JAGC: Yes that's my point, the conventional level fitting is wrong even for walking on the level. The point is implied in the medical report cited above: the leverage is wrong and it creates a twisting moment. To really take weight of the knees, the effort is much better expended it a single straight line nearer to the center of gravity, like a cane or crutch. Its fine out in front for balance or curb detection, but not for weight bearing.
I think the adjustments you use are about the same ones I do. I use the palms on top, too. In fact I am thinking of getting a pair with the cane handles like the Kaito Bt 409, which can be gripped either like a ski pole or cane. Hope I'll be doing the same at 80. Only 18 years to go
