Summary: Decreased knee adduction moment after unilateral total knee arthroplasty improved patient outcome, but contralateral residual osteoarthritis knee did not due to increased pain with high gait speed.

Introduction

The knee adduction moment (KAM) is often focused on total knee arthroplasty (TKA) research for assessing postoperative functional outcome. The impact of the operative knee on contralateral nonoperative osteoarthritis (OA) knee about gait analysis also remain unclear. The aim of this study was to investigate pre- and postoperative changes of gait parameters based on an interactive musculoskeletal modelling software and knee joint pain in patients who underwent unilateral TKA for bilateral knee OA.

Methods

In this prospective study, 10 patients (mean age, 74 years) with bi-lateral varus knee OA were participated, which included Kellgren–Lawrence grade 2 or greater severity by knee radiographs and underwent posterior cruciate-substituting TKA with follow-up for more than 2 years. The gait measurements in bilateral knees preoperatively and 1-year follow-up after TKA were analyzed using the point cluster technique and three force plates. An interactive musculoskeletal modelling software was used for calculating the KAM, knee flexion moment, and tibiofemoral (TF) joint force during each gait phase. The 2011 Knee Society Knee Scoring System (2011 KSS) were also measured pre- and postoperatively.

Results

For operative knee, peak KAM was lower, and TF joint force was higher postoperatively than preoperatively, but all parameters including the nonoperative knees did not have significantly different before and after TKA. However, gait analyses showed that postoperative KAM was significantly lower than preoperative KAM at the 30%, 40%, and 50% phases for the operative knee, and only at the 60% phase for nonoperative knee, all in stance phase. Postoperative gait flexion moment was higher than preoperative moment at 100 % swing phase only in nonoperative knee. Meanwhile, in operative knee, postoperative TF joint force was significantly larger than preoperative force at 10% stance phase and 70% swing phase. Operative knees with postoperative decreased KAM had high 2011 KSS total and functional score improvement, while increased knee flexion moment in gait analysis was correlated with only total score. On the other hand, in nonoperative knees, the only factor that correlated with decreased symptom score was increased postoperative gait speed.

Discussion

Gait analysis particularly showed that postoperative KAM significantly decreased in mid to late stance phase, and postoperative TF joint force increased in heel strike and early swing phases. This suggests that preoperative avoidance gait from knee pain was improved by post-TKA pain relief. As a result, an improvement in 2011 KSS might be achieved. On the other hand, contralateral TKA did not improve postoperative symptom score in the nonoperative knees. This is because postoperative decreased symptoms score was significantly correlated with only increased gait speed due to contralateral TKA; patients with advanced nonoperative knee OA increased gait speed after successful contralateral TKA and might easily feel more knee pain postoperatively than preoperatively. We believe that patients with increased gait speed after contralateral TKA might reasonably be considered for TKA in the nonoperative knees.

