Skip to main content
Log in

Anteroposterior and varus–valgus laxity of the knee increase after stair climbing in patients with mild osteoarthritis

  • Original Article
  • Published:
Rheumatology International Aims and scope Submit manuscript

Abstract

The aim of this study was to measure exercise-induced changes in knee joint laxity in patients with knee osteoarthritis (OA). The study subjects were 46 female patients with OA and 22 age- and sex-matched normal controls. Radiographs of the knee were taken in all subjects, and the disease severity was graded according to the Kellgren and Lawrence (K–L) grading system. The K–L grade of the control subjects (non-OA group) was 0–1. The OA patients were divided into those with mild OA (K–L grade 2, n = 20) and advanced OA (K–L grade 3–4, n = 26). The subject climbed up and down 8 steps on a staircase apparatus over a period of 10 min. The anteroposterior (A–P) translation was measured with KT2000 arthrometer, and varus–valgus (V–V) rotation was measured on stress radiographs before and after the stair climbing. The Δchange in A–P translation after the exercise was significantly larger in mild OA group than other groups (P < 0.005). The Δchange in V–V rotation after exercise was significantly larger in mild and advanced OA groups than the control (P < 0.003). There were no significant differences in A–P laxity and V–V laxity before exercise among the non-OA, mild OA and advanced OA groups. Exercise resulted in significant changes in A–P knee joint laxity in patients with mild OA relative to the control. The results suggest that daily physical activities (e.g., knee bending or squatting) play a role in the development of knee laxity, particularly in patients with mild OA, and that progression of knee OA seems to correlate with increments of A–P knee joint laxity.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Felson DT, Naimark A, Anderson J, Kazis L, Castelli W, Meenan RF (1987) The prevalence of knee osteoarthritis in the elderly. The Framingham Osteoarthritis Study. Arthritis Rheum 30(8):914–918

    Article  PubMed  CAS  Google Scholar 

  2. Blagojevic M, Jinks C, Jeffery A, Jordan KP (2010) Risk factors for onset of osteoarthritis of the knee in older adults: a systematic review and meta-analysis. Osteoarthr Cartil 18(1):24–33

    Article  PubMed  CAS  Google Scholar 

  3. Dawson J, Juszczak E, Thorogood M, Marks SA, Dodd C, Fitzpatrick R (2003) An investigation of risk factors for symptomatic osteoarthritis of the knee in women using a life course approach. J Epidemiol Community Health 57(10):823–830

    Article  PubMed  CAS  Google Scholar 

  4. Harms S, Larson R, Sahmoun AE, Beal JR (2007) Obesity increases the likelihood of total joint replacement surgery among younger adults. Int Orthop 31(1):23–26

    Article  PubMed  CAS  Google Scholar 

  5. Hochberg M, Lethbridge C, Tobin J (2004) Bone mineral density and osteoarthritis: data from the Baltimore Longitudinal Study of Aging. Osteoarthr Cartil 12:45–48

    Article  Google Scholar 

  6. Holmberg S, Thelin A, Thelin N (2005) Knee osteoarthritis and body mass index: a population-based case control study. Scand J Rheumatol 34(1):59–64

    Article  PubMed  CAS  Google Scholar 

  7. Hootman J, Macera C, Helmick C, Blair S (2003) Influence of physical activity-related joint stress on the risk of self-reported hip/knee osteoarthritis: a new method to quantify physical activity. Prev Med 36(5):636–644

    Article  PubMed  Google Scholar 

  8. Hunter DJ (2009) Risk stratification for knee osteoarthritis progression: a narrative review. Osteoarthr Cartil 17(11):1402–1407

    Article  PubMed  CAS  Google Scholar 

  9. Karpansalo M, Manninen P, Lakka TA, Kauhanen J, Rauramaa R, Salonen JT (2002) Physical workload and risk of early retirement: prospective population-based study among middle-aged men. J Occup Environ Med 44(10):930–939

    Article  PubMed  Google Scholar 

  10. Sharma L, Lou C, Cahue S, Dunlop DD (2000) The mechanism of the effect of obesity in knee osteoarthritis: the mediating role of malalignment. Arthritis Rheum 43(3):568–575

    Article  PubMed  CAS  Google Scholar 

  11. Sharma L (2001) Local factors in osteoarthritis. Curr Opin Rheumatol 13(5):441–446

    Article  PubMed  CAS  Google Scholar 

  12. Sutton AJ, Muir KR, Mockett S, Fentem P (2001) A case-control study to investigate the relation between low and moderate levels of physical activity and osteoarthritis of the knee using data collected as part of the Allied Dunbar National Fitness Survey. Ann Rheum Dis 60(8):756–764

    Article  PubMed  CAS  Google Scholar 

  13. Dayal N, Chang A, Dunlop D, Hayes K, Chang R, Cahue S et al (2005) The natural history of anteroposterior laxity and its role in knee osteoarthritis progression. Arthritis Rheum 52(8):2343–2349

    Article  PubMed  Google Scholar 

  14. Marshall JL, Olsson SE (1971) Instability of the knee. A long-term experimental study in dogs. J Bone Joint Surg Am 53:1561–1570

    PubMed  CAS  Google Scholar 

  15. Matsui Y, Iwasaki N, Kon S, Takahashi D, Morimoto J, Matsui Y et al (2009) Accelerated development of aging-associated and instability-induced osteoarthritis in osteopontin-deficient mice. Arthritis Rheum 60(8):2362–2371

    Article  PubMed  CAS  Google Scholar 

  16. Rehan Youssef A, Longino D, Seerattan R, Leonard T, Herzog W (2009) Muscle weakness causes joint degeneration in rabbits. Osteoarthr Cartil 17(9):1228–1235

    Article  PubMed  CAS  Google Scholar 

  17. Sharma L, Hayes KW, Felson DT, Buchanan TS, Kirwan-Mellis G, Lou C et al (1999) Does laxity alter the relationship between strength and physical function in knee osteoarthritis? Arthritis Rheum 42(1):25–32

    Article  PubMed  CAS  Google Scholar 

  18. Brage ME, Draganich LF, Pottenger LA, Curran JJ (1994) Knee laxity in symptomatic osteoarthritis. Clin Orthop Relat Res 304:184–189

    PubMed  Google Scholar 

  19. Sharma L, Lou C, Felson DT, Dunlop DD, Kirwan-Mellis G, Hayes KW et al (1999) Laxity in healthy and osteoarthritic knees. Arthritis Rheum 42(5):861–870

    Article  PubMed  CAS  Google Scholar 

  20. Wada M, Imura S, Baba H, Shimada S (1996) Knee laxity in patients with osteoarthritis and rheumatoid arthritis. Br J Rheumatol 35(6):560–563

    Article  PubMed  CAS  Google Scholar 

  21. Skinner HB, Wyatt MP, Stone ML, Hodgdon JA, Barrack RL (1986) Exercise-related knee joint laxity. Am J Sports Med 14(1):30–34

    Article  PubMed  CAS  Google Scholar 

  22. Weisman G, Pope MH, Johnson RJ (1980) Cyclic loading in knee ligament injuries. Am J Sports Med 8(1):24–30

    Article  PubMed  CAS  Google Scholar 

  23. Stoller DW, Markolf KL, Zager SA, Shoemaker SC (1983) The effects of exercise, ice and ultrasonography on torsional laxity of the knee. Clin Orthop Relat Res 174:172–180

    PubMed  Google Scholar 

  24. Dahaghin S, Tehrani-Banihashemi SA, Faezi ST, Jamshidi AR, Davatchi F (2009) Squatting, sitting on the floor, or cycling: are life-long daily activities risk factors for clinical knee osteoarthritis? Stage III results of a community-based study. Arthritis Rheum 61(10):1337–1342

    Article  PubMed  CAS  Google Scholar 

  25. Kellgren JH, Lawrence JS (1957) Radiological assessment of osteoarthrosis. Ann Rheum Dis 16(4):494–502

    Article  PubMed  CAS  Google Scholar 

  26. Pollock ML, Gaesser GA, Butcher JD, Després JP, Dishman JK, Franklin BA et al (1998) The recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness, and flexibility in healthy adults. Med Sci Sports Exerc 30(6):975–991

    Article  Google Scholar 

  27. van der Esch M, Steultjens M, Ostelo RW, Harlaar J, Dekker J (2006) Reproducibility of instrumented knee joint laxity measurement in healthy subjects. Rheumatology 45(5):595–599

    Article  PubMed  Google Scholar 

  28. Shrader MW, Draganich LF, Pottenger LA, Piotrowski GA (2004) Effects of knee pain relief in osteoarthritis on gait and stair-stepping. Clin Orthop Relat Res 421:188–193

    Article  PubMed  Google Scholar 

  29. Morrissey MC, Perry MC, King JB (2009) Is knee laxity change after ACL injury and surgery related to open kinetic chain knee extensor training load? Am J Phys Med Rehabil 88(5):369–375

    Article  PubMed  Google Scholar 

  30. Patel RR, Hurwitz DE, Bush-Joseph CA, Bach BR Jr, Andriacchi TP (2003) Comparison of clinical and dynamic knee function in patients with anterior cruciate ligament deficiency. Am J Sports Med 31(1):68–74

    PubMed  Google Scholar 

  31. Pollard CD, Braun B, Hamill J (2006) Influence of gender, estrogen and exercise on anterior knee laxity. Clin Biomech (Bristol Avon) 21(10):1060–1066

    Article  Google Scholar 

  32. Risberg MA, Holm I, Tjomsland O, Ljunggren E, Ekeland A (1999) Prospective study of changes in impairments and disabilities after anterior cruciate ligament reconstruction. J Orthop Sports Phys Ther 29(7):400–412

    PubMed  CAS  Google Scholar 

  33. Shultz SJ, Shimokochi Y, Nguyen AD, Ambegaonkar JP, Schmitz RJ, Beynnon BD et al (2006) Nonweight-bearing anterior knee laxity is related to anterior tibial translation during transition from non-weight bearing to weight bearing. J Orthop Res 24(3):516–523

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We thank Dr. Keiichiro Kamitani and Yoshinori Kano (RPT) for providing assistance with data collection and processing.

Conflict of interest

None of the authors had any financial or personal relationship with other people or organizations that could inappropriately influence this work.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Tsuyoshi Miyazaki.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Miyazaki, T., Uchida, K., Wada, M. et al. Anteroposterior and varus–valgus laxity of the knee increase after stair climbing in patients with mild osteoarthritis. Rheumatol Int 32, 2823–2828 (2012). https://doi.org/10.1007/s00296-011-2081-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00296-011-2081-x

Keywords

Navigation