Effects of Knee Osteoarthritis on Hip and Ankle Gait Mechanics

Abstract

Introduction. Knee osteoarthritis (OA) can affect the hip and ankle joints, as these three joints operate as a kinetic/kinematic chain while walking. Purpose. This study was performed to compare (1) hip and ankle joint gait mechanics between knee OA and control groups and (2) to investigate the effects of knee gait mechanics on the ipsilateral hip and ankle joint. Methods. The study group included 89 patients with end-stage knee OA and 42 age- and sex-matched controls without knee pain or OA. Kinetic and kinematic parameters were evaluated using a commercial optoelectric gait analysis system. Range of motion (ROM) during gait, coronal motion arc, and peak joint moment of hip, knee, and ankle joints were investigated. Results. Ankle varus moment was 50% higher in the OA group (p=0.005) and was associated with higher knee adduction moment (p<0.001). The ROM of the hip and ankle joints were significantly smaller in the OA group and were associated with limited ROM of the knee joint (both p<0.001). The coronal motion arc of the hip was smaller in the OA group and was also associated with limited motion arc of the knee (p<0.001). Conclusions. Knee OA has a negative effect on the ROM, coronal motion arc, and joint moment of the ankle joint and hip joint. As knee OA is associated with increased moment of the ankle joint, attention should be paid to the ankle joint when treating patients with knee OA.

A machine learning-based diagnostic model associated with knee osteoarthritis severity

“…Similarly, Segal et al 35 reported joint power differences between symptomatic KOA patients and high-functioning controls. In one of our previous studies, we have reported that difference between maximum and minimum value of both hip flexion angle and hip adduction angle were smaller in KOA patients compared with control group 36 . Weidow et al have reported that 37 the maximum value of hip rotation moment significantly differed between symptomatic and asymptomatic group.…”

Association between Foot Posture Asymmetry and Static Stability in Patients with Knee Osteoarthritis: A Case‐Control Study

“…The ankle and foot play an important role in biomechanical alterations in the lower limbs of individuals with KOA. As the axis of movement in the lower extremity, the ankle is biomechanically related to problems in the knee [4]. An increased knee adduction angle is observed in subjects with early knee osteoarthritis [5], and a lateral shift in foot center of pressure (COP) could reduce the knee adduction moment through shortening the knee lever arm [6].…”

Effects of knee osteoarthritis severity on inter-joint coordination and gait variability as measured by hip-knee cyclograms

“…However, hip RoM did not significantly differ among groups in this study, which may be due to the criteria used to divide patients into groups. In previous studies in which reduced hip RoM was observed in severe KOA, patients with severe KOA were defined as those who had a KL grade 4 change in knee radiography or who were indicated for joint replacement surgery 5 , 9 . In this study, advanced KOA was defined as a KL grade 3 or 4 in knee radiographs.…”

“…Differences in knee joint angles during the gait cycle between patients with KOA and healthy adults have been reported. Previous studies showed that gait kinematics of the hip joints could be affected by KOA 5 , 9 . Furthermore, gait variability, which a factor associated with falls 10 , 11 , could be affected by KOA 12 – 14 .…”