{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T22:00:23Z","timestamp":1774303223793,"version":"3.50.1"},"reference-count":33,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2021,7,12]],"date-time":"2021-07-12T00:00:00Z","timestamp":1626048000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Deforming osteoarthritis (OA) of the knee is a progressive disease associated with pain and compromised function of the joint. Typical biomechanical modifications in the gait of subjects with medial knee OA are characterized by decreased gait speed and overload on the affected limb. The borderline stage for conservative versus surgical management is Grade II OA. The aim of this research was to study preoperatively the specific features of gait, knee, and hip function in patients with Grade II medial OA. We examined 26 patients with Grade II unilateral gonarthritis with varus deformity and 20 healthy adults. Biomechanical parameters of gait were recorded using an inertial sensor system. The gait cycle (GC) slightly increased both for the affected and for the intact limb. The hip joint movements showed significant symmetrical reduction in the first flexion amplitude, as well as a symmetrical delay in full hip extension at the end of the stance phase. In the knee, the first flexion amplitude was significantly reduced on the affected side compared to healthy control. The extension amplitude in the single support phase was significantly increased in both the affected and the intact lower limbs. The swing amplitude was significantly reduced on the affected side. On the affected side, the changes were more pronounced, both in incidence and in severity. The affected knee showed a syndrome of three reduced amplitudes. In patients, walking is characterized by several groups of symptoms: those of unloading of the affected limb, those of limiting the load on the affected joint and the musculoskeletal system as a whole, and those of gait harmonization. The symptoms of unloading the affected side and those of harmonization are the common symptoms of adaptation, typical for several pathological conditions with a relatively preserved function. The intensity of the observed symptoms can help assess changes in the subject\u2019s functional condition over time and during the treatment.<\/jats:p>","DOI":"10.3390\/diagnostics11071242","type":"journal-article","created":{"date-parts":[[2021,7,12]],"date-time":"2021-07-12T21:56:37Z","timestamp":1626126997000},"page":"1242","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Biomechanical Changes in Gait Patterns of Patients with Grade II Medial Gonarthritis"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2794-4912","authenticated-orcid":false,"given":"Dmitry","family":"Skvortsov","sequence":"first","affiliation":[{"name":"Scientific Department, Federal Research and Clinical Centre of Russia\u2019s Federal Medical-Biological Agency (FNKC FMBA), Orekhoviy Bulvar, 28, 115682 Moscow, Russia"},{"name":"Medical Rehabilitation Chair, Pirogov Russian National Research Medical University (RNRMU), Ostrovitianova St. h.1, 117997 Moscow, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5232-7740","authenticated-orcid":false,"given":"Sergey","family":"Kaurkin","sequence":"additional","affiliation":[{"name":"Scientific Department, Federal Research and Clinical Centre of Russia\u2019s Federal Medical-Biological Agency (FNKC FMBA), Orekhoviy Bulvar, 28, 115682 Moscow, Russia"},{"name":"Medical Rehabilitation Chair, Pirogov Russian National Research Medical University (RNRMU), Ostrovitianova St. h.1, 117997 Moscow, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexey","family":"Prizov","sequence":"additional","affiliation":[{"name":"Orthopedic Department, Buyanov V.M. Moscow City Clinical Hospital, Bakinskaya St, h. 26, Bild. 10, 115516 Moscow, Russia"},{"name":"Ortopedic Chair, Peoples Friendship University of Russia (RUDN University), Miklukho-Maklaya Str. 6, 117198 Moscow, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aljona","family":"Altukhova","sequence":"additional","affiliation":[{"name":"Scientific Department, Federal Research and Clinical Centre of Russia\u2019s Federal Medical-Biological Agency (FNKC FMBA), Orekhoviy Bulvar, 28, 115682 Moscow, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Troitskiy","sequence":"additional","affiliation":[{"name":"Scientific Department, Federal Research and Clinical Centre of Russia\u2019s Federal Medical-Biological Agency (FNKC FMBA), Orekhoviy Bulvar, 28, 115682 Moscow, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fedor","family":"Lazko","sequence":"additional","affiliation":[{"name":"Orthopedic Department, Buyanov V.M. Moscow City Clinical Hospital, Bakinskaya St, h. 26, Bild. 10, 115516 Moscow, Russia"},{"name":"Ortopedic Chair, Peoples Friendship University of Russia (RUDN University), Miklukho-Maklaya Str. 6, 117198 Moscow, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,7,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1659","DOI":"10.1136\/annrheumdis-2013-203355","article-title":"Incidence and risk factors for clinically diagnosed knee, hip and hand osteoarthritis: Influences of age, gender and osteoarthritis affecting other joints","volume":"73","author":"Judge","year":"2014","journal-title":"Ann. Rheum. Dis."