Lower limb osteoarthritis: biomechanical alterations and implications for therapy

Purpose of review To review the role of biomechanics in the pathogenesis of lower-extremity osteoarthritis and recent advances in biomechanically active intervention strategies for osteoarthritis. Recent findings The conventional approach to treating knee osteoarthritis with analgesics and physical therapy has not been shown to alter the natural history of the disease, suggesting that novel strategies are necessary. Progression of lower-extremity osteoarthritis is mediated by aberrant biomechanics, which can be assessed using gait analyses and validated markers of dynamic knee loading such as the peak adduction moment (AddM) and adduction angular impulse (AddImp). Recognition of the mechanical component of osteoarthritis progression has led to intervention strategies that seek to reduce functional loads at the knee, and thereby, potentially, to palliate pain and retard disease progression. Summary Biomechanically active interventions have been demonstrated to reduce dynamic loading of the knees in patients with osteoarthritis, and are potentially promising strategies to treat symptoms as well as to alter disease progression in osteoarthritis.