Abstract
Background
Malalignment, knee laxity, and repetitive physical activity are considered biomechanical
risk factors for knee osteoarthritis (KOA), though the correlation among these factors
is poorly understood. The purpose of this study was to elucidate the relationship
between knee laxity and alignment, and to determine the effects of repetitive physical
activity on knee laxity in patients with KOA.
Methods
The study subjects were 68 patients with radiographic tibiofemoral KOA and 68 control
subjects. Each participant underwent clinical evaluation, muscle strength test, radiography,
and knee laxity test. Laxity was evaluated before and after repetitive stepping exercise
using tri-axial accelerometer.
Results
Mediolateral acceleration correlated (P < 0.01) with two coronal alignments (mechanical axis: hip–knee–ankle angle (HKA);
and joint line convergent angle (JLCA)). Pearson correlation coefficient was small
(r = 0.23–0.24) before but increased after stepping (r = 0.28–0.33). Increased mediolateral acceleration after stepping correlated with
JLCA (r = 0.37, P < 0.001). There were significant differences in coronal alignments, gait speed, mediolateral
acceleration, and accelerations in all directions between the control and KOA groups.
Anteroposterior acceleration did not correlate with sagittal knee alignment. Multiple
logistic regression analysis identified HKA/JLCA, and increased mediolateral acceleration
after stepping as significant diagnostic predictors of KOA.
Conclusions
We found a direct relationship between knee laxity and alignment or repetitive physical
activity. Repetitive stepping activity significantly increased mediolateral acceleration
in KOA patients, compared with the control. Stepping increased the correlation between
mediolateral acceleration and coronal alignment. In knees with large JLCA, repetitive
stepping caused much larger mediolateral laxity.
Keywords
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Article info
Publication history
Published online: November 21, 2022
Accepted:
October 4,
2022
Received in revised form:
September 21,
2022
Received:
October 29,
2021
Identification
Copyright
© 2022 Elsevier B.V. All rights reserved.
