Division of Sports Medicine, Midwest Orthopaedics at Rush, Chicago, IL, USA; Brazil Institute of Health Technologies (Instituto Brasil de Tecnologias da Saúde), Rio de Janeiro, Brazil; Post Graduation Program of Clinical Radiology, Escola Paulista de Medicina, Federal University of São Paulo (Universidade Federal de São Paulo), São Paulo, Brazil.
Brazil Institute of Health Technologies (Instituto Brasil de Tecnologias da Saúde), Rio de Janeiro, Brazil; Post Graduation Program of Clinical Radiology, Escola Paulista de Medicina, Federal University of São Paulo (Universidade Federal de São Paulo), São Paulo, Brazil.
Knee. 2023 Oct;44:211-219. doi: 10.1016/j.knee.2023.08.002. Epub 2023 Sep 5.
Previous authors have utilized gait kinematics to categorize knee osteoarthritis patients into four distinct profiles: (1) flexed knee; (2) externally rotated knee; (3) stiff knee; and (4) knee varus thrust and rotational rigidity. However, the relationship between these gait profiles and patients' characteristics remains poorly understood. Thus, this study aimed to investigate whether differences in clinical and radiographic characteristics were associated with these four gait profiles.
This cross-sectional study used available data from a previous biomechanical study. Data on the four gait profiles were collected from 42 patients with advanced knee osteoarthritis. Three-dimensional kinematics of the knee was recorded during gait using an optoelectronic system. Subjects were evaluated for knee strength, range of motion, tibial slope, femorotibial angle, radiographic severity, anthropometric measurements, and patient-reported outcomes. Multiple comparisons were made using Dunn's test. The level of significance was set at 5%, and the effect size was calculated.
Body mass index (BMI) was the only variable associated with a specific gait profile: profile 4 (P = 0.01; effect size = P1 × P4: -0.62; P2 × P4: -0.41; P3 × P4: -0.40).
Our findings suggest that most clinical and radiographic characteristics commonly measured in clinical practice did not differ significantly among knee osteoarthritis patients with the four different gait profiles. The only exception was a higher BMI noted in those with gait profile 4; however, it remains unclear whether it can cause varus thrust or rotation rigidity. The incorporation of three-dimensional motion analysis to identify gait profiles provided clinical insights beyond the limitations of traditional clinical assessments.
先前的作者已经利用步态运动学将膝骨关节炎患者分为四个不同的类型：（1）膝关节弯曲；（2）膝关节外旋；（3）僵硬膝关节；和（4）膝关节内翻推力和旋转僵硬。然而，这些步态类型与患者特征之间的关系仍不清楚。因此，本研究旨在探讨这些步态类型与临床和影像学特征之间是否存在差异。
本横断面研究使用了先前生物力学研究中的可用数据。从 42 名患有晚期膝骨关节炎的患者中收集了四种步态类型的数据。使用光电系统在步态期间记录膝关节的三维运动学。对膝关节力量、活动范围、胫骨斜率、股胫角、放射学严重程度、人体测量学测量值和患者报告的结果进行评估。使用 Dunn 检验进行多次比较。显著性水平设定为 5%，并计算了效应量。
体重指数（BMI）是唯一与特定步态类型相关的变量：类型 4（P=0.01；效应量 P1×P4：-0.62；P2×P4：-0.41；P3×P4：-0.40）。
我们的发现表明，在患有四种不同步态类型的膝骨关节炎患者中，大多数在临床实践中通常测量的临床和影像学特征没有显著差异。唯一的例外是在步态类型 4 的患者中观察到较高的 BMI；然而，尚不清楚它是否会导致内翻推力或旋转僵硬。通过三维运动分析来识别步态类型提供了超越传统临床评估局限性的临床见解。
