6

Comparison of the tibiofemoral contact force-time curves (Ⅰ), peak force and force impulse (Ⅱ) between patients with KOA and healthy individuals in mediolateral (ML) direction, (A) total compartment, (B) medial compartment and (C) lateral compartment. Asterisk *** represent significance level at 0.001.

Fig. 7

Comparison of the tibiofemoral contact force-time curves (Ⅰ), peak force and force impulse (Ⅱ) between patients with KOA and healthy individuals in anteroposterior (AP) direction, (A) total compartment, (B) medial compartment and (C) lateral compartment. Asterisk * and ** represent significance level at 0.05 and 0.01 respectively.