Summary: We suggest that the peak timing of knee flexion moment could be helpful to understand the abnormal gait pattern and to develop the targeted rehabilitation for patients after total knee arthroplasty.

Background

The patterns of knee joint loading during walking are diverse in patients with knee osteoarthritis (OA) before and after total knee arthroplasty (TKA). However, the gait mechanics by the different loading patterns are not fully understood. We aimed to compare the gait mechanics between groups distinguished by peak timing of knee flexion moment (KFM) and to identify whether altered knee joint loading pattern after TKA could be associated with pre-surgery gait function and how changed in adjacent joints.

Materials And Methods

Lower limb biomechanics and The Knee Injury and Osteoarthritis Outcome Score (KOOS) were assessed in 43 patients (60 legs) and 9 participants of the control group before and one year after TKA. An “earlier peak (EP)” (23 patients, 30 TKA legs) was defined as the peak of the external KFM during early stance phase and a “later peak (LP)” (20 patients, 30 TKA legs) was defined as the peak of the external KFM during late stance phase. Gait biomechanical data were collected using a three-dimensional motion analysis system. (Fig. 1)

Results

Most of parameters showed the improved changes in both of two groups after TKA (p<0.05). Significant effects of interactions between group and time were found for timing of peak KFM (p=0.001), foot progression angles (p=0.011), and K5 power absorption (p=0.030). The timing of peak KFM in EP group after TKA was faster (mean difference, 19.37sec) compared to LP and control group. The foot progression angle in LP after TKA increased compared to pre-operation (mean difference, 2.72°) and EP group (mean difference, 5.14°). K5 power absorption during terminal swing after TKA in LP group is significantly lower than both of EP and control group (p<0.05). Scores of pain and activities on daily living in LP group significantly lower than them in EP group before and after TKA.
In three group’s comparison, there were significantly decreases on H3 power generation, K2 and K5 power absorption, and walking speed in LP group, compared to both of EP and control group. Peak KFM increased significantly, but hip and knee extension moment, and ankle dorsiflexion moment and H1 power generation and K1 power generation decreased significantly in EP and LP group, compared to the control group. Peak hip adduction, knee flexion and ankle dorsiflexion angles, hip flexion moment, A2 power generation were significantly decreased in LP group compared to the control group.

Conclusion

The persistent gait abnormalities including toe out gait and reduction of knee absorption power during terminal swing were more noticeable in LP group. Patients who had more pain and less daily activity were included in LP group. We suggest that the peak timing of KFM could be helpful to understand the abnormal gait pattern and to develop the targeted rehabilitation for patients after TKA. Hip and knee muscle strengthening for EP group, and balanced exercise between medial and lateral muscles as well as hip, knee and ankle muscle strengthening for LP group should be applied after TKA.

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Diagnosis of Central Sensitization and Its Effects on Postoperative Outcomes Following Total Knee Arthroplasty: A Systematic Review and Meta-Analysis ePoster Presentation Man-Soo Kim, MD, PhD, KOREA, REPUBLIC OF Dongho Kwak, MD, KOREA, REPUBLIC OF Sungcheol Yang, MD, KOREA, REPUBLIC OF Hyukjin Jang, MD, KOREA, REPUBLIC OF Ryu Kyoung Cho, MD, KOREA, REPUBLIC OF Yong In, MD, PhD, KOREA, REPUBLIC OF
Patellofemoral Arthroplasty In Community Programs: Case Series of 425 Patients ePoster Presentation Alexander P. Sah, MD, UNITED STATES
Evaluation of The Safety And Efficacy of The Fully Automated Active Robotic System In Robotic Assisted Total Knee Arthroplasty ePoster Presentation Sanjay B. Londhe, MS, FRCS, FRCSI, MCh, INDIA Santosh Chandrashekar Shetty, MS, INDIA Ashit Hasmukhbhai Shah, FRCS Orth, M ChOrth, M S Orth, D N B Orth, INDIA Niraj Vora, MS,MRCS, INDIA Vijay Shetty, MD, MSc, FRCSC, INDIA Rakesh Nair, MS, INDIA Clevio Joao Baptista Desouza, MD, INDIA Farheen Khan, B.Tech, INDIA
Bilateral Simultaneous Unicompartimental Knee Arthroplasty. Midterm Results in 86 Arthroplasties with an Average Follow-Up Of 6.2 Years ePoster Presentation Stefano Gaggiotti, MD, ARGENTINA Gabriel Gaggiotti, MD, ARGENTINA Santino Gaggiotti, MD, ARGENTINA Julio Cesar Ringa
Detection Loosening of Total Knee Arthroplasty Implant from Plain Radiograph Using Machine Learning Algorithm ePoster Presentation Man-Soo Kim, MD, PhD, KOREA, REPUBLIC OF Dongho Kwak, MD, KOREA, REPUBLIC OF Sungcheol Yang, MD, KOREA, REPUBLIC OF Hyukjin Jang, MD, KOREA, REPUBLIC OF Ryu Kyoung Cho, MD, KOREA, REPUBLIC OF Yong In, MD, PhD, KOREA, REPUBLIC OF
Relationship Between The Femoral And Tibial Component Positions And Postoperative Knee Range Of Motion After Posterior-Stabilized Total Knee Arthroplasty ePoster Presentation Mitsuru Hanada, MD, PhD, JAPAN Yukihiro Matsuyama, MD, PhD, Prof., JAPAN
Accuracy of the Component Alignment and Sizing in Total Knee Arthroplasty: Preoperative Templating and Postoperative Evaluation Using CT-Based 3D Pre-Operative Planning Software ePoster Presentation Takayuki Koya, MD, PhD, JAPAN Atsushi Sato, MD, PhD, JAPAN Jun Oike, MD, PhD, JAPAN Masataka Ota, MD, JAPAN Kanako Izukashi, MD, JAPAN Takayuki Okumo, MD, PhD, JAPAN Saki Yagura, MD, JAPAN Naoki Okuma, MD, JAPAN Fumiyoshi Kawashima, MD, JAPAN Hiroshi Takagi, MD, PhD, JAPAN Koji Kanzaki, Prof., JAPAN
Total Knee Arthroplasty Outcomes Following Anterior Cruciate Ligament Reconstruction ePoster Presentation Brian Rao, BS, UNITED STATES Alex C. Dibartola, MD, MPH, UNITED STATES Eric Milliron, BS, UNITED STATES Parker Cavendish, BS, UNITED STATES James C. Kirven, BS, UNITED STATES Spencer E. Talentino, MD, UNITED STATES Charles Qin, MD, UNITED STATES Ryan H. Barnes, MD, UNITED STATES Robert A. Duerr, MD, UNITED STATES Christopher C. Kaeding, MD, UNITED STATES Robert A Magnussen, MD, MPH, UNITED STATES David C. Flanigan, MD, UNITED STATES
Knee Arthroscopy Prior to UKA Does Not Cause Infection ePoster Presentation Kevin D. Plancher, MD, MPH, UNITED STATES Karen Briggs, MPH, UNITED STATES Stephanie C. Petterson, MPT, PhD, UNITED STATES
Association Of Ischemia Time And Serum Lactate Levels With Postoperative Pain In Primary Total Knee Arthroplasty At The Orthopedics And Traumatology Service At The Unidad Médica De Alta Especialidad No. 1 Bajío. ePoster Presentation Juan Antonio García Ramírez, MD, MEXICO
Does Robotic Assisted Unicompartmental Knee Arthroplasty Restore Native Jointline More Accurately Than With Conventional Instruments? ePoster Presentation Ashok Kumar Podhili Subramani, MS, INDIA Shantanu S. Patil, MBBS, MS(Orth), INDIA SAWAN PAWAR, MBBS MS (ORTH), INDIA Kalaivanan Kanniyan, MBBS MS Orth, INDIA karthik jayachandran, MS, INDIA PICHAI SURYANARAYAN, MBBS MS ORTH, INDIA
Anatomical distribution of radiological OA Influences the Outcome of TKA ePoster Presentation Johanna Elliott, MB, BS, B.Med Sci, Master Science, GERMANY

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Effect of Altered Knee Joint Loading Pattern in Gait Biomechanics of Total Knee Arthroplasty Patient

Effect of Altered Knee Joint Loading Pattern in Gait Biomechanics of Total Knee Arthroplasty Patient

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Effect of Altered Knee Joint Loading Pattern in Gait Biomechanics of Total Knee Arthroplasty Patient

Effect of Altered Knee Joint Loading Pattern in Gait Biomechanics of Total Knee Arthroplasty Patient

Background

Materials And Methods

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Conclusion

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