The Impact of Cartilage Defect Location on Knee Kinematics and Gait

Background: It is unclear whether prehabilitation protocols prior to cartilage repair surgery should be tailored according to defect location. This study compared gait patterns of individuals with symptomatic lesions in the knee's lateral and medial femoral condyles (LFC/MFC) to assess if defect location changes gait, and hence whether prehabilitation needs to be targeted. <br/><br/>Methods: Three-dimensional gait analyses were performed at a regional Joint Preservation Centre on patients with chondral defects in the MFC or LFC. Participants walked for two minutes on a treadmill. The Plug-in-Gait biomechanical model calculated kinematic and spatiotemporal parameters. Independent t-tests or Mann-Whitney tests compared the outcomes of both cohorts (α=0.05). <br/><br/>Results: 15 patients with MFC defects and 14 with LFC defects participated. No differences were observed in spatio-temporal parameters - Walking speed: 2.9±0.6km/h vs 3.0±0.7km/h (p=0.695), cadence: 67.8±13.9 vs 69.5±21.5 steps/minute (p=0.797), stride length: 0.907±0.123m vs 0.954±0.147m( p=0.353). Maximum flexion during swing did not differ between cohorts (54.5±6.8° vs 51.4±11.5°:p=0.385). Neither did maximal extension at heel strike (2.9±6.0° vs 4.6±12.0°:p=0.793). On average, the knees remained in adduction throughout the gait cycle, with the degree of adduction greater in flexion in the MFC cohort. However, differences in adduction were not statistically significant (19.9±9.3° vs 17.0±11.7°:p=0.461). Maximal internal-external rotation patterns were comparable in stance (-0.1±13.1° vs 2.2±7.4°: p=0.598) and swing (7.0±12.2° vs 8.0±9.4°:p=0.814). <br/><br/>Conclusion: Spatio-temporal parameters and knee kinematics during walking were not statistically different between cohorts, suggesting that the location of the defect has minimal influence on the biomechanical parameters investigated. However, the impact of lesion location on joint loading and on all parameters during more demanding tasks remains unknown. <br/><br/>Implications: Prehabilitation protocols prior to cartilage repair surgery do not need to be altered according to defect location.