Compensatory gait deviations during single-limb stance in patients with excessive tibial torsion

Lower limb torsion profiles, such as tibial torsion, can influence gait as well as joint biomechanics and potentially cause functional impairment. It is still unknown how morphological variations in tibial torsion would affect joint mechanics. This work investigated the correlation between tibial torsion and joint kinetics and kinematics using numerical modeling. We utilized an optimal control strategy to generate torque actuator simulations of the stance phase of gait for tibial torsion angles ranging from -2° to 58°, with a normally developing baseline of 28° of tibial torsion. The results indicated that while the ankle plantar flexion moment remains largely unaffected by the tibial torsion, plantar flexion angles are greatly affected, especially in higher inward and outward rotations. Both knee extension/flexion moments and plantar flexion angles tended to decrease with an increase in outward tibial torsion. Hip flexion and adduction moments were found to change slightly, while hip rotation moments showed greater variations as a result of tibial torsion, especially in high outward rotations. The findings of this study would help physiotherapist in planning treatments for patients with excessive inward or outward tibial torsion.