Biomechanical Changes in Gait Patterns of Patients with Grade II Medial Gonarthritis.

Abstract

Deforming osteoarthritis (OA) of the knee is a progressive disease associated with pain and compromised function of the joint. Typical biomechanical modifications in the gait of subjects with medial knee OA are characterized by decreased gait speed and overload on the affected limb. The borderline stage for conservative versus surgical management is Grade II OA. The aim of this research was to study preoperatively the specific features of gait, knee, and hip function in patients with Grade II medial OA. We examined 26 patients with Grade II unilateral gonarthritis with varus deformity and 20 healthy adults. Biomechanical parameters of gait were recorded using an inertial sensor system. The gait cycle (GC) slightly increased both for the affected and for the intact limb. The hip joint movements showed significant symmetrical reduction in the first flexion amplitude, as well as a symmetrical delay in full hip extension at the end of the stance phase. In the knee, the first flexion amplitude was significantly reduced on the affected side compared to healthy control. The extension amplitude in the single support phase was significantly increased in both the affected and the intact lower limbs. The swing amplitude was significantly reduced on the affected side. On the affected side, the changes were more pronounced, both in incidence and in severity. The affected knee showed a syndrome of three reduced amplitudes. In patients, walking is characterized by several groups of symptoms: those of unloading of the affected limb, those of limiting the load on the affected joint and the musculoskeletal system as a whole, and those of gait harmonization. The symptoms of unloading the affected side and those of harmonization are the common symptoms of adaptation, typical for several pathological conditions with a relatively preserved function. The intensity of the observed symptoms can help assess changes in the subject’s functional condition over time and during the treatment.