Knee instability 'requires greater attention when treating osteoarthritis patients'

A new study has demonstrated the need for greater attention to be paid to knee instability when addressing functional outcomes for people with osteoarthritis.

Led by Northwestern University in Chicago, the study aimed to examine the extent to which overall knee confidence, people’s confidence in their knee buckling (giving way) and excessive motion while walking can be associated with advanced two-year functional outcomes in knee osteoarthritis, assessed in terms of rates of disability and physical impairment trends.

Low overall knee confidence or fears that the knees will buckle are common manifestations of instability in knee osteoarthritis, as is excessive motion during gait. Confidence and buckling can influence activity choices, contributing to events leading to disability.

It is also known that buckling is more likely to affect advanced than basic functional tasks.

For this research, published in the medical journal Arthritis Care & Research, a group of 212 patients were asked about their confidence levels and measured for their physical performance over a two-year period.

It was shown that buckling was significantly associated with poor advanced functional outcomes, as was overall knee confidence, while associations between buckling confidence and both outcomes also approached significance.

The researchers concluded: "Knee buckling and low knee confidence were each associated with poor two-year advanced function outcomes. Current treatment does not address these modifiable factors; interventions to address them may improve outcome in knee osteoarthritis."

Osteoarthritis causes the joints to become painful and stiff and is the most common type of arthritis in the UK, affecting 8.75 million people.

A spokeswoman for Arthritis Research UK said: "Some people with osteoarthritis of the knee find that as well as pain and stiffness, the condition causes the knee to give way, or buckle, because their muscles have become weak, or the joint structure is less stable.

"More evidence to support the use of knee braces for osteoarthritis is becoming available. Several types of braces can help to stabilise the kneecap and make it move correctly. A brace can correct knee alignment and also reduce pain in some types of knee osteoarthritis that affects the kneecap."

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