Article

The peak knee adduction moment is a valid proxy for medial knee joint
loading. However as it only measures load at one instance of stance, knee
adduction moment impulse, a measure that takes into account both the magnitude
and duration of the stance phase, may provide more comprehensive information.
This study directly compared the abilities of peak knee adduction moment and knee
adduction moment impulse to distinguish between knee osteoarthritis severities.
METHODS: 169 participants with medial knee osteoarthritis completed radiographic
and magnetic resonance imaging, the Western Ontario and McMaster Universities
Arthritis Index to assess pain and a three-dimensional gait analysis.
Participants were classified using four dichotomous classifications:
Kellgren-Lawrence grading, alignment, medial tibiofemoral bone marrow lesions,
and pain. FINDINGS: When using Kellgren-Lawrence grade and alignment
classifications, the area under the receiver operator curves were significantly
greater for knee adduction moment impulse than for peak knee adduction moment.
Based on analysis of covariance, knee adduction moment impulse was significantly
different between Kellgren-Lawrence grade and alignment groups while peak knee
adduction moment was not significantly different. Both peak knee adduction moment
and knee adduction moment impulse distinguished between bone marrow lesion
severities while neither measure was significantly different between pain
severity groups. INTERPRETATIONS: Findings suggest knee adduction moment impulse
is more sensitive at distinguishing between disease severities and may provide
more comprehensive information on medial knee joint loading. Future studies
investigating biomechanics of knee osteoarthritis should include knee adduction
moment impulse in conjunction with peak knee adduction moment.
CI - Copyright (c) 2011 Elsevier Ltd. All rights reserved.

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