Treatment effect for knee osteoarthritis detected by early dynamic changes of knee joint movement during gait

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We, Japanese have nearly seven million patients with symptomatic knee osteoarthritis, who are often indicated with conservative treatments like quadriceps strengthening or foot insoles. Osteoarthritis patients may exhibit different kinematics according to the stage of disease, however, the pathomechanism of such treatments is still uncertain. The purpose of this study was to investigate changes in the knee kinematic gait variables of osteoarthritis patients, including the frontal and horizontal planes, with respect to the severity of the disease.All subjects were examined their gait patterns during walking on a flat walkway. In each trial, we calculated the angular displacements of flexion/extension, abduction/adduction, and external/internal tibial rotation. We also measured muscle strength, range of motion(ROM), and ground reaction force(GRF). We compared the differences in osteoarthritis severity and knee kinematic variables in the frontal and horizontal planes between osteoarthritis patients and normal subjects.Osteoarthritis patients had different knee kinematics during gait, depending on the progress of osteoarthritis. Early-stage patients mainly exhibited decreased axial tibial rotation excursion, while severe-stage patient exhibit increased knee adduction. In the third year, we added a new device which can produce sudden floor perturbation to simulate a clinical situation, and ultrasound therapy for analgesic effect to separate factors from knee alignment and from pain. We continue the investigation to understand the pathomechanism and prognosis of knee osteoarthritis.