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Association Between Surgeon Volume And Patient Outcomes After Elective Patellofemoral Joint Replacement Surgery Using Data From The National Joint Registry And Hospital Episode Statistics For England: Population Based Cohort Study ePoster Presentation Martinique Vella-Baldacchino, MD, MRCS, PG CERT (HEALTH LEADERSHIP), IOC DIp Spo, UNITED KINGDOM Alex Bottle, Phd, UNITED KINGDOM Justin Cobb, MCh FRCS, UNITED KINGDOM Alex D Liddle, MBBS BSc DPhil FRCS(Orth), UNITED KINGDOM
Preservation of Pre-Arthritic Coronal Knee Phenotype and Pre-Arthritic Coronal Alignment Yielded Improved Kujala Scores Following Ligament-Guided Medial Unicompartmental Knee Arthroplasty ePoster Presentation Roderick J.M. Vossen, MD, UNITED STATES Joost Burger, MD, PhD, GERMANY Gaby Victoria Ten Noever De Brauw, NETHERLANDS Tarik Bayoumi, MD, NETHERLANDS Jake Fiore, Bsc, UNITED STATES Lindsey Ruderman, BA, UNITED STATES Hendrik Aernout Zuiderbaan, MD PhD, NETHERLANDS Andrew D. Pearle, MD, UNITED STATES
Local Soft Tissue Thickness in Unicompartimental Knee Arthroplasty: Strong Inter-Parameter Correlation, Moderate Correlation with BMI, and no Impact on Implant Positioning ePoster Presentation Lorenz Pichler, MD, AUSTRIA Moses Kamal Dieter El Kayali, MD, GERMANY Rosa Berndt, MD, GERMANY Carsten Perka, MD, PhD, GERMANY Clemens Gwinner, MD, GERMANY Danko Dan Milinkovic, MD, GERMANY
Tourniquet use Does not Affect Bleeding and Surgical Time in Robotic Assisted Total Knee Arthroplasty ePoster Presentation João P.F. Guerreiro, MD, PhD, BRAZIL JOAO BALAN, MD, BRAZIL MARSAL VILHENA, MD, BRAZIL SERGIO MERÇON, MD, BRAZIL Paulo Roberto Bignardi, PhD, BRAZIL Marcus Vinicius Danieli, MD, PhD, BRAZIL
Double-blinded Prospective Randomized Clinical Trial in Total Knee Arthroplasty: Impact of Tourniquet Inflation Timing on Postoperative Pain, Joint Function, and Quality of Life ePoster Presentation Po-Yao Wang, MD, TAIWAN Ting-Chun Lin, TAIWAN Chia-Hui Wang, PhD, TAIWAN Jia-Lin Wu, MD, MS, TAIWAN
Is Bi-Cruciate Stabilized Total Knee Arthroplasty Better Than Conventional Knee Arthroplasty In Knee Biomechanics During Gait? ePoster Presentation Kengo Harato, MD, PhD, JAPAN Kohei Nishizawa, PhD, JAPAN Shu Kobayashi, MD, PhD, JAPAN Kazuya Kaneda, MD, PhD, JAPAN Tatsuaki Matsumoto, MD, PhD, JAPAN Takeo Nagura, MD, JAPAN
Early Clinical Outcome In Inverse Kinematic Alignment For Total Knee Arthroplasty Using A Robotic Assisted System: Two Years Follow-Up ePoster Presentation Federica Manca, MD, ITALY Leo Massari, Prof., ITALY Alberto Belluati, MD, ITALY Andrea Colombelli, MD, ITALY
Large Variance in a Lateral Osteoarthritic Population Prior to and Following Lateral Unicompartmental Arthroplasty: An Analysis of Knee Phenotypes ePoster Presentation Hendrik Aernout Zuiderbaan, MD PhD, NETHERLANDS Roderick J.M. Vossen, MD, UNITED STATES Gaby Victoria Ten Noever De Brauw, NETHERLANDS Lindsey Ruderman, BA, UNITED STATES Tarik Bayoumi, MD, NETHERLANDS Gino M. M. J. Kerkhoffs, MD, PhD, Prof., NETHERLANDS Andrew D. Pearle, MD, UNITED STATES
Forgotten Joint Score : Role in Identifying Patients Unlikely To Improve Following Total Knee Arthroplasty ePoster Presentation Adit Rajesh Maniar, MBBS, MS Orthopaedics, DNB Orthopaedics, INDIA Rajesh Maniar, INDIA Ishan Khanna, MBBS, MS, INDIA Pranav Shere, MS,DNB , INDIA Anish Nandkumar Tawde, M. S. Orthopaedics , INDIA Muhammad Naqvi, MBBS, MS, DNB, FNB, MRCSEd, INDIA
