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Arthritis & Rheumatism

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Volume 50, Issue 4 , Pages 1172 - 1178

Published Online: 5 Apr 2004

Copyright © 2004 by the American College of Rheumatology

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 Research Article
Potential strategies to reduce medial compartment loading in patients with knee osteoarthritis of varying severity: Reduced walking speed
Anne Mündermann 1 *, Chris O. Dyrby 1, Debra E. Hurwitz 2, Leena Sharma 3, Thomas P. Andriacchi 4
1Stanford University, Stanford, California
2Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois
3Feinberg School of Medicine, Northwestern University, Chicago, Illinois
4Stanford University and Stanford University Medical Center, Stanford, California, and Bone and Joint Center, Palo Alto Veterans Administration, Palo Alto, California
email: Anne Mündermann (amuender@stanford.edu)

*Correspondence to Anne Mündermann, Durand Building 205, Stanford University, Stanford, CA 94305-3030

Funded by:
 NIH; Grant Number: AR-39239

Abstract

Objective
To determine whether reducing walking speed is a strategy used by patients with knee osteoarthritis (OA) of varying disease severity to reduce the maximum knee adduction moment.

Methods
Self-selected walking speeds and maximum knee adduction moments of 44 patients with medial tibiofemoral OA of varying disease severity, as assessed by using the Kellgren/Lawrence grade, were compared with those of 44 asymptomatic control subjects matched for sex, age, height, and weight.

Results
Differences in self-selected normal walking speed explained only 8.9% of the variation in maximum knee adduction moment for the group of patients with knee OA. The severity of the disease influenced the adduction moment-walking speed relationship; the individual slopes of this relationship were significantly greater in patients with less severe OA than in asymptomatic matched control subjects. Self-selected walking speed did not differ between patients with knee OA, regardless of the severity, and asymptomatic control subjects. However, knees with more-severe OA had significantly greater adduction moments (mean SD 3.80 0.89% body weight height) and were in more varus alignment (6.0 4.5) than knees with less-severe OA (2.94 0.70% body weight height; and 0.0 2.9, respectively).

Conclusion
Patients with less-severe OA adapt a walking style that differs from that of patients with more-severe OA and controls. This walking style is associated with the potential to reduce the adduction moment when walking at slower speeds and could be linked to decreased disease severity.

Received: 4 August 2003; Accepted: 17 December 2003

Digital Object Identifier (DOI)

10.1002/art.20132  About DOI

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