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Purpose: The diagnosis of knee osteoarthritis (OA) is typically well established with a clinical evaluation and confirmed with an X-Ray assessing the joint’ structural changes and disease progression. Guidelines also recommend taking into account mechanical factors (static and dynamic) to better understand knee function, since they may influence treatment outcomes. However, the relationship between clinical condition of the knee and biomechanical characteristics is not well known, including how such information stands compared to those from other conventional assessments, such as X-ray and physical assessment. The aim of this study is to evaluate the associations between the knee clinical condition assessed by patient-reported outcome measures and parameters from three different types of assessments, namely radiographic, musculoskeletal, and biomechanical assessment in OA patients. Methods: This cross-sectional study was conducted on patients with 1) knee pain ≥ 4/10 on a numeric rating scale in the past 7 days, 2) Kellgren-Lawrence (KL) radiographic OA severity grade higher than KL2, and 3) who were not on a waiting list for knee arthroplasty. Patients’ knee clinical condition was assessed using the Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire that consists of five subscales: pain, symptoms, function in daily living (ADL), function in sport and recreation (Sport/Rec) and knee-related quality of life (QOL). Twenty musculoskeletal tests were performed by a therapist, including passive flexion and extension ranges of motion (ROM), muscle strength (10 tests assessing hip, knee, and ankle), flexibility (4 tests), swelling measured by the circumference difference between knees, effusion, balance, and functional 30-second chair stand tests (30s_CST). Finally, dynamic mechanical factors were measured during a knee kinesiography exam with the KneeKG™ system (Emovi Inc., QC, Canada) where 70 biomechanical parameters were extracted from 3D knee kinematic

Purpose: Knee osteoarthritis (OA) often leads to gait kinematic impairments. The knee kinesiography exam, measuring three-dimensional (3D) knee kinematics during gait on a treadmill, allows to objectively identify gait impairments (GIs) in order to provide recommendations for a personalized care approach (targeted home-based exercises, bracing, etc.) to correct these impairments. A clinical trial showed that this approach can lead to significant improvement in function and pain reduction after 6 months compared to a control group. The aim of this study was to assess the impact of this personalized care approach (PCA) on 3D mechanical GIs in knee OA patients compared to a control group. Methods: Primary care physicians in this cluster randomized controlled trial in the Province of Quebec (Canada) were asked to recruit patients with a clinical diagnosis of knee OA. Patients were included if 1) knee OA was the main cause of their knee pain, 2) they rated their worst pain in the past 7 days ≥ 4 on a 0-10 pain intensity scale, 3) they had a Kellgren-Lawrence grade ≥ 2 on radiographs. Eligible patients from a same primary care clinic were randomized to the same group: 1- a control group (usual care), 2- a group with the PCA, and 3- a group with the PCA + an educational program. In all of the three groups, primary care physicians managed their patients according to their individual needs, but only physicians from groups 2- and 3- had access to the recommendations for the PCA. These were treatment recommendations (e.g. bracing, specific activities, etc.) and tailored home exercises targeting the GIs identified with the knee kinesiography results. Patients from group 3- also had a one-hour educational session on knee OA self-management and two follow-up group meetings with a therapist (to answer their questions, regulate the nature and intensity of their exercises, etc.). For all patients, we assessed the presence of 14 known GIs in knee OA at baseline and 6-month follow-up

Purpose: Primary care physicians (PCPs) have underscored the lack of adequate assessment tools to guide therapies within current medical management (CMM) of knee osteoarthritis (KOA) patients. It is well recognized that joint mechanics are important risk factors in KOA progression and that kinematics information can be useful to assess causes of symptoms. Dynamic knee KinesioGraphy (KG-Knee) assessment can be performed by a trained therapist (physical therapist, kinesiologist, physical rehabilitation therapist) in a clinical setting to serve as an objective measurement tool to identify and measure evidence-based mechanical markers. The aim of this study was to determine the impact on clinical outcomes of adding a KG-Knee assessment and personalized treatment recommendations to CMM for KOA patients. Methods: This pragmatic, cluster randomized, controlled trial was carried out in primary care clinics (Montreal, Canada). Patients with a clinical diagnosis of KOA as identified by their PCP were selected for participation if 1) KOA was the main cause of their knee pain, 2) they rated their worst pain in the past 7 days ≥ 4 on a 0-10 pain intensity scale, 3) they had a Kellgren-Lawrence (KL) grade ≥ 2 on radiographs. They were excluded if they 1) were on a waiting list for total knee replacement, 2) suffered from rheumatoid arthritis or active cancer, 3) had met a specialist of KOA in the past or 4) were pregnant. Participants from a same clinic formed a cluster which was randomly assigned to one of 3 groups: 1- a control group with patients receiving CMM (Group 1-CMM), 2- an intervention group receiving CMM plus KG-Knee-based recommendations (Group 2-KG-Knee), and 3- an intervention group receiving CMM, KG-Knee-based recommendations, and a self-management education session plus two follow-up supervised meetings (Group 3-KG-Knee+Education). In the KG-Knee groups, three-dimensional knee kinematics at baseline were captured using the KneeKG™ system (Figure 1) during treadmi