The Effect of Torsion Deformity and Medial Knee Osteoarthritis on Lower Limb Extensor Moments during Gait

The aim of this study was to quantify the effect of torsion deformity on the lower limb kinetics during the loading response phase of gait. A total of 24 subjects: 6 end-staged medial knee OA with torsion deformity (TKO), 8 without torsion deformity (KOA), and 10 controls (CON) were imaged using computed tomography (CT). Internal moment of support and sagittal hip, knee and ankle joint moments were assessed using gait analysis. TKO showed greater external rotations of the proximal tibia and the distal femur compared to subjects with medial knee OA without torsion deformity and controls. TKO showed greater moment of support and a greater knee extensor moment when compared to controls when supporting the weight of the body during gait. The TKO intorsion deformity occurred as a result of a proximal malrotation of the tibia. In the presence of torsion deformity, the kinetic synergy of the lower limb showed increased total moment of support for subjects with medial knee OA. The greater extensor output from TKO may be the result of an increased muscular response to overcome an interrupted inter-segmental exchange of accelerations during the loading response phase of gait.