},{"key":"ref_2","unstructured":"Zorgregistraties, N. (2019, April 07). Zorg Door De Huisarts; Jaarcijfers 2016 Entrendcijfers 2011\u20132016. Available online: https:\/\/www.volksgezondheidenzorg.info\/onderwerp\/artrose\/cijfers-context\/huidige-situatie."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1745","DOI":"10.1016\/S0140-6736(19)30417-9","article-title":"Osteoarthritis","volume":"393","author":"Hunter","year":"2019","journal-title":"Lancet"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1545","DOI":"10.1016\/S0140-6736(16)31678-6","article-title":"Global, regional, and national incidence, preva-lence, and years lived with disability for 310 diseases and injuries, 1990\u20132015: A systematic analysis for the global burden of disease study 2015","volume":"388","author":"Vos","year":"2016","journal-title":"Lancet"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1002\/acr.21898","article-title":"Lifetime risk and age at diagnosis of symptomatic knee osteoarthritis in the US","volume":"65","author":"Losina","year":"2013","journal-title":"Arthritis Care Res."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1186\/ar2655","article-title":"Developments in the scientific understanding of osteoarthritis","volume":"11","author":"Abramson","year":"2009","journal-title":"Arthritis Res. Ther."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"3538","DOI":"10.1016\/j.jbiomech.2016.08.005","article-title":"A method for concise reporting of joint reaction forces orientation during gait","volume":"49","author":"Fraysse","year":"2016","journal-title":"J. Biomech."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1177\/0363546508315471","article-title":"High tibial osteotomy for unloading osteochondral defects in the medial compartment of the knee","volume":"36","author":"Mina","year":"2008","journal-title":"Am. J. Sports Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2164","DOI":"10.1016\/j.jbiomech.2010.03.046","article-title":"Loading of the knee joint during activities of daily living measured in vivo in five subjects","volume":"43","author":"Kutzner","year":"2010","journal-title":"J. Biomech."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Jin, P.M., and Holloway, E.S. (2013). The young osteoarthritic knee: Dilemmas in management. BMC Med., 11.","DOI":"10.1186\/1741-7015-11-14"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1838","DOI":"10.1007\/s00167-017-4421-1","article-title":"Gait analysis following medial opening-wedge high tibial osteotomy","volume":"26","author":"Morin","year":"2017","journal-title":"Knee Surg. Sports Traumatol. Arthrosc."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Abid, M., Mezghani, N., and Mitiche, A. (2019). Knee Joint Biomechanical Gait Data Classification for Knee Pathology Assessment: A Literature Review. Appl. Bionics Biomech., 2019.","DOI":"10.1155\/2019\/7472039"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1016\/j.jbiomech.2007.09.015","article-title":"Toe-out gait in patients with knee osteoarthritis partially transforms external knee adduction moment into flexion moment during early stance phase of gait: A tri-planar kinetic mechanism","volume":"41","author":"Jenkyn","year":"2008","journal-title":"J. Biomech."},{"key":"ref_14","first-page":"150","article-title":"Biomechanical changes in gait of subjects with medial knee osteoarthritis","volume":"20","author":"Zorzi","year":"2012","journal-title":"Acta Ortop. Bras."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1002\/acr.20380","article-title":"Gait Modification Strategies for Altering Medial Knee Joint Load: A Systematic Review","volume":"63","author":"Simic","year":"2011","journal-title":"Arthritis Care Res."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1007\/s10195-016-0413-z","article-title":"High tibial osteotomy in the ACL-deficient knee with medial compartment osteoarthritis","volume":"17","author":"Herman","year":"2016","journal-title":"J. Orthop. Traumatol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"647","DOI":"10.3109\/17453670209178029","article-title":"Kinetic and kinematic characteristics of gait in patients with medial knee arthrosis","volume":"73","author":"Ergin","year":"2002","journal-title":"Acta Orthop. Scand."