Osteotomy around the Knee - Biomechanics and Gait Analysis

Description

In this presentation, Richie Gill, Chair of Health Care Engineering at the University of Bath, discusses osteotomy around the knee, specifically focusing on the biomechanics of osteoarthritis and gait analysis. He references a pivotal 2013 paper by David Felson that describes osteoarthritis as largely influenced by mechanical factors, emphasizing that treatments addressing these mechanics yield longer-term benefits over merely anti-inflammatory approaches. Gill highlights the rising incidence of knee osteoarthritis, particularly among older individuals and the underappreciation of early-stage cases in younger populations, often treated ineffectively with anti-inflammatories.



As more knee replacements are performed, especially in younger patients, the demand for such surgeries is expected to double by 2030, leading to concerns about future revision burdens. Gill points out the need for alternative treatments and presents a dichotomy of future scenarios—either a breakthrough in treatment or a persistence of unmet demand.



He explains the loading mechanics during walking, showcasing the importance of measuring ground reaction forces and their impact on knee joints. Gill discusses high-impact loading experienced during heel strikes, revealing variations in how individuals absorb these forces and their implications for joint health. He notes that knee adduction moments correlate closely with medial compartment loading, highlighting the relationship between excessive loading and arthritis progression.



The presentation culminates in the discussion of high tibial osteotomy as a corrective measure to adjust knee alignment, potentially reducing medial loading and improving outcomes. Gill urges for a more dynamic approach to treatment planning that incorporates individual gait analysis, challenging current static methodologies based on X-rays, to advance knee osteoarthritis treatment effectively.

DOI: 10.1302/3114-210635

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