Knee Contact Forces of Individuals With Osteoarthritis and Those With Lower Limb Amputation: A Systematic Review.

Lovemore Kunorozva, Phoebe Runciman, Wayne Derman, Lizanne Andrag

Journal: American journal of physical medicine & rehabilitation 2025;104(3):210-218

PMID: 38917373

Abstract

OBJECTIVE

Osteoarthritis is a major cause of impairment. Research has shown that individuals with unilateral lower limb amputation are 17 times more likely to develop osteoarthritis on their sound side limb. Therefore, this review aimed to describe similarities and differences in the biomechanical loading variables of individuals with osteoarthritis and those with unilateral lower limb amputation.

DESIGN

Researchers systematically searched PubMed-Medline, EBSCOhost, and Web of Science for articles published between January 1990 and February 2022. Included studies investigated the biomechanical profiles (peak external knee adduction moment; peak external knee flexion moment; ground reaction force; external knee adduction moment loading rate; external knee adduction moment impulse) of both population groups.

RESULTS

A total of 31 articles were included in this review. Only knee adduction moment and knee flexion moment presented similar profiles in both groups, while all other variables were dissimilar. The use of advanced prostheses reduced the loading on the sound side of individuals with unilateral lower limb amputation.

CONCLUSIONS

As both knee adduction moment and knee flexion moment are surrogate measures for knee contact forces, interventions need to target these variables to help manage and prevent the development of osteoarthritis. Interventions, particularly for addressing these variables in individuals with unilateral lower limb amputation, should be further investigated in future research.

Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.

Address: From the Institute of Sport and Exercise Medicine (ISEM), Department of Exercise, Sport and Lifestyle Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, Cape Town, South Africa (LA, LK, WD, PR); and International Olympic Committee (IOC) Research Centre, Cape Town, South Africa (WD).
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