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Potential strategies to reduce medial compartment loading in patients with knee osteoarthritis of varying severity: Reduced walking speed

2004; Wiley; Volume: 50; Issue: 4 Linguagem: Inglês

10.1002/art.20132

1529-0131

Annegret Mündermann, Chris O. Dyrby, Debra E. Hurwitz, Leena Sharma, Thomas P. Andriacchi,

Lower Extremity Biomechanics and Pathologies

Abstract Objective To determine whether reducing walking speed is a strategy used by patients with knee osteoarthritis (OA) of varying disease severity to reduce the maximum knee adduction moment. Methods Self‐selected walking speeds and maximum knee adduction moments of 44 patients with medial tibiofemoral OA of varying disease severity, as assessed by using the Kellgren/Lawrence grade, were compared with those of 44 asymptomatic control subjects matched for sex, age, height, and weight. Results Differences in self‐selected normal walking speed explained only 8.9% of the variation in maximum knee adduction moment for the group of patients with knee OA. The severity of the disease influenced the adduction moment–walking speed relationship; the individual slopes of this relationship were significantly greater in patients with less severe OA than in asymptomatic matched control subjects. Self‐selected walking speed did not differ between patients with knee OA, regardless of the severity, and asymptomatic control subjects. However, knees with more‐severe OA had significantly greater adduction moments (mean ± SD 3.80 ± 0.89% body weight × height) and were in more varus alignment (6.0 ± 4.5°) than knees with less‐severe OA (2.94 ± 0.70% body weight × height; and 0.0 ± 2.9°, respectively). Conclusion Patients with less‐severe OA adapt a walking style that differs from that of patients with more‐severe OA and controls. This walking style is associated with the potential to reduce the adduction moment when walking at slower speeds and could be linked to decreased disease severity.