Functional Alignment Restores Native Kinematics More Consistently than Mechanical Axis Alignment in Total Knee Arthroplasty ePoster Presentation Jonathan R Manara, BMBS, FRCS (Tr & Orth), UNITED KINGDOM Rick Steer, FRACS, AUSTRALIA Sarah L. Whitehouse, PhD, AUSTRALIA Dermot M Collopy, FRACS, AUSTRALIA Gavin William Clark, MBBS, FRACS, AUSTRALIA
Soft Tissue Safety In Robotic-Assisted Total Knee Arthroplasty: Is It Reliable? ePoster Presentation Eric Camprubí, MD, SPAIN Juan Ignacio Erquicia, MD, PhD, SPAIN Berta Gasol Cudos, MD, SPAIN Albert Pons Riverola, MD, SPAIN Angela Zumel, PhD, SPAIN Joan Leal-Blanquet, MD, PhD, SPAIN
The Impact Of Aging On Recovery And Satisfaction In Knee Replacement Patients ePoster Presentation Tess L.Y Tsoi , MBChB, HONG KONG Harbeer Ahedi, PhD Biomedical Sciences, AUSTRALIA David A. Parker, MBBS, BMedSc, FRACS, AUSTRALIA
Mid-Term Outcomes Of Lateral Fixed-Bearing Unicompartmental Knee Arthroplasty ePoster Presentation Sumin Lim, MD, PhD, KOREA, REPUBLIC OF Jun-Young Chung, MD, KOREA, REPUBLIC OF Tae Hun Kim, MD, KOREA, REPUBLIC OF Myung-Sub Lee, MD, KOREA, REPUBLIC OF Jeong-Hyun Koh, MD, KOREA, REPUBLIC OF Jeong Sunwoo, MD, KOREA, REPUBLIC OF
Lateral Laxity is Related to the Postoperative Kinematics and Knee Symptoms After Total Knee Arthroplasty Using Medial Stabilizing Technique with a Navigation System ePoster Presentation Takahiro Tsushima, MD, PhD, JAPAN Eiji Sasaki, MD, PhD, JAPAN Kazuki Oishi, MD, JAPAN Yukiko Sakamoto, MD, PhD, JAPAN Yuka Kimura, MD, PhD, JAPAN Eiichi Tsuda, Prof., JAPAN Yasuyuki Ishibashi, MD, JAPAN
Conversion To Total Knee Arthroplasty Following High Tibial Osteotomy And Unicompartmental Knee Arthroplasty: A Propensity-Matched Analysis ePoster Presentation Griffith G. Gosnell, MS, UNITED STATES Katherine L. Esser, BS, UNITED STATES Michael Moore, BA, UNITED STATES Nathaniel P. Mercer, MD, UNITED STATES Heath Patrick Gould, MD, UNITED STATES Laith M. Jazrawi, MD, UNITED STATES Eric Strauss, UNITED STATES Michael J Alaia, MD, UNITED STATES
An Artificial Intelligence-Based Approach In Total Knee Arthroplasty ePoster Presentation Umile Giuseppe Longo, MD, MSc, PhD, Prof., ITALY Sergio De Salvatore, MD, ITALY Federica Valente, MD, ITALY Bruno Violante, MD Ph.d, ITALY Mariajose Villa Corta, MD, ITALY Kristian Samuelsson, Prof, MD, PhD, MSc, SWEDEN Giuseppe Salvatore, MD, PhD, ITALY Alessandra Berton, MD, ITALY Letizia Mancini, MD, ITALY Vincenzo Candela, MD, PhD, ITALY Arianna Carnevale, PhD, ITALY Rocco Papalia, MD, PhD, Prof., ITALY
Longer Hospital Length of Stay After Total Knee Arthroplasty is an Independent Risk Factor for Increased Complication Rates ePoster Presentation Logan Finger, MD, UNITED STATES Kelly A Murphy, BS, UNITED STATES Kenneth Urish, MD, PhD Michael O'Malley, MD, UNITED STATES Brian Klatt, MD, UNITED STATES Johannes F. Plate, MD, PhD, UNITED STATES
Integrating Elongation Patterns with AR-Based Navigation in Kinematic Alignment TKA. ePoster Presentation Atsushi Sato, MD, PhD, JAPAN Marika Mukunoki, MD, JAPAN Masataka Ota, MD, JAPAN Misako Takizawa, MD, JAPAN Kanako Izukashi, MD, JAPAN Jun Oike, MD, PhD, JAPAN Takayuki Okumo, MD, PhD, JAPAN Takayuki Koya, MD, PhD, JAPAN Koji Kanzaki, Prof., JAPAN
