Knee joint kinematics associated with osteoarthritis in an older cohort

Abstract

Osteoarthritis (OA) is a degenerative joint condition that affects roughly one third of adults over the age of 60. In the UK, this amounts to over 8 million people with the total cost of the disease to the economy estimated at £12 billion. Symptoms can include joint pain, stiffness, effusion (swelling of the affected joint) and reduced mobility. Whilst the symptoms and diagnosis of the disease have been clearly defined in medical research, the underlying causes are not yet fully understood. It is thought that biomechanical factor’s, and walking kinematics in particular, play a key role in OA aetiology. Furthering the understanding of these factors could lead to better treatments and help reduce prevalence through preventative measures. A gait analysis protocol suitable for a clinical environment was developed to analyse the Newcastle Thousand Families Study birth cohort. This presented a unique opportunity to study an existing cohort of adults who are representative of the overall population. Gait analysis was performed on every able cohort member who attended for clinical assessment over a period of 16 months. Females showed more significant differences in their gait than males. Of the differences found in males, most were found to be associated with altered cadence. Some variables among female participants were found to be associated with altered cadence, as well as body mass index (BMI), pain and stiffness. It was concluded that female gait is more susceptible to kinematic changes but that these changes are adaptations that slow disease progression. Males do not make these adaptations and show higher prevalence at later OA grades. Differences in cadence were thought to account for most differences in gait kinematics with BMI, pain and stiffness also contributing. Overall, none of the variables measured seem likely to have caused the initiation of OA, however there is potential that the variables showing significant associations between grade 0 and 1 (particularly cadence) could be used for the prediction of OA incidence from gait and could be used as a supporting measure for other diagnostic tools.