The Effects of Alternative Joint Models in the Study of Lower-Limb Joint Moments in Knee Osteoarthritis

Knee osteoarthritis is a disease that affects nearly 40% of the global population over the age of seventy. It is believed that the incidence and progression of osteoarthritis can be partially attributed to changes in mechanical joint loading. Consequently, changes in lower-limb joint moments are important outcome measures for its treatment and prevention. The purpose of this study was to investigate the effect of four different anatomic joint models on the detection of changes in lower-limb joint moments due to knee osteoarthritis.

Moments during gait were calculated for 44 subjects with moderate osteoarthritis and 44 asymptomatic subjects, then expressed using four joint models: Joint Coordinate System, Plane of Progression, Distal, and Proximal. Discrete peak measures and principal component scores were compared between groups.

Hip adduction magnitude, knee adduction magnitude, peak early-stance knee internal rotation, and peak ankle plantarflexion moments were different between groups regardless of joint model. Differences detected using principal component analysis were less sensitive to the choice of joint model. Results support adoption of the Joint Coordinate System as a standard for joint moment expression due to its clinical relevance and ability to detect differences due to moderate knee osteoarthritis.

Year	Entry
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Year

Entry

1983

Grood ES, Suntay WJ. A joint coordinate system for the clinical description of three-dimensional motions: application to the knee. J Biomech Eng. May 1983;105(2):136-144.

1998

Sharma L, Hurwitz DE, Thonar EJ-MA, Sum JA, Lenz ME, Dunlop DD, Schnitzer TJ, Kirwan-Mellis G, Andriacchi TP. Knee adduction moment, serum hyaluronan level, and disease severity in medial tibiofemoral osteoarthritis. Arthritis Rheum. July 1998;41(7):1233-1240.

2002

Hurwitz DE, Ryals AB, Case JP, Block JA, Andriacchi TP. The knee adduction moment during gait in subjects with knee osteoarthritis is more closely correlated with static alignment than radiographic disease severity, toe out angle and pain. J Orthop Res. January 2002;20(1):101-107.

2007

Zhao D, Banks SA, Mitchell KH, D'Lima DD, Colwell CW Jr, Fregly BJ. Correlation between the knee adduction torque and medial contact force for a variety of gait patterns. J Orthop Res. June 2007;25(6):789-797.

1977

Andriacchi TP, Ogle IJA, Galante JO. Walking speed as a basis for normal and abnormal gait measurements. J Biomech. 1977;10(4):261-268.