Two-Year Results Of The Kneefix Study: A Randomised Controlled Trial Comparing Uncemented Versus Cemented Fixation In Total Knee Arthroplasty With Patella Resurfacing ePoster Presentation Simon W. Young, MD, FRACS, NEW ZEALAND Bill Farrington, FRCS, NEW ZEALAND Rupert S Van Rooyen, MBChB, FRACS, NEW ZEALAND Mei Lin Tay, PhD, NEW ZEALAND Matthew Walker, MBChB, FRACS, NEW ZEALAND Ali Bayan, MBChB, FRACS, NEW ZEALAND
Differences In Coronal Plane Alignment Of The Knee (CPAK) Measured On Long-Leg Radiographs Compared To Computed Tomography For The Patients Undergoing Total Knee Arthroplasty ePoster Presentation Kohei Kawaguchi, MD, PhD, JAPAN Mei Lin Tay, PhD, NEW ZEALAND Bill Farrington, FRCS, NEW ZEALAND Rupert S Van Rooyen, MBChB, FRACS, NEW ZEALAND Matthew Walker, MBChB, FRACS, NEW ZEALAND Ali Bayan, MBChB, FRACS, NEW ZEALAND Simon W. Young, MD, FRACS, NEW ZEALAND
The Knee Pain Decreases After Total Hip Arthroplasty ePoster Presentation Yugo Morita, MD, PhD, JAPAN Yaichiro Okuzu, MD, PhD, JAPAN Toshiyuki Kawai, MD, PhD, JAPAN Kohei Nishitani, MD, PhD, JAPAN Shinichiro Nakamura, MD, PhD, JAPAN Yutaka Kuroda, MD, PhD, JAPAN Shinichi Kuriyama, MD, PhD, JAPAN Shuichi Matsuda, MD, PhD, JAPAN
Short-term Results and Learning Curve of TKA with Robotic Arm ePoster Presentation Masayoshi Okuda, MD, PhD, JAPAN Yuki Kawaguchi, PT, JAPAN Shuhei Sugioka, MD, JAPAN Yusuke Inagaki, MD, PhD, JAPAN Yasuhito Tanaka, Prof., JAPAN
Primary Followed by Revision Total Knee Arthroplasty at Non-Tertiary Centers Have Higher Risk of Complications ePoster Presentation Logan Finger, MD, UNITED STATES Yunseo Linda Park, BS, UNITED STATES Matthew Como, BS, UNITED STATES Nicolas Aycardi, BS, UNITED STATES Kenneth Urish, MD, PhD Michael O'Malley, MD, UNITED STATES Brian Klatt, MD, UNITED STATES Johannes F. Plate, MD, PhD, UNITED STATES
An Extended-Release Sebacoyl Dinalbuphine Ester For Perioperative Pain Management In Improving Enhanced Recovery After Surgery In Total Knee Arthroplasty ePoster Presentation Jia-Lin Wu, MD, MS, TAIWAN Ching Lu, MD, TAIWAN
Clinical Outcomes Of Functional Versus Mechanical Alignment In Robotic-Arm Assisted Total Knee Arthroplasty: A Randomised Controlled Trial ePoster Presentation Simon W. Young, MD, FRACS, NEW ZEALAND Mei Lin Tay, PhD, NEW ZEALAND Kohei Kawaguchi, MD, PhD, JAPAN Bill Farrington, FRCS, NEW ZEALAND Rupert S Van Rooyen, MBChB, FRACS, NEW ZEALAND Matthew Walker, MBChB, FRACS, NEW ZEALAND Ali Bayan, MBChB, FRACS, NEW ZEALAND
Changes In Improvement Of Physical Function And Qol After Cr Type Total Knee Arthroplasty ePoster Presentation Yuki Kawaguchi, PT, JAPAN Masayoshi Okuda, MD, PhD, JAPAN Shuhei Sugioka, MD, JAPAN Yusuke Inagaki, MD, PhD, JAPAN Yasuhito Tanaka, Prof., JAPAN
Impact of Preoperative Limb Alignment and Deformity on Postoperative Limb Alignment in Unicompartmental Knee Arthroplasty ePoster Presentation Takashi Ishitani, MD, JAPAN Shuhei Otsuki, MD, JAPAN Yoshinori Okamoto, MD, PhD, JAPAN
Short-term Outcomes of Robotic-Assisted Restricted Kinematic Alignment vs Mechanical Alignment in Unilateral Total Knee Arthroplasty ePoster Presentation Eiichi Shiigi, MD、PhD, JAPAN
The Effect Of Excessive Alignment Correction And Limb Length Discrepancy After Total Knee Arthroplasty On Contralateral Lower Extremity Alignment And Knee Condition ePoster Presentation Seung