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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Use of Tibial Stem for Patients with Morbid Obesity in Total Knee Arthroplasty ePoster Presentation José Eduardo Flores Naranjo, MD, MEXICO Adrian Aziz Cortes De La Fuente, MD, MEXICO Octavio Martinez Montiel, MD, MEXICO Fernando Martinez Zuñiga, MD, MEXICO
Success of Debridement, Antibiotics, and Implant Retention vs Revision In Early And Late Prosthetic Joint Infections Following Primary TKA: A Prospective, Multicenter Study of 251 Cases ePoster Presentation Mark Zhu, MBChB, NEW ZEALAND Richard Rahardja, MBChB, BMedSc(Hons), NEW ZEALAND Laurens Manning, MBChB, AUSTRALIA Sarah Metcalf, MBChB, NEW ZEALAND Simon W. Young, MD, FRACS, NEW ZEALAND
Anatomical distribution of radiological OA Influences the Outcome of TKA ePoster Presentation Johanna Elliott, MB, BS, B.Med Sci, Master Science, GERMANY
Bicruciate Substituting Total Knee Arthroplasty Improved Anteroposterior Displacement in Mid-Flexion Range ePoster Presentation Keinosuke Ryu, MD, PhD, JAPAN Takanori Iriuchisima, MD, JAPAN
Modular Knee Arthrodesis as Definitive Treatment for Periprosthetic Infection, Bone Loss, and Failure of the Extensor Mechanism after Total Knee Arthroplasty ePoster Presentation Gloria Shoshana Coden, MD, UNITED STATES Maksym Bartashevskyy, BA, UNITED STATES Zachary Berliner, MD, UNITED STATES Ruijia Niu, MPH, UNITED STATES James V. Bono, MD, UNITED STATES Ayesha Abdeen, MD, UNITED STATES Eric L. Smith, MD, UNITED STATES
Antero-Posterior Translation of Mobile-Bearing in Mobile-Bearing Unicompartmental Knee Arthroplasty ePoster Presentation Takahiro Arakawa, MD, JAPAN Kenichi Kono, MD, PhD, JAPAN Tetsuya TOMITA, MD, PhD, JAPAN Shuji Taketomi, MD, PhD, JAPAN Ryota Yamagami, MD, JAPAN Kohei Kawaguchi, MD, JAPAN Tomofumi Kage, JAPAN Ryo Murakami, MD, JAPAN Hiroshi Inui, PhD, JAPAN Sakae Tanaka, MD, PhD, JAPAN
High Cure Rate In Hematogenous TKA PJI At A Long-Term Follow-Up By Means Of Dair Procedure ePoster Presentation Daniel Pérez-Prieto, MD, SPAIN Albert Fontanellas, MD, SPAIN Raúl Torres-Claramunt, PhD, SPAIN Juan Francisco Sanchez-Soler, MD, PhD, SPAIN Joan Carles Monllau, MD, PhD, Prof., SPAIN Pedro Hinarejos-Gomez, MD, PhD, SPAIN
Lateral Unicompartmental Knee Arthroplasty (UKA) Showed a Lower Risk of Failure Compared to Medial Unicompartmental Knee Arthroplasty in the Register of Prosthetic Orthopedic Implants (RIPO) ePoster Presentation Stefano Zaffagnini, MD, Prof., ITALY Domenico Alesi, MD, ITALY Barbara Bordini, Stat, ITALY Stefano Fratini, MD, ITALY Cristina Ancarani, Stat, ITALY Piero Agostinone, MD, ITALY Alberto Grassi, PhD, ITALY Giulio Maria Marcheggiani Muccioli, MD, PhD, Associate Professor, ITALY
Patient Satisfaction and Functional outcomes in a Latin American cohort: Comparative Study Between Conventional Technique vs. Robotic Arm Assistance. ePoster Presentation Rafael Calvo, MD, CHILE Maria Loreto Figueroa Berrios, MD, CHILE Rodrigo Guiloff, MD, Prof, CHILE Zoy Anastasiadis, MD, CHILE David H. Figueroa, MD, CHILE
The Effect of Minor Adjustments to Tibial and Femoral Component Position on Soft Tissue Balance in Robotic Total Knee Arthroplasty ePoster Presentation Simon W. Young, MD, FRACS, NEW ZEALAND Matthew Carter, NEW ZEALAND Gavin William Clark, MBBS, FRACS, AUSTRALIA Christina Esposito, PhD, AUSTRALIA Matthew Walker, MBChB, FRACS, NEW ZEALAND
Combined Fixed-Bearing Unicompartmental Knee Arthroplasty and Anterior Cruciate Ligament Reconstruction ePoster Presentation Claudio Legnani, MD, ITALY Enrico Borgo, MD, ITALY Vittorio Macchi, MD, ITALY Alberto Ventura, MD, ITALY

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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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Conclusion

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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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Materials And Methods

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