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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Participation of Physical Activity Following Knee Arthroplasty: A Meta-Analysis ePoster Presentation Ahmed A Magan, BM BSc (Hons) MRCS (Eng) FRCS (Eng) Trauma & Orth, UNITED KINGDOM Babar Kayani, BSc (HONS), MBBS, MRCS (Eng), UNITED KINGDOM Warran Wignadasan, MBBS, BSc (Hons), MRCS, UNITED KINGDOM Dia Eldean Giebaly, MBChB, MSc, FRCS, EMBA, UNITED KINGDOM Flaminia Ronca, PHD, UNITED KINGDOM Fares S. Haddad, MCh(Orth), BSc, FRCS(Orth), UNITED KINGDOM
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
Effect of Direct Adductor Canal Block Performed by a Surgeon in a Patient Who Underwent Simultaneous Bilateral TKA 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
Comparison of Outcomes between Fungal and Non-fungal Periprosthetic Joint Infections in Total Knee Arthroplasty: A Propensity Score-Matched Analysis ePoster Presentation Hong Yeol Yang, MD, PhD, KOREA, REPUBLIC OF Jong-Keun Seon, MD, PhD, Prof, KOREA, REPUBLIC OF
Is Surgeon Assessed Bone Quality During Total Knee Arthroplasty a Valid Tool To Diagnose Osteoporosis ? ePoster Presentation Adit Rajesh Maniar, MBBS, MS Orthopaedics, DNB Orthopaedics, INDIA Arpit Vasantbhai Bavaskar, MBBS, D.Orth., INDIA Vishal Raina, MS, INDIA Akshay Nayak, M.B.B.S, M.S , INDIA Ashwini Khokhar, MS, INDIA Rajesh Maniar, INDIA
Antibiotic-Loaded Bone Cement with Colistin at Erythromycin Do Not Decrease Chronic TKA Pji at a Long-Term ePoster Presentation Daniel Pérez-Prieto, MD, SPAIN Albert Fontanellas, MD, SPAIN Pedro Hinarejos, MD, PhD, SPAIN Juan Francisco Sanchez-Soler, MD, PhD, SPAIN Raúl Torres-Claramunt, PhD, SPAIN Joan Carles Monllau, MD, PhD, Prof., SPAIN
Quality of Life Following Primary Total Knee Arthroplasty: Factors Predicting Satisfaction in Low-Income Population ePoster Presentation Mohamed Amine Gharbi , MD, TUNISIA Houssem Eddine Chahed, MD, TUNISIA Ahmed Zendeoui, MD, TUNISIA Moatassem Belleh Jelassi, MD, TUNISIA Anis Tebourbi, MD, TUNISIA Ramzi Bouzidi, PhD, TUNISIA Khelil Ezzaouia, PhD, TUNISIA Mouadh Nefiss, MD, TUNISIA
Factors Associated With Failure and Survivorship Following Unicompartmental Knee Arthroplasty: A Single-Center Experience ePoster Presentation Anirudh K Gowd, MD, UNITED STATES Johannes F. Plate, MD, PhD, UNITED STATES Asher Lichtig, MD, UNITED STATES Orhan Yanmis, MD, UNITED STATES Gary G. Poehling, 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
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
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
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

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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

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