The Effects of Alternative Joint Models in the Study of Lower-Limb Joint Moments in Knee Osteoarthritis
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Knee osteoarthritis is a disease that affects nearly 40% of the global population over the age of seventy. It is believed that the incidence and progression of osteoarthritis can be partially attributed to changes in mechanical joint loading. Consequently, changes in lower-limb joint moments are important outcome measures for its treatment and prevention. The purpose of this study was to investigate the effect of four different anatomic joint models on the detection of changes in lower-limb joint moments due to knee osteoarthritis. Moments during gait were calculated for 44 subjects with moderate osteoarthritis and 44 asymptomatic subjects, then expressed using four joint models: Joint Coordinate System, Plane of Progression, Distal, and Proximal. Discrete peak measures and principal component scores were compared between groups. Hip adduction magnitude, knee adduction magnitude, peak early-stance knee internal rotation, and peak ankle plantarflexion moments were different between groups regardless of joint model. Differences detected using principal component analysis were less sensitive to the choice of joint model. Results support adoption of the Joint Coordinate System as a standard for joint moment expression due to its clinical relevance and ability to detect differences due to moderate knee osteoarthritis.