Introduction
Methods
Gait analysis
Biomechanical analysis
Statistical analysis
Results
Demographics | Controls Mean (SD) | Pre-HTO Mean (SD) | Pre-HTO vs controls p value |
---|---|---|---|
Number of knees | 18 | 19 | |
Gender (M/F) | 10/8 | 16/2 | |
Mean age, years (SD) | 34.6 (11.2) | 51.2 (7.0) | < 0.001** |
Height, m (SD) | 1.7 (0.1) | 1.7 (0.1) | ns |
Mass, kg (SD) | 70.2 (12.9) | 90.1 (22.5) | 0.002** |
BMI, kg/m2 (SD) | 24.5 (4.1) | 29.5 (5.8) | 0.003†† |
KL Grade | 2 KL2, 12 KL3, 5 KL4 | ||
mTFA (°) | 8.0 (3.6) post-HTO: 0.7 (2.9) for n = 16 |
Scores | Controls Mean (SD) | Pre-HTO Mean (SD) | Post-HTO Mean (SD) | Controls vs pre-HTO p value | Controls vs post-HTO p value | Pre- vs post-HTO p value |
---|---|---|---|---|---|---|
Oxford Knee Score | 47.7 (1.0) (n = 17) | 26.6 (7.9) (n = 18) | 36.8 (6.0) (n = 18) | < 0.001†† | < 0.001†† | < 0.001** |
Knee Outcome Survey | 79 .4 (1.2) (n = 16) | 47.2 (11.8) (n = 18) | 60.3 (9.9) (n = 18) | < 0.001†† | < 0.001†† | 0.002** |
Pain Score | 0.4 (1.1) (n = 15) | 49.4 (26.3) (n = 16) | 15.4 (10.9) (n = 16) | < 0.001†† | < 0.001†† | < 0.001** |
Metrics | Control Mean (SD) | Pre-HTO Mean (SD) | Post-HTO Mean (SD) | Control vs pre-HTO p value | Control vs post-HTO p value | Pre- vs post-HTO p value |
---|---|---|---|---|---|---|
Gait speed (m/s) | 1.2 (0.1) | 1.0 (0.2) | 1.1 (0.2) | 0.042† | ns | 0.014* |
Stance percentage (%) | 60.1 (1.5) | 62.5 (2.5) | 61.9 (2.3) | 0.001** | 0.008** | ns |
Foot progression angle ( + ) = toe out (°) | 13.1 (4.0) | 14.6 (6.8) | 15.3 (7.3) | ns | ns | ns |
Stance width (m) | 0.15 (0.03) | 0.16 (0.03)a | 0.17 (0.03) | ns | ns | ns |
Trunk sway ROM (°) | 3.3 (1.2) | 5.0 (2.8) | 4.1 (2.3) | 0.031† | ns | 0.007** |
COP related to foot, 1st half stance | ||||||
Medial ( + ) lateral (−) (% foot width) | − 8.2 (3.3) | − 7.6 (4.3) | − 9.3 (3.5) | ns | ns | ns |
Anterior ( + ) posterior (−) (% foot length) | 22.4 (11.0) | 27.2 (10.7) | 24.6 (11.5) | ns | ns | ns |
COP related to foot, 2nd half stance | ||||||
Medial ( + ) lateral (−) (% foot width) | 1.7 (4.2) | − 1.0 (4.1) | − 1.1 (3.3) | ns | 0.034* | ns |
Anterior ( + ) posterior (−) (% foot length) | 119.5 (8.6) | 114.3 (7.7) | 112.3 (8.2) | ns | 0.014* | ns |
COP related to the knee origin, 1st half stance, mm | ||||||
Medial ( + ) lateral (−) | − 0.7 (12.8) | 18.7 (22.1) | − 1.1 (17.6) | 0.003** | ns | < 0.001** |
Anterior ( + ) posterior (−) | − 0.4 (21.7) | 16.7 (23.5) | 15.5 (19.6) | 0.027* | 0.025* | ns |
COP related to the knee origin, 2nd half stance (mm) | ||||||
Medial ( + ) lateral (−) | − 8.0 (15.2) | 8.1 (22.8) | − 12.7 (21.3) | 0.017* | ns | < 0.001** |
Anterior ( + ) posterior (−) | − 31.6 (12.9) | − 27.3 (22.5) | − 37.8 (19.3) | ns | ns | 0.012* |
Knee frontal plane ROM (°) | 10.2 (2.8) | 11.6 (3.8) | 13.0 (3.5) | ns | 0.013* | ns |
Knee sagittal plane ROM (°) | 64.6 (4.1) | 57.9 (6.3) | 59.5 (5.6) | < 0.001†† | 0.003** | 0.021* |
Knee transverse plane ROM (°) | 16 .0 (4.2) | 16.3 (4.0) | 17.2 (3.9) | ns | ns | ns |
Frontal plane dynamic knee alignment ROM, HS-16% (°) | 2.4 (1.0) | 3.2 (1.7) | 3.2 (2.1) | ns | ns | ns |
Peak knee adduction (+) velocity, HS-16% (°/s) | 43.6 (29.1) | 57.1 (35.3) | 43.4 (19.3) | ns | ns | ns |
Peak knee abduction (−) velocity, HS-16% (°/s) | − 32.5 (27.6) | − 29.0 (31.5) | − 40.6 (28.8) | ns | ns | ns |
