Abstract:
BACKGROUND:Lower limb malalignment in the frontal plane is one of the major causes of developing knee osteoarthritis. Growing children can be treated by temporary hemiepiphysiodesis when diagnosed with lower limb malalignment. RESEARCH QUESTION:Is there a difference between medial or lateral knee contact force (KCF) before (PRE) and after (POST) hemiepiphysiodesis in patients with valgus malalignment and compared to a typically developed control group (TD)? Does a linear relationship exist between the static radiographic mechanical axis angle and dynamic medial/lateral KCF? METHODS:In this prospective study, an OpenSim full body model with an adapted knee joint was used to calculate KCFs in the stance phase of 16 children with diagnosed genu valgum and 16 age- and sex-matched TDs. SPM was applied to compare KCFs before and after guided growth and to test a linear relationship between the mechanical axis angle and KCFs. RESULTS:After the intervention, POST revealed a significantly increased medial KCF (p < 0.001, 4-97 % of stance) and decreased lateral KCF (p < 0.001, 6-98 %) compared to PRE. Comparing POST with TD, short phases with a significant difference were found (medial: p = 0.039, 84-88 %; lateral: p = 0.019, 3-11 %). The static mechanical axis angle showed a longer phase of a significant relation to KCFs for POST compared to PRE. SIGNIFICANCE:This study showed that temporary hemiepiphysiodesis in patients with valgus malalignment reduces the loading in the lateral compartment of the knee and thus the risk of developing osteoarthritis in this compartment. The determination of dynamic KCFs can be clinically relevant for the treatment of lower limb malalignment, especially for decision making before surgery, when compensatory mechanisms may play an important role. Additionally, the static radiographic mechanical axis angle does not necessarily represent the dynamic loading of the lateral knee compartment.
journal_name
Gait Posturejournal_title
Gait & postureauthors
Holder J,Feja Z,van Drongelen S,Adolf S,Böhm H,Meurer A,Stief Fdoi
10.1016/j.gaitpost.2020.03.012subject
Has Abstractpub_date
2020-05-01 00:00:00pages
80-88eissn
0966-6362issn
1879-2219pii
S0966-6362(20)30099-0journal_volume
78pub_type
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