Stride-to-stride variability of knee motion in patients with knee osteoarthritis

Purpose Individuals with knee osteoarthritis (OA) experience pain, frontal plane joint laxity and instability. Co-contraction can control laxity and instability but may place constraints on the variability of the kneeʹs motion during gait. Slight variation among gait cycles is normal, but reduced variability of joint motions could be detrimental. The purpose of this study was to quantify knee motion variability during gait and assess the influence of muscle activity, frontal plane laxity, and pain on knee movement variability in patients with medial knee OA. Methods Fifteen subjects with unilateral medial knee OA and 15 age and gender matched uninjured subjects underwent gait analysis, with electromyography to compute co-contraction. Stress radiographs were obtained for measuring frontal plane laxity. Knee motion variability was assessed from the phase angle (knee angle versus angular velocity) during early stance. Results Despite altered involved side knee kinematics and kinetics, individuals with knee OA showed involved side frontal plane variability which was not significantly different from the control group, but was significantly lower than the variability of the uninvolved kneeʹs motion. Laxity and medial co-contraction influenced the amount of joint motion variability in the involved knee of the OA subjects. Pain did not influence variability. Conclusion Patients with medial knee OA displayed altered involved knee kinematics and kinetics, although stride-to-stride variability of knee motion was unchanged. Evidence of excessive joint motion variability on the uninvolved side, however, may provide insight into the development of OA in the contralateral cognate joint.