Knee kinematics of severe medial knee osteoarthritis showed tibial posterior translation and external rotation: a cross-

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ORIGINAL ARTICLE

Knee kinematics of severe medial knee osteoarthritis showed tibial posterior translation and external rotation: a cross‑sectional study Futoshi Ikuta1,2   · Kei Yoneta3 · Takeshi Miyaji4 · Kenichi Kidera5 · Akihiko Yonekura5 · Makoto Osaki5 · Kazuyoshi Gamada1 Received: 8 June 2019 / Accepted: 21 September 2019 © Springer Nature Switzerland AG 2019

Abstract Background  Knee osteoarthritis (OA) gradually reduces knee function and limits activities of daily living with age. However, the progression of abnormal kinematics of the knee in knee OA is unclear. Aims  This study aimed to clarify the relationship between stage of knee OA and abnormal knee kinematics and to identify a strategy for prevention of knee OA. Methods  A total of 112 knees of 99 patients (45 men/54 women; 55.9 ± 18.2 years), comprising 28 (27/1) in Kellgren– Lawrence grade 0, 18 (8/10) in grade 1, 27 (2/25) in grade 2, 28 (6/22) in grade 3, and 11 (3/8) in grade 4, were enrolled in this cross-sectional study. In vivo knee kinematics was obtained using a three-dimensional-to-two-dimensional registration technique utilizing CT-based bone models and lateral fluoroscopy during knee extension–flexion in an upright sitting position and squatting. Results  The external rotation angle of the tibia relative to the femur was greater in grade 3/4 knees than in grade 0/1 knees and tibial posterior translation was greater in grade 3/4 knees than in grade 0–2 knees. Discussion  Age-related changes in muscle activity and joint instability are considered to be the cause of these abnormal kinematics. Conclusions  As the stage of knee OA progresses, there was a tendency toward increasing tibial external rotation and tibial posterior translation during knee extension–flexion in sitting position and squatting. Prevention of the progress of the abnormal knee kinematics may prevent the progression of the knee OA. Keywords  Knee · Osteoarthritis · Kinematics · Progression · Squatting · In vivo

Introduction

Electronic supplementary material  The online version of this article (https​://doi.org/10.1007/s4052​0-019-01361​-w) contains supplementary material, which is available to authorized users. * Futoshi Ikuta [email protected] 1

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Department Medical Engineering and Technology, Graduate School of Medical Technology and Health Welfare Sciences, Hiroshima International University, 555‑36 Kurosegakuendai, Higashihiroshima‑shi, Hiroshima‑ken 739‑2695, Japan Inanami Spine and Joint Hospital, 3‑17‑5 Higashishinagawa, Shinagawa‑ku, Tokyo 140‑0002, Japan

Knee osteoarthritis (OA) is a serious condition that limits activities of daily living and impairs quality of life with age [1]. Knee OA has a global prevalence of 3.8% and a prevalence of 6.0% in the high-income Asia–Pacific region [2]. An epidemiological survey in Japan showed that the prevalence 3



Department of Rehabilitation, Kobayashi Hospital, Kita 3 Jo Nishi 4‑chome, Kitami‑shi, Hokkaido 090‑0043, Japan

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Department of Orthopaedic Surgery, Aino Memorial Hospital, 3838‑1 Ainomachi