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Individuals With Knee Osteoarthritis and Symmetrical Total Joint Moment Exhibit Bilateral Gait Characteristics Associated With Osteoarthritis

2026/02/28 by Carson Halliwell, Aleksandra R. Budarick, Janie Astephen Wilson +3 · 1 voice
Medicine · #Bone health and osteoporosis research #Musculoskeletal pain and rehabilitation #Osteoarthritis Treatment and Mechanisms

paper · doi:10.1123/jab.2025-0183

openalex publication_date 2026/02/28 · openalex created_date 2026/03/01 · openalex updated_date 2026/07/12

Abstract

Interlimb asymmetries may influence contralateral knee osteoarthritis (OA) progression, yet research remains unclear. This study examined whether patient-reported outcomes and knee biomechanics differ between individuals with knee OA exhibiting symmetrical versus asymmetrical knee loading. Forty-three individuals with knee OA were dichotomized into symmetrical (≤14% asymmetry; n = 19) and asymmetrical (>14% asymmetry; n = 24) groups based on total joint moment symmetry indices. Participants completed the Knee Injury and Osteoarthritis Outcome Score and Intermittent and Constant Osteoarthritis Pain questionnaires. Three-dimensional kinematics and kinetics were collected during walking at a self-selected speed. Independent t tests and statistical parametric mapping examined between-group differences in patient-reported outcomes and biomechanical measures. Individuals with symmetrical knee loading had worse Knee Injury and Osteoarthritis Outcome Score activities of daily living scores (P = .041) than those with asymmetrical loading. Individuals with symmetrical knee loading exhibited less knee extension moment during late stance (P = .031) and lower knee adduction moment range in their affected knee compared with asymmetrical loaders. Individuals with symmetrical knee loading walked with lower knee flexion angles (P = .011), less midstance unloading (P = .011), and lower peak knee flexion moment (P < .001) in their contralateral knee compared with asymmetrical loaders. Symmetrical knee loading was associated with affected and contralateral knee biomechanics that were consistent with more severe knee OA and worse functional outcomes.

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