Static and dynamic correlates of the knee adduction moment in healthy knees ranging from normal to varus-aligned

Abstract

Background: Individuals with medial knee osteoarthritis often present with varus knee alignment and ambulate with increased knee adduction moments. Understanding the factors that relate to the knee adduction moment in healthy individuals may provide insight into the development of this disease. Thus, this study aimed to examine the relationships of both static and dynamic lower extremity measures with the knee adduction moment. We hypothesized that the dynamic measures would be more closely related to this moment.

Methods: Arch height index, hip abduction strength and two static measures of knee alignment were recorded for 37 young asymptomatic knees that varied from normal to varus-aligned. Overground gait analyses were also performed. Correlation coefficients were used to assess the relationships between the static and dynamic variables to the knee adduction moment. Hierarchical regression analyses were then conducted using the static measures, the dynamic measures, and the static and dynamic measures together.

Results: Among the static measures, the tibial mechanical axis and the distance between the medial knee joint lines were correlated with the knee adduction moment. The best predictive static model (R(2)=0.53) included only the tibial mechanical axis. Among the dynamic variables, knee adduction and rearfoot eversion angles were correlated with the knee adduction moment. Knee adduction and rearfoot eversion, together, were the best dynamic model (R(2)=0.53). The static and dynamic measures together created the strongest of the three models (R(2)=0.59).

Conclusions: These results suggest that dynamic measures slightly enhance the predictive strength of static measures when explaining variation in the knee adduction moment.

Figures

Figure 1

Clinical measurement of tibial mechanical axis with a caliper-inclinometer device using procedures modified from Hinman and colleagues (2006).

Figure 2

Schematic representation of landmarks used in determining arch height index. FL=foot length, TFL=truncated foot length, DORS=dorsum height. Adapted from Williams et al., 2000, with permission.