Knee Kinematics of Severe Medial Knee Osteoarthritis Showed Tibial Posterior Translation and External Rotation: a Cross-sectional Study
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Background: Knee osteoarthritis (OA) gradually reduces knee function and limits activities of daily living with age. However, the progression of abnormal kinematics of the knee in knee OA is unclear.
Aims: This study aimed to clarify the relationship between stage of knee OA and abnormal knee kinematics and to identify a strategy for prevention of knee OA.
Methods: A total of 112 knees of 99 patients (45 men/54 women; 55.9 ± 18.2 years), comprising 28 (27/1) in Kellgren-Lawrence grade 0, 18 (8/10) in grade 1, 27 (2/25) in grade 2, 28 (6/22) in grade 3, and 11 (3/8) in grade 4, were enrolled in this cross-sectional study. In vivo knee kinematics was obtained using a three-dimensional-to-two-dimensional registration technique utilizing CT-based bone models and lateral fluoroscopy during knee extension-flexion in an upright sitting position and squatting.
Results: The external rotation angle of the tibia relative to the femur was greater in grade 3/4 knees than in grade 0/1 knees and tibial posterior translation was greater in grade 3/4 knees than in grade 0-2 knees.
Discussion: Age-related changes in muscle activity and joint instability are considered to be the cause of these abnormal kinematics.
Conclusions: As the stage of knee OA progresses, there was a tendency toward increasing tibial external rotation and tibial posterior translation during knee extension-flexion in sitting position and squatting. Prevention of the progress of the abnormal knee kinematics may prevent the progression of the knee OA.
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