Knee stabilization in patients with medial compartment knee osteoarthritis
Article first published online: 2 SEP 2005
Copyright © 2005 by the American College of Rheumatology
Arthritis & Rheumatism
Volume 52, Issue 9, pages 2845–2853, September 2005
How to Cite
Lewek, M. D., Ramsey, D. K., Snyder-Mackler, L. and Rudolph, K. S. (2005), Knee stabilization in patients with medial compartment knee osteoarthritis. Arthritis & Rheumatism, 52: 2845–2853. doi: 10.1002/art.21237
- Issue published online: 2 SEP 2005
- Article first published online: 2 SEP 2005
- Manuscript Accepted: 18 MAY 2005
- Manuscript Received: 29 NOV 2004
- NIH. Grant Numbers: 1P20-RR-016458, 2T32-HD-007490
- Foundation for Physical Therapy (PODS II)
- American College of Sports Medicine
- EBI Medical, LP
Individuals with medial knee osteoarthritis (OA) experience knee laxity and instability. Strategies aimed at muscle stabilization may influence the long-term integrity of the joint. This study sought to determine how individuals with medial knee OA respond to a rapid valgus knee movement, to investigate the relationship between muscle-stabilization strategies and knee instability.
Twenty-one subjects with medial knee OA and genu varum and 19 control subjects were tested. Subjects stood with the test limb on a movable platform, comprising a plate that translated laterally to rapidly stress the knee's medial periarticular structures and create a potentially destabilizing sensation at the knee joint. Knee motion and muscle responses were recorded. Subjects rated the condition of their knee with a self-report questionnaire about knee instability during daily activities.
Prior to plate movement, the OA subjects demonstrated more medial muscle co-contraction than did controls (P= 0.014). Following plate movement, the OA subjects shifted less weight off the test limb (P = 0.013) and had greater medial co-contraction (P = 0.037). OA subjects without knee instability had higher co-contraction of the vastus medialis medial hamstrings than did those who reported having instability that affected their daily activities (P = 0.038). More knee stability correlated positively with higher co-contraction of the vastus medialis medial hamstrings prior to plate movement (r = 0.459, P = 0.042).
Individuals with medial knee OA attempt to stabilize the knee with greater co-contraction of the medial muscle in response to laxity that appears on the medial side of the joint only. This strategy presumably contributes to higher joint compression and could exacerbate joint destruction, and therefore needs to be altered to slow or stop the progression of the OA disease process.