Changes in in vivo knee contact forces through gait modification |
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| Authors: | Allison L Kinney Thor F Besier Amy Silder Scott L Delp Darryl D D'Lima Benjamin J Fregly |
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| Institution: | 1. Department of Mechanical and Aerospace Engineering, University of Florida, Gainesville, Florida;2. Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand;3. Department of Bioengineering, Stanford University, Stanford, California;4. Department of Orthopaedic Surgery, Stanford University, Stanford, California;5. Department of Mechanical Engineering, Stanford University, Stanford, California;6. Shiley Center for Orthopaedic Research and Education at Scripps Clinic, La Jolla, California;7. Department of Biomedical Engineering, University of Florida, Gainesville, Florida;8. Department of Orthopaedics & Rehabilitation, University of Florida, Gainesville, Florida |
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| Abstract: | Knee osteoarthritis (OA) commonly occurs in the medial compartment of the knee and has been linked to overloading of the medial articular cartilage. Gait modification represents a non‐invasive treatment strategy for reducing medial compartment knee force. The purpose of this study was to evaluate the effectiveness of a variety of gait modifications that were expected to alter medial contact force. A single subject implanted with a force‐measuring knee replacement walked using nine modified gait patterns, four of which involved different hiking pole configurations. Medial and lateral contact force at 25, 50, and 75% of stance phase, and the average value over all of stance phase (0–100%), were determined for each gait pattern. Changes in medial and lateral contact force values relative to the subject's normal gait pattern were determined by a Kruskal–Wallis test. Apart from early stance (25% of stance), medial contact force was most effectively reduced by walking with long hiking poles and wide pole placement, which significantly reduced medial and lateral contact force during stance phase by up to 34% (at 75% of stance) and 26% (at 50% of stance), respectively. Although this study is based on data from a single subject, the results provide important insight into changes in medial and lateral contact forces through gait modification. The results of this study suggest that an optimal configuration of bilateral hiking poles may significantly reduce both medial and lateral compartment knee forces in individuals with medial knee osteoarthritis. © 2012 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 31: 434–440, 2013 |
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| Keywords: | knee osteoarthritis in vivo knee loads gait retraining walking biomechanics |
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