Article

Coexisting patellofemoral osteoarthritis (PFOA) is a common finding in patients
with tibiofemoral osteoarthritis (TFOA). The purpose of this study was to
elucidate whether severity of coexisting PFOA in patients with TFOA is correlated
with altered sagittal-plane gait biomechanics and greater knee-specific
impairments. One hundred and six patients with radiographic TFOA were stratified
into three groups of no PFOA, mild PFOA, and severe PFOA. All patients completed
instrumented gait analysis, quantitative quadriceps strength testing and knee
range of motion assessment. Compared to patients with no PFOA, those with severe
PFOA exhibited reduced loading-response knee flexion excursions (p = 0.002) and
increased peak single-leg stance external knee flexion moments (p < 0.05). The
severe PFOA group also demonstrated lower quadriceps strength compared to the no
PFOA and mild PFOA groups (p < 0.001). Regression analysis further revealed that
quadriceps strength and knee extension range of motion were independently
associated with altered sagittal-plane knee biomechanics during gait (p < 0.03).
Reduced loading response knee flexion excursion during gait may be an attempt to
decrease patellofemoral joint loading by patients with severe PFOA but it may
increase impact loading of their arthritic tibiofemoral joint. Additionally, the
greater external knee flexion moments observed during the single-leg stance phase
of gait can lead to an overall increase in patellofemoral joint loading and
symptoms in patients with more severe PFOA. Given the association between
knee-specific impairments and altered gait biomechanics in our study, addressing
quadriceps muscle weakness and limited knee extension range of motion may be
indicated in patients with TFOA and severe coexisting PFOA.
CI - Copyright (c) 2014 Elsevier B.V. All rights reserved.

Langue : ANGLAIS