Knee Contact Forces of Individuals With Osteoarthritis and Those With Lower Limb Amputation: A Systematic Review.

Objective: Osteoarthritis is a major cause of impairment. Research has shown that individuals with unilateral lower limb amputation are 17 times more likely to develop osteoarthritis on their sound side limb. Therefore, this review aimed to describe similarities and differences in the biomechanical loading variables of individuals with osteoarthritis and those with unilateral lower limb amputation.

Design: Researchers systematically searched PubMed-Medline, EBSCOhost, and Web of Science for articles published between January 1990 and February 2022. Included studies investigated the biomechanical profiles (peak external knee adduction moment; peak external knee flexion moment; ground reaction force; external knee adduction moment loading rate; external knee adduction moment impulse) of both population groups.

Results: A total of 31 articles were included in this review. Only knee adduction moment and knee flexion moment presented similar profiles in both groups, while all other variables were dissimilar. The use of advanced prostheses reduced the loading on the sound side of individuals with unilateral lower limb amputation.

Conclusions: As both knee adduction moment and knee flexion moment are surrogate measures for knee contact forces, interventions need to target these variables to help manage and prevent the development of osteoarthritis. Interventions, particularly for addressing these variables in individuals with unilateral lower limb amputation, should be further investigated in future research.