Quantification of joint alignment and stability during a single leg stance task in a knee osteoarthritis cohort.

ABSTRACT

BACKGROUND: Knee osteoarthritis alters joint stability but its kinematics during functional weight-bearing tasks remain unclear. We propose and validate an assessment technique for the quantification of knee alignment and stability in patients during a short single leg stance task. METHODS: Three-dimensional knee kinematics were acquired non-invasively from 31 knee osteoarthritis patients (subdivided as moderate or severe) and 15 asymptomatic individuals during six short single-leg stance tasks. Data of participants achieving ≥3 trials were retained. From flexion-extension signals, a data treatment method compared the average between-trial root-mean-square error (RMSE) across trial triplets, and the average within-trial range of movement (RoM) for two data windows. From secondary knee motions (ab/adduction and int/external rotations, anteroposterior and mediolateral translations), we extracted measures characterizing alignments (mean), largest deviations (maximum, minimum), and extent of micro-adjustments (RoM, length of knee excursion). Their sensitivity to disease and severity was determined using an ANOVA, and between-trial repeatability using ICC2,3. RESULTS: Ninety-four percent of patients achieved ≥3 trials. The retained trial triplet and window reduced the RMSE (2.15 to 1.54) and RoM (4.9° to 1.77°) for flexion-extension. Mean, minimum, and maximum measures were sensitive to disease for anteroposterior translations, and to severity for ab/adduction (P < 0.05). High repeatability was found for those measures (ICC ≥0.84). RoM and length of knee excursion, although sensitive to disease for anteroposterior translations, had lower ICC. CONCLUSION: The proposed technique is feasible and exposed measures of knee alignment sensitive to knee osteoarthritis, for instance, an anterior femoral shift and an increased adduction malalignment with greater severity.