Relation of vertical ground reaction forces while walking to contralateral structural worsening in adults with unilateral knee osteoarthritis: The multicenter osteoarthritis study

Patrick Corrigan; Cara L. Lewis; Kerry E. Costello; Deepak Kumar; David T. Felson; Tuhina Neogi; Kathryn Bacon; Michael P. LaValley; Ali Guermazi; Frank Roemer; Michael C. Nevitt; Cora E. Lewis; James Torner; Joshua J. Stefanik

doi:10.1016/j.clinbiomech.2025.106718

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Relation of vertical ground reaction forces while walking to contralateral structural worsening in adults with unilateral knee osteoarthritis: The multicenter osteoarthritis study

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Relation of vertical ground reaction forces while walking to contralateral structural worsening in adults with unilateral knee osteoarthritis: The multicenter osteoarthritis study

Patrick Corrigan, Cara L. Lewis, Kerry E. Costello, Deepak Kumar, David T. Felson, Tuhina Neogi, Kathryn Bacon, Michael P. LaValley, Ali Guermazi, Frank Roemer, …

Clinical biomechanics (Bristol), Vol.132, 106718

02/2026

DOI: 10.1016/j.clinbiomech.2025.106718

PMCID: PMC12799055

PMID: 41352273

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https://pmc.ncbi.nlm.nih.gov/articles/PMC12799055/View

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Abstract

It is unclear why knee osteoarthritis (KOA) progresses from a unilateral to bilateral joint disease. This study aimed to evaluate relations between vertical ground reaction forces (VGRFs) while walking and structural worsening in the unaffected limb of adults with unilateral KOA. Discrete metrics were extracted from the unaffected limb VGRF signal while walking at a self-selected speed. Structural worsening of the unaffected knee was evaluated over 2 years with radiographs (primary) and MRIs (secondary). Logistic regression models evaluated associations between VGRF metrics and structural worsening outcomes, while adjusting for relevant covariates. Similar relations were evaluated in adults without OA in either knee to determine if VGRF metrics uniquely relate to contralateral structural worsening in adults with unilateral KOA. In adults with unilateral KOA (n = 262), VGRFs were not associated with radiographic joint space narrowing within the tibiofemoral compartments of the unaffected knee. Additionally, VGRFs were not associated with MRI-detected cartilage loss in the medial tibiofemoral compartment. However, for the lateral tibiofemoral compartment, higher vertical loading and unloading rates were protective against cartilage loss (Odd ratios (OR) = 0.31–0.47), while larger vertical impulses and valley magnitudes were associated with increased odds of cartilage loss (OR = 2.50 and 2.26, respectively). No relations were found in adults without OA in either knee (n = 985). VGRF metrics lack the ability to predict medial tibiofemoral structural worsening in knees without OA. However, vertical impulse and valley magnitude can assist with identifying contralateral knees at risk for lateral tibiofemoral cartilage loss in those with unilateral KOA. •Reasons for unilateral to bilateral knee osteoarthritis progression are unclear.•Walking forces did not relate to contralateral medial tibiofemoral worsening.•Some vertical force metrics relate to contralateral lateral tibiofemoral worsening.•Walking forces are unrelated to cartilage loss in adults without osteoarthritis.

Biomechanics

Epidemiology

Gait

Musculoskeletal

Details

Title: Subtitle: Relation of vertical ground reaction forces while walking to contralateral structural worsening in adults with unilateral knee osteoarthritis: The multicenter osteoarthritis study
Creators: Patrick Corrigan - Cleveland Clinic
Cara L. Lewis - Boston University
Kerry E. Costello - University of Florida
Deepak Kumar - Boston University
David T. Felson - Boston University
Tuhina Neogi - Boston University
Kathryn Bacon - Boston University
Michael P. LaValley - Boston University
Ali Guermazi - Boston University
Frank Roemer - Boston University
Michael C. Nevitt - University of California, San Francisco
Cora E. Lewis - University of Alabama at Birmingham
James Torner - Department of Epidemiology, University of Iowa, Iowa City, IA, United States of America
Joshua J. Stefanik - Northeastern University
Resource Type: Journal article
Publication Details: Clinical biomechanics (Bristol), Vol.132, 106718
DOI: 10.1016/j.clinbiomech.2025.106718
PMID: 41352273
PMCID: PMC12799055
NLM abbreviation: Clin Biomech (Bristol)
ISSN: 0268-0033
eISSN: 1879-1271
Publisher: Elsevier Ltd
Grant note: National Institute on Aging (NIA): U19AG076471, U01AG18820, U01AG18832, U01AG18947, U01AG19069 Rheumatology Research FoundationAcademy of Orthopaedic Physical TherapyNational Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS): K23AR070913 NIAMS: K24AR070892 Boston University Core Center for Clinical Research: P30AR072571
MOST is funded by the National Institute on Aging (NIA) under the following award numbers: U19AG076471 (MPI: Felson & Neogi) , U01AG18820 (PI: Felson) , U01AG18832 (PI: Torner) , U01AG18947 (PI: Lewis) , and U01AG19069 (PI: Nevitt) . Patrick Corrigan was supported by the Rheumatology Research Foundation and the Academy of Orthopaedic Physical Therapy. Joshua Stefanik was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) under award number K23AR070913. Tuhina Neogi was supported by NIAMS under award number K24AR070892. Kerry Costello was supported by the Rheumatology Research Foundation. Other support for this study was provided by the Boston University Core Center for Clinical Research under award number P30AR072571. Funding sources had no role in the design, conduct, or reporting of this study.
Language: English
Electronic publication date: 11/2025
Date published: 02/2026
Academic Unit: Neurology; Epidemiology; Injury Prevention Research Center; Neurosurgery
Record Identifier: 9985034930602771

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