Effects of Weight-Bearing-Induced Changes in Tibial Inclination Angle on Varus Thrust During Gait in Female Patients with Knee Osteoarthritis

<b>Background:</b> The relationship between varus thrust (VT) during gait and static limb alignment on radiography in knee osteoarthritis (OA) remains unclear. Therefore, the present study investigated the association between the tibial inclination angle (TA), which was noninvasively measured from the body surface, and radiographic parameters. In Addition, this study analyzed how TA changes under different loading conditions (<i>Δ</i>TA) relate to VT acceleration (VTA) during early stance using an inertial measurement unit (IMU) sensor. <b>Methods:</b> Nineteen female patients (mean age: 63.5 ± 8.6 years) with knee OA or medial meniscus injury were included. The TA was defined as the angle between the tibial mechanical axis and a vertical line from the floor, which was measured in standardized standing and supine positions. The <i>Δ</i>TA was calculated as the difference between these positions. To assess lower limb alignment, the femorotibial angle (FTA) and joint line convergence angle (JLCA) were measured. The VTA was measured using IMU sensors on the thigh and tibia, and the differences between lateral and medial VTA were defined as femoral and tibial <i>Δ</i>VTA, respectively. Spearman’s correlation coefficient and linear regression were used for analysis. <b>Results:</b> The standing TA was significantly correlated with the FTA (<i>ρ</i> = 0.47, <i>p</i> = 0.04) and JLCA (<i>ρ</i> = 0.80, <i>p</i> < 0.01). The <i>Δ</i>TA was significantly associated with femoral <i>Δ</i>VTA (<i>β</i> = 0.70, <i>p</i> < 0.01) and tibial <i>Δ</i>VTA (<i>β</i> = 0.67, <i>p</i> < 0.01). <b>Conclusions:</b> Surface-measured TA reflects radiographic alignment. The <i>Δ</i>TA also captures dynamic instability not explained by static measures, suggesting its potential utility as an assessment indicator, although further validation is warranted.