Altered gait characteristics in individuals with knee osteoarthritis and self-reported knee instability

Shawn Farrokhi*, Megan O'Connell, Alexandra B. Gil, Patrick J. Sparto, G. Kelly Fitzgerald

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

31 Scopus citations


STUDY DESIGN: Experimental laboratory study. OBJECTIVE: To characterize the differences in lower extremity gait biomechanics in individuals who have knee osteoarthritis (OA) with and without self-reported knee instability. BACKGROUND: Individuals with knee OA who experience episodes of knee instability often report gait difficulties that interfere with their daily lives. A better understanding of the alterations in gait biomechanics may help to mitigate symptomatic knee instability in this patient population. METHODS: Seventeen participants with knee OA and self-reported knee instability and 36 participants with knee OA and no self-reported knee instability underwent instrumented gait analysis on level ground. Knee-specific symptoms and functional limitations were assessed using the Western Ontario and McMaster Universities Osteoarthritis Index. RESULTS: Knee instability was associated with greater odds of reporting moderate to severe gait-related pain (odds ratio = 6.0; 95% confidence interval: 1.2, 28.9) and moderate to severe difficulty when walking on flat surfaces (odds ratio = 10.7; 95% confidence interval: 1.7, 69.2). During early stance, the group with self-reported knee instability walked with a greater knee flexion excursion (P = .02) and a smaller lower extremity support moment (P<.01), due to reduced contributions from the hip extensors (P<.01) and ankle plantar flexors (P = .04). The group with self-reported knee instability also walked with a greater knee extensor contribution to the lower extremity support moment (P = .04) during the initial knee extension phase of gait compared to their counterparts with good knee stability. CONCLUSION: These findings suggest that self-reported knee instability is associated with significant alterations in hip, knee, and ankle joint function during the stance phase of gait in individuals with knee OA.

Original languageEnglish
Pages (from-to)351-359
Number of pages9
JournalJournal of Orthopaedic and Sports Physical Therapy
Issue number5
StatePublished - 1 May 2015
Externally publishedYes


  • Biomechanics
  • Kinematics
  • Kinetics
  • Lower extremity


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