Abstract
Biomechanical differences between the paretic knee (PK) and non-paretic knee (NPK) post-stroke are well documented. Due to limited knowledge of the potential impacts of altered biomechanics on knee morphology, this study aimed to (1) assess and compare gross morphological characteristics of the distal femoral cartilage and patellar tendon in the PK and NPK; (2) compare knee biomechanics; (3) investigate associations between biomechanical and morphological data. This exploratory case-control observational study included seven people with stroke (6 male; M (SD) age, 75.7 (4.5) years). Magnetic resonance imaging was used to assess the femoral articular cartilage (thickness and integrity) and patellar tendon (physical characteristics), alongside optic-based gait analyses. Descriptive and correlational (ρ and τ) analyses were applied. The PK and NPK were morphologically similar. Maximum flexion was reduced at the PK (49.3°; 95%CI [41.9, 56.7]) compared to the NPK (62.7°; 95%CI [57.3, 68.2]). Correlations were observed between maximal PK extension moments and medial condyle chondral thickness (ρ = –0.87, 95%CI [–0.98, –0.32]); maximum PK extension and patellar tendon length (ρ = 0.86, 95%CI [0.27, 0.98]); maximum NPK extension and patellar tendon width (ρ=0.93, 95%CI [0.56, 0.99]); maximum PK valgus and patellar tendon width (ρ = 0.86, 95%CI [0.27, 0.98]); maximum PK flexion moments and patellar tendon length (ρ = 0.93, 95%CI [0.56,0.99]); and NPK maximum extension moments and patellar tendon thickness (ρ = –0.84, 95%CI [0.98, 0.20]). These findings suggest a relationship between biomechanics and knee morphology post-stroke. This study offers insight for physiotherapists working in gait rehabilitation, and for future research.