Kinematics
Knee loading
External knee moments, % BW.h | Controls Mean (SD) | Pre-HTO Mean (SD) | Post-HTO Mean (SD) | Control vs pre-HTO p value | Control vs post-HTO p value | Pre- vs post-HTO p value |
---|---|---|---|---|---|---|
Adduction (+) moment | ||||||
Maximum | 2.18 (0.60) | 3.15 (1.25) | 2.11 (0.97) | 0.005** | ns | < 0.001†† |
1st peak (1st half stance) | 2.11 (0.60) | 3.02 (1.25) | 2.06 (0.96) | 0.008** | ns | < 0.001†† |
2nd peak (2nd half stance) | 1.44 (0.72) | 2.46 (1.14) | 1.49 (0.80) | 0.003** | ns | < 0.001** |
Midstance | 1.21 (0.47) | 2.07 (0.80) | 1.23 (0.58) | < 0.001** | ns | < 0.001†† |
Flexion (+) moment peak | 3.57 (1.41) | 2.29 (1.16) | 2.52 (1.05) | 0.005** | 0.016* | ns |
Extension (−) moment peak | − 2.36 (0.79) | − 2.01 (0.76) | − 1.81 (0.78) | ns | 0.042* | ns |
Internal (+) rotation moment peak | 0.76 (0.24) | 1.05 (0.50) | 0.68 (0.39) | 0.032* | ns | < 0.001†† |
External (−) rotation moment peak | − 0.18 (0.10) | − 0.11 (0.09) | − 0.12 (0.09) | 0.026† | ns | ns |
Knee angular impulse, %BW.h.s | Controls Mean (SD) | Pre-HTO Mean (SD) | Post-HTO Mean (SD) | Control vs pre-HTO p value | Control vs post-HTO p value | Pre- vs post-HTO p value |
---|---|---|---|---|---|---|
Adduction (+) angular impulse | ||||||
Stance | 0.73 (0.28) | 1.35 (0.54) | 0.79 (0.39) | < 0.001** | ns | < 0.001** |
1st half stance | 0.42 (0.14) | 0.73 (0.28) | 0.45 (0.20) | < 0.001** | ns | < 0.001** |
2nd half stance | 0.31 (0.16) | 0.61 (0.28) | 0.35 (0.20) | < 0.001†† | ns | < 0.001** |
0–16% stance | 0.05 (0.02) | 0.11 (0.07) | 0.06 (0.03) | 0.002†† | ns | < 0.001** |
17%–midstance | 0.36 (0.11) | 0.61 (0.22) | 0.38 (0.17) | < 0.001** | ns | < 0.001** |
Midstance–83% stance | 0.26 (0.13) | 0.52 (0.23) | 0.29 (0.16) | < 0.001†† | ns | < 0.001** |
84–100% stance | 0.04 (0.02) | 0.07 (0.05) | 0.04 (0.03) | 0.026* | ns | 0.002** |
Abduction (−) angular impulse in stance | ||||||
1st half stance | − 0.02 (0.01) | − 0.01 (0.01) | − 0.01 (0.01) | 0.002†† | ns | 0.014† |
2nd half stance | − 0.02 (0.01) | − 0.01 (0.01) | − 0.01 (0.01) | 0.036† | ns | ns |
Flexion (+) angular impulse | 0.64 (0.26) | 0.53 (0.40) | 0.57 (0.30) | ns | ns | ns |
Extension (−) angular impulse | − 0.30 (0.17) | − 0.37 (0.33) | − 0.25 (0.27) | ns | ns | 0.013* |
Internal (+) angular impulse | 0.19 (0.07) | 0.32 (0.15) | 0.18 (0.11) | 0.002** | ns | < 0.001** |
External (−) angular impulse | − 0.02 (0.01) | − 0.01 (0.01) | − 0.02 (0.02) | 0.049† | ns | ns |
Work done
Work done at the knee, mJ/kg | Controls Mean (SD) | Pre-HTO Mean (SD) | Post-HTO Mean (SD) | Control vs pre-HTO p value | Control vs post-HTO p value | Pre- vs post-HTO p value |
---|---|---|---|---|---|---|
Frontal plane positive work | 24.4 (16.4) | 50.4 (43.1) | 27.0 (16.5) | 0.004†† | ns | 0.009†† |
Frontal plane negative work | − 20.1 (12.9) | − 32.6 (17.6) | − 18.9 (11.5) | 0.012† | ns | < 0.001** |
Sagittal plane positive work | 83.4 (36.7) | 68.7 (37.0) | 57.3 (26.3) | ns | 0.018* | ns |
Sagittal plane negative work | − 137.5 (49.6) | − 84.0 (32.6) | − 106.7 (44.4) | < 0.001** | ns | 0.007** |
Transverse plane positive work | 8.1 (4.0) | 8.7 (5.2) | 5.5 (3.6) | ns | 0.007†† | 0.008** |
Transverse plane negative work | − 11.8 (4.1) | − 14.7 (9.4) | − 8.0 (3.8) | ns | 0.005** | < 0.001** |