@article {Chang1271, author = {Alison Chang and Debra Hurwitz and Dorothy Dunlop and Jing Song and September Cahue and Karen Hayes and Leena Sharma}, title = {The relationship between toe-out angle during gait and progression of medial tibiofemoral osteoarthritis}, volume = {66}, number = {10}, pages = {1271--1275}, year = {2007}, doi = {10.1136/ard.2006.062927}, publisher = {BMJ Publishing Group Ltd}, abstract = {Background: A greater knee adduction moment increases risk of medial tibiofemoral osteoarthritis (OA) progression. Greater toe-out during gait shifts the ground reaction force vector closer to the centre of the knee, reducing the adduction moment. The present study was designed to test whether greater toe-out is associated with lower likelihood of medial OA progression.Methods: Baseline assessments included: kinematic/kinetic gait parameters using an optoelectronic camera system, force platform and inverse dynamics to calculate three-dimensional external knee moments; toe-out angle (formed by the line connecting heel strike and toe-off plantar surface centres of pressure and the forward progression line; knee pain; and full-limb alignment. Knee x-rays (semi-flexed) were obtained at baseline and at 18 months, with progression noted as medial joint space grade worsening. With logistic regression, odds ratios (ORs) for progression/5{\textdegree} toe-out were estimated.Results: In the 56 subjects (59\% women, mean age 66.6 years, body mass index (BMI) 29), baseline toe-out angle was less in knees with than without progression (difference {\textendash}4.4, 95\% CI {\textendash}8.5 to {\textendash}0.3). Greater toe-out was associated with reduced likelihood of progression (OR 0.60, 95\% CI 0.37 to 0.98). Adjusting for age, gender, BMI, pain severity and disease severity, the OR was 0.62, 95\% CI 0.36 to 1.06. Adjusting for adduction moment (second peak), the OR was 0.72, 95\% CI 0.40 to 1.28.Conclusions: Osteoarthritic knees that progressed had less toeing-out than knees without progression. Greater toe-out was associated with a lower likelihood of progression. Adjustment for covariates did not alter the OR, although the 95\% CI included 1. Further adjustment for adduction moment did alter the OR, consistent with the possibility that a mechanism of the effect may be via lowering of the adduction moment.}, issn = {0003-4967}, URL = {https://ard.bmj.com/content/66/10/1271}, eprint = {https://ard.bmj.com/content/66/10/1271.full.pdf}, journal = {Annals of the Rheumatic Diseases} }