External knee adduction and flexion moments during gait and medial tibiofemoral disease progression in knee osteoarthritis

Alison Hsin-I Chang*, Kirsten C Moisio, Joan S Chmiel, F. Eckstein, A. Guermazi, P. V. Prasad, Y. Zhang, O. Almagor, L. Belisle, K. Hayes, Leena Sharma

*Corresponding author for this work

Research output: Contribution to journalArticle

86 Citations (Scopus)

Abstract

Objective: Test the hypothesis that greater baseline peak external knee adduction moment (KAM), KAM impulse, and peak external knee flexion moment (KFM) during the stance phase of gait are associated with baseline-to-2-year medial tibiofemoral cartilage damage and bone marrow lesion progression, and cartilage thickness loss. Methods: Participants all had knee OA in at least one knee. Baseline peak KAM, KAM impulse, and peak KFM (normalized to body weight and height) were captured and computed using a motion analysis system and six force plates. Participants underwent MRI of both knees at baseline and 2 years later. To assess the association between baseline moments and baseline-to-2-year semiquantitative cartilage damage and bone marrow lesion progression and quantitative cartilage thickness loss, we used logistic and linear regressions with generalized estimating equations (GEE), adjusting for gait speed, age, gender, disease severity, knee pain severity, and medication use. Results: The sample consisted of 391 knees (204 persons): mean age 64.2 years (SD 10.0); BMI 28.4 kg/m2 (5.7); 156 (76.5%) women. Greater baseline peak KAM and KAM impulse were each associated with worsening of medial bone marrow lesions, but not cartilage damage. Higher baseline KAM impulse was associated with 2-year medial cartilage thickness loss assessed both as % loss and as a threshold of loss, whereas peak KAM was related only to % loss. There was no relationship between baseline peak KFM and any medial disease progression outcome measures. Conclusion: Findings support targeting KAM parameters in an effort to delay medial OA disease progression.

Original languageEnglish (US)
Pages (from-to)1099-1106
Number of pages8
JournalOsteoarthritis and Cartilage
Volume23
Issue number7
DOIs
StatePublished - Jul 1 2015

Fingerprint

Knee Osteoarthritis
Cartilage
Gait
Disease Progression
Knee
Bone
Linear regression
Magnetic resonance imaging
Logistics
Bone Marrow
Body Height

Keywords

  • Biomechanics
  • Gait
  • Knee osteoarthritis

ASJC Scopus subject areas

  • Rheumatology
  • Biomedical Engineering
  • Orthopedics and Sports Medicine

Cite this

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title = "External knee adduction and flexion moments during gait and medial tibiofemoral disease progression in knee osteoarthritis",
abstract = "Objective: Test the hypothesis that greater baseline peak external knee adduction moment (KAM), KAM impulse, and peak external knee flexion moment (KFM) during the stance phase of gait are associated with baseline-to-2-year medial tibiofemoral cartilage damage and bone marrow lesion progression, and cartilage thickness loss. Methods: Participants all had knee OA in at least one knee. Baseline peak KAM, KAM impulse, and peak KFM (normalized to body weight and height) were captured and computed using a motion analysis system and six force plates. Participants underwent MRI of both knees at baseline and 2 years later. To assess the association between baseline moments and baseline-to-2-year semiquantitative cartilage damage and bone marrow lesion progression and quantitative cartilage thickness loss, we used logistic and linear regressions with generalized estimating equations (GEE), adjusting for gait speed, age, gender, disease severity, knee pain severity, and medication use. Results: The sample consisted of 391 knees (204 persons): mean age 64.2 years (SD 10.0); BMI 28.4 kg/m2 (5.7); 156 (76.5{\%}) women. Greater baseline peak KAM and KAM impulse were each associated with worsening of medial bone marrow lesions, but not cartilage damage. Higher baseline KAM impulse was associated with 2-year medial cartilage thickness loss assessed both as {\%} loss and as a threshold of loss, whereas peak KAM was related only to {\%} loss. There was no relationship between baseline peak KFM and any medial disease progression outcome measures. Conclusion: Findings support targeting KAM parameters in an effort to delay medial OA disease progression.",
keywords = "Biomechanics, Gait, Knee osteoarthritis",
author = "Chang, {Alison Hsin-I} and Moisio, {Kirsten C} and Chmiel, {Joan S} and F. Eckstein and A. Guermazi and Prasad, {P. V.} and Y. Zhang and O. Almagor and L. Belisle and K. Hayes and Leena Sharma",
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External knee adduction and flexion moments during gait and medial tibiofemoral disease progression in knee osteoarthritis. / Chang, Alison Hsin-I; Moisio, Kirsten C; Chmiel, Joan S; Eckstein, F.; Guermazi, A.; Prasad, P. V.; Zhang, Y.; Almagor, O.; Belisle, L.; Hayes, K.; Sharma, Leena.

In: Osteoarthritis and Cartilage, Vol. 23, No. 7, 01.07.2015, p. 1099-1106.

Research output: Contribution to journalArticle

TY - JOUR

T1 - External knee adduction and flexion moments during gait and medial tibiofemoral disease progression in knee osteoarthritis

AU - Chang, Alison Hsin-I

AU - Moisio, Kirsten C

AU - Chmiel, Joan S

AU - Eckstein, F.

AU - Guermazi, A.

AU - Prasad, P. V.

AU - Zhang, Y.

AU - Almagor, O.

AU - Belisle, L.

AU - Hayes, K.

AU - Sharma, Leena

PY - 2015/7/1

Y1 - 2015/7/1

N2 - Objective: Test the hypothesis that greater baseline peak external knee adduction moment (KAM), KAM impulse, and peak external knee flexion moment (KFM) during the stance phase of gait are associated with baseline-to-2-year medial tibiofemoral cartilage damage and bone marrow lesion progression, and cartilage thickness loss. Methods: Participants all had knee OA in at least one knee. Baseline peak KAM, KAM impulse, and peak KFM (normalized to body weight and height) were captured and computed using a motion analysis system and six force plates. Participants underwent MRI of both knees at baseline and 2 years later. To assess the association between baseline moments and baseline-to-2-year semiquantitative cartilage damage and bone marrow lesion progression and quantitative cartilage thickness loss, we used logistic and linear regressions with generalized estimating equations (GEE), adjusting for gait speed, age, gender, disease severity, knee pain severity, and medication use. Results: The sample consisted of 391 knees (204 persons): mean age 64.2 years (SD 10.0); BMI 28.4 kg/m2 (5.7); 156 (76.5%) women. Greater baseline peak KAM and KAM impulse were each associated with worsening of medial bone marrow lesions, but not cartilage damage. Higher baseline KAM impulse was associated with 2-year medial cartilage thickness loss assessed both as % loss and as a threshold of loss, whereas peak KAM was related only to % loss. There was no relationship between baseline peak KFM and any medial disease progression outcome measures. Conclusion: Findings support targeting KAM parameters in an effort to delay medial OA disease progression.

AB - Objective: Test the hypothesis that greater baseline peak external knee adduction moment (KAM), KAM impulse, and peak external knee flexion moment (KFM) during the stance phase of gait are associated with baseline-to-2-year medial tibiofemoral cartilage damage and bone marrow lesion progression, and cartilage thickness loss. Methods: Participants all had knee OA in at least one knee. Baseline peak KAM, KAM impulse, and peak KFM (normalized to body weight and height) were captured and computed using a motion analysis system and six force plates. Participants underwent MRI of both knees at baseline and 2 years later. To assess the association between baseline moments and baseline-to-2-year semiquantitative cartilage damage and bone marrow lesion progression and quantitative cartilage thickness loss, we used logistic and linear regressions with generalized estimating equations (GEE), adjusting for gait speed, age, gender, disease severity, knee pain severity, and medication use. Results: The sample consisted of 391 knees (204 persons): mean age 64.2 years (SD 10.0); BMI 28.4 kg/m2 (5.7); 156 (76.5%) women. Greater baseline peak KAM and KAM impulse were each associated with worsening of medial bone marrow lesions, but not cartilage damage. Higher baseline KAM impulse was associated with 2-year medial cartilage thickness loss assessed both as % loss and as a threshold of loss, whereas peak KAM was related only to % loss. There was no relationship between baseline peak KFM and any medial disease progression outcome measures. Conclusion: Findings support targeting KAM parameters in an effort to delay medial OA disease progression.

KW - Biomechanics

KW - Gait

KW - Knee osteoarthritis

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