Walking biomechanics in women with patellofemoral osteoarthritis differ compared to men with and women without patellofemoral osteoarthritis.
Matthew G King, David C Ackland, Harvi F Hart and 4 others
PMID 39476510WHAT IT FOUND
Women with patellofemoral knee OA had some different hip and knee walking mechanics than men with the same condition and than controls, and some symptom links appeared only in men.
Key findings
01Women with patellofemoral osteoarthritis had smaller hip flexion moments and impulses and greater hip adduction angles and moments than men with patellofemoral osteoarthritis.
02Compared with women without patellofemoral osteoarthritis, women with patellofemoral osteoarthritis had greater hip flexion angles across most stance, greater mid-to-late hip adduction angles, greater knee valgus angles, and smaller knee adduction moments and impulses.
03Some walking moment impulse associations with KOOS were sex-specific: in men only, lower hip flexion impulse was linked to worse quality of life scores, and greater knee adduction impulse was linked to worse daily living scores.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
This was an exploratory subset from a previous randomized controlled trial, and the authors did not calculate a sample size in advance. The groups were unbalanced, with 24 men with patellofemoral osteoarthritis, 43 women with patellofemoral osteoarthritis, and 14 control women, so the study may have missed additional differences or sex-specific associations. The researchers did not adjust for the many statistical tests they ran. Walking speed was not controlled, so differences may reflect usual walking speed variation rather than patellofemoral osteoarthritis itself. Pain during the walking trials was not recorded, so symptom differences could have influenced mechanics. Patellofemoral osteoarthritis diagnosis is imprecise because there is no specific or sensitive clinical test to separate patellofemoral from tibiofemoral osteoarthritis. The sample focused on lateral patellofemoral osteoarthritis of generally mild severity, so results may not apply to all people with patellofemoral osteoarthritis.
Declared interests
The authors declare no competing interest.
The easy way to misread this
Do not conclude that these walking differences cause patellofemoral osteoarthritis or symptoms, or that changing hip or knee mechanics will improve them. This was an exploratory cross-sectional study with no treatment tested, no sample size calculated in advance, no adjustment for multiple statistical tests, and pain was not recorded during walking.