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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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
Clinical Comparison and Survival Rate Between Unicompartmental Knee Arthroplasty and High Tibial Osteotomy With An External Fixator For Varus Knee In Patients Younger Than 60 Years at Mid-Term Follow-Up ePoster Presentation Amit Kumar Yadav, M.S (Orth),DNB(Orth),MNAMS, UNITED KINGDOM Riccardo D'Ambrosi, MD, ITALY Mangal Parihar, MS Ortho, INDIA
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
Novel Technique For Surgeon-Placed Nerve Block And Continuous Nerve Block In Total Knee Arthroplasty. A Cadaveric Study ePoster Presentation Daniel E Matthews, MD, FAAOS, UNITED STATES
Golfers Have Greater Preoperative and Equal Postoperative Function When Undergoing Total Knee Arthroplasty Compared to Non-Golfers ePoster Presentation Patrick G Robinson, MBChB, MRCS, MS, MBA, UNITED KINGDOM Robert Kay, MBChB, UNITED KINGDOM Deborah Macdonald, BA(Hons), UNITED KINGDOM Andrew Murray, MBChB, FFSEM, UNITED KINGDOM Nick David Clement, MBBS, MD, PhD, FRCS(Orth), UNITED KINGDOM
Preoperative Bone Marrow Edema Negatively Impacts Intermediate to Long-Term Outcomes after Unicompartmental Knee Arthroplasty ePoster Presentation Hong Yeol Yang, MD, PhD, KOREA, REPUBLIC OF Jong-Keun Seon, MD, PhD, Prof, KOREA, REPUBLIC OF
Comparative Analysis Of Time Taken In Conventional vs. Robotic Assisted Total Knee Arthroplast 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
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
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, PhD, JAPAN Tomofumi Kage, JAPAN Ryo Murakami, MD, JAPAN Hiroshi Inui, PhD, JAPAN Sakae Tanaka, MD, PhD, JAPAN
Large Reduction In Postoperative Posterior Tibial Slope Risks Anterior Collapse Of The Tibial Component In Fixed-Bearing Unicompartmental Knee Arthroplasty ePoster Presentation Kazuhisa Hatayama, MD, PhD, JAPAN Masanori Terauchi, MD, JAPAN Shingo Kurihara, MD, JAPAN Satoshi Nonaka, MD, JAPAN Hibiki Kakiage, MD, JAPAN
Same Complication Rate After Day-Case Procedure Or Fast-Track Procedure After Total Hip And Knee Arthroplasty. A Prospective, Propensity Score-Matched Case-Control Study ePoster Presentation Jean-Yves Jenny, Prof., FRANCE Vincent Gisonni, MD, FRANCE

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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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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

Background

Materials And Methods

Results

Conclusion

More 2023 ISAKOS Congress Content