Article

Ipsilateral trunk lean toward the affected stance limb has been identified as a
compensatory mechanism to unload the hip joint. However, this altered gait
pattern increases the lever arm around the knee joint by shifting the ground
reaction vector more lateral to the knee joint center, which could be sufficient
to deform the lateral compartment of the knee. The purpose of the present study
was to show the effect of ipsilateral trunk lean on hip and knee joint moments in
the frontal plane in 132 young patients with different orthopedic diagnosis.
Linear correlations between ipsilateral trunk lean and the external knee and/or
hip adduction moment were detected for patients with Legg-Calve-Perthes disease
(LCPD), arthrogryposis multiplex congenita, myelomeningocele, and unilateral
cerebral palsy (CP). In contrast, children with bilateral CP did not show such a
relationship due to an increased internal foot placement. In comparison to the
hip joint, the effect of ipsilateral trunk lean in patients with LCPD is
obviously more pronounced in the knee joint. The valgus thrust of the knee could
initiate degenerative changes by placing altered loads on regions of the
articular cartilage that were previously conditioned for different load levels.
The results suggest that the ipsilateral trunk lean should not be considered and
recommended as unloading mechanism for the hip joint on its own but also as a
potential increased joint loading of the lateral knee compartment. Therefore, an
acceptable therapy concept for limping patients should aim for an inconspicuous
gait pattern with a reduced trunk movement.
CI - Copyright (c) 2013 Elsevier B.V. All rights reserved.

Langue : ANGLAIS