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"98","DOI":"10.11138\/jts\/2016.4.2.098","article-title":"High Tibial Osteotomy in Varus Knees: Indications and Limits","volume":"4","author":"Loia","year":"2016","journal-title":"Joints"},{"key":"ref_19","first-page":"96","article-title":"Reliability and concurrent validity of angle measurements in lower limb: EOS 3D goniometer versus 2D manual goniometer","volume":"24","author":"Huang","year":"2020","journal-title":"J. Orthop. Transl."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1186\/1477-7525-1-64","article-title":"The Knee injury and Osteoarthritis Outcome Score (KOOS): From joint injury to osteoarthritis","volume":"1","author":"Roos","year":"2003","journal-title":"Health Qual. Life Outcomes"},{"key":"ref_21","unstructured":"Stoller, D.W. (1993). Magnetic Resonance Imaging in Orthopaedics & Sports Medicine, JB Lippincott."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1127","DOI":"10.1016\/S0140-6736(74)90884-8","article-title":"Measurement of pain","volume":"304","author":"Huskisson","year":"1974","journal-title":"Lancet"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"58","DOI":"10.2106\/00004623-200300002-00008","article-title":"Evaluation of cartilage injuries and repair","volume":"85","author":"Brittberg","year":"2003","journal-title":"J. Bone Jt. Surg. Am."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"662","DOI":"10.1093\/geronj\/39.6.662","article-title":"The Effect of Age on Variability in Gait","volume":"39","author":"Gabell","year":"1984","journal-title":"J. Gerontol."},{"key":"ref_25","first-page":"210","article-title":"Basic gait parameters: Reference data for normal subjects, 10\u201379 years of age","volume":"30","author":"Oberg","year":"1993","journal-title":"J. Rehabil. Res. Dev."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Skvortsov, D., Kaurkin, S., Akhpashev, A., Altukhova, A., Troitskiy, A., and Zagorodniy, N. (2020). Gait Analysis and Knee Kinematics in Patients with Anterior Cruciate Ligament Rupture: Before and After Reconstruction. Appl. Sci., 10.","DOI":"10.3390\/app10103378"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1038","DOI":"10.1016\/j.joca.2015.03.032","article-title":"It\u2019s not all about the knee adduction moment: The role of the knee flexion moment in medial knee joint loading","volume":"23","author":"Creaby","year":"2015","journal-title":"Osteoarthr. Cartil."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Leporace, G., Batista, L.A., Muniz, A.M., Zeitoune, G., Luciano, T., Metsavaht, L., and Nadal, J. (September, January 28). Classification of gait kinematics of anterior cruciate ligament reconstructed subjects using principal component analysis and regressions modelling. Proceedings of the 2012 Annual International Conference of the IEEE Engineering in Medicine and Biology Society, San Diego, CA, USA.","DOI":"10.1109\/EMBC.2012.6347486"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1369","DOI":"10.1002\/jor.20440","article-title":"Knee instability after acute ACL rupture affects movement patterns during the mid-stance phase of gait","volume":"25","author":"Hurd","year":"2007","journal-title":"J. Orthop. Res."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1002\/jor.22249","article-title":"Altered loading in the injured knee after ACL rupture","volume":"31","author":"Gardinier","year":"2013","journal-title":"J. Orthop. Res."},{"key":"ref_31","first-page":"47","article-title":"Evaluation of the kinematic parameters of normal-paced gait in subjects with gonarthrosis and the influence of gonarthrosis on the function of the ankle joint and hip joint","volume":"13","author":"Ogrodzka","year":"2011","journal-title":"Acta Bioeng. Biomech."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1093\/rheumatology\/40.5.499","article-title":"Relationships among bonemineral densities, static alignment and dynamic load in patients with medial compartment knee osteoarthritis","volume":"40","author":"Wada","year":"2001","journal-title":"Rheumatology"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1176","DOI":"10.1016\/j.jbiomech.2013.01.001","article-title":"Sensitivity of joint moments to changes in walking speed and body-weight-support are interdependent and vary across joints","volume":"46","author":"Goldberg","year":"2013","journal-title":"J. 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