Tibiofemoral Contact Measures During Standing in Toe-In and Toe-Out Postures
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Knee osteoarthritis is thought to result, in part, from excessive and unbalanced joint loading. Toe-in and toe-out gait modifications produce alterations in external knee joint moments, and some improvements in pain over the short- and long-term. The aim of this study was to probe mechanisms of altered joint loading through the assessment of tibiofemoral contact in standing with toe-in and toe-out positions using an open magnetic resonance scanner. In this study, 15 young, healthy participants underwent standing magnetic resonance imaging of one of their knees in 3 foot positions. Images were analyzed to determine contact in the tibiofemoral joint, with primary outcomes including centroid of contact and contact area for each compartment and overall. The centroid of contact shifted laterally in the lateral compartment with both toe-in and toe-out postures, compared with the neutral position (P < .01), while contact area in the medial and lateral compartments showed no statistical differences. Findings from this study indicate that changes in the loading anatomy are present in the tibiofemoral joint with toe-in and toe-out and that a small amount of lateralization of contact, especially in the lateral compartment, does occur with these altered lower limb orientations.
Hunt is with the Department of Physical Therapy, The University of British Columbia, Vancouver, BC, Canada. Hunt and Cochrane are with the Motion Analysis and Biofeedback Laboratory, The University of British Columbia, Vancouver, BC, Canada. Cochrane is also with the Graduate Programs in Rehabilitation Sciences, The University of British Columbia, Vancouver, BC, Canada. Hunt, Schmidt, Zhang, Stockton, and Wilson are with the Centre for Hip Health and Mobility, The University of British Columbia, Vancouver, BC, Canada. Black is with the Motion Lab at BC Children's Hospital, Vancouver, BC, Canada. Wilson and Black are also with the Department of Orthopedics, The University of British Columbia, Vancouver, BC, Canada.
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