Abstract
BackgroundAlthough unloading of the joint is related to reduction of the local bone mineral density (BMD), little attention had been paid to the relationship between loading asymmetry and side-to-side difference of BMD in patients with bilateral knee osteoarthritis (OA). The aim of the present study was to evaluate and clarify the relationship between gait parameters and bone mineral density in those patients.MethodsA total of 36 knees in eighteen patients (mean age = 73.7 ± 6.3 years, mean body mass index = 26.7 ± 3.8 kg/m2) with bilateral medial knee OA were enrolled in the present study. All subjects performed relaxed standing and level walking at our gait laboratory after informed consent was obtained. First, ground reaction force was calculated on bilateral knees during standing. The knees in each patient were divided into higher and lower force side for the definition of dominant side limb. Second, gait parameters in each subject were obtained. To analyze the factors that affect the weight-bearing distribution in both limbs, clinical data and biomechanical parameters were compared between knees. Clinical data included radiographic OA grade, femorotibial angle, and BMD at the bilateral femoral neck.ResultsKnees on higher force side were significantly more extended than on lower force side in standing (P = 0.012) and knee excursion during weight acceptance phase in gait was significantly larger in higher side than in lower side (P = 0.006), while the other parameters were not significantly different. As to the clinical data, higher force side had greater BMD, compared to lower force side. In terms of Kellgren–Lawrence scale and femorotibial angle on plain radiographs, there were no significant differences between higher and lower force side.ConclusionsBased on loading asymmetry in the present study, lower BMD was observed on Lower force side in patients with knee OA. Therefore, it is helpful for orthopedic surgeons to examine side-to-side differences of bone mineral density or extension limitation during standing for evaluation of the loading condition in patients with bilateral knee OA.
Highlights
End-stage osteoarthritis (OA) at the knee joint is a leading cause of functional impairment and disability which is correlated with deterioration of daily activities in the elderly population
Weight-bearing asymmetry in standing and walking is a well-known phenomenon in knee OA [3, 4]
Some studies have indicated that OA is associated with higher bone mineral density (BMD) [19,20,21,22], and other studies have shown that high BMD decreases the risk of progression of OA [18, 23]
Summary
End-stage osteoarthritis (OA) at the knee joint is a leading cause of functional impairment and disability which is correlated with deterioration of daily activities in the elderly population. Knee extension in standing seemed to be a key factor to decide side-toside difference of loading condition in patients with knee OA [3, 5, 6]. Unloading of the joint is related to reduction of the local BMD [24], little attention had been paid to the relationship between loading asymmetry and side-to-side difference of local BMD in those with knee OA. Unloading of the joint is related to reduction of the local bone mineral density (BMD), little attention had been paid to the relationship between loading asymmetry and side-to-side difference of BMD in patients with bilateral knee osteoarthritis (OA). The aim of the present study was to evaluate and clarify the relationship between gait parameters and bone mineral density in those patients
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
