Goal

To identify mechanisms by which knee osteoarthritis develops and progresses, by examining the interaction of in vivo mechanical and biological factors in patients with medial compartment knee OA:

• Gait analysis
• MR imaging

Major Findings

• Over 5 years, baseline knee joint loading, as measured with the peak knee adduction moment and peak knee flexion moment, can predict OA progression.
• An increased loss of cartilage thickness and reduction in medial-to-lateral cartilage thickness ratio is associated with greater magnitudes in the adduction and flexion moments.
• Both of these measures should be considered within the context of understanding and attempting to alter joint loading in OA gait.
• The magnitude of the knee moment in the transverse plane (vectoral sum of the adduction and flexion moments) may be more sensitive to knee joint loading than either the adduction or flexion moment independently.
• Transverse plane moment was able to statistically detect differences in joint loading during ambulation between a younger healthy group and an older healthy group. Neither the adduction nor the flexion moment were able to detect such differences.
• While stair climbing, OA patients displayed more forward trunk lean and reduced knee flexion moment when compared to control subjects.

Representative Publications

• Baseline knee adduction and flexion moments during walking are both associated with five year cartilage changes in patients with medial knee osteoarthritis
  Chehab E, Favre J, Erhart-Hledik J, Andriacchi T. Osteoarthritis and Cartilage. In press, September 2014.
• Erhart J, Favre J, Andriacchi T: Walking loading at the knee predicts MRI-derived cartilage thickness changes in medial compartment knee osteoarthritis, Osteoarthritis Research Society International (OARSI), San Diego, CA September 15-18, 2011.
• Adaptive patterns of movement during stair climbing in patients with knee osteoarthritis.
  Asay JL, Mündermann A, Andriacchi TP. J Orthop Res. 2009 Mar; 27(3):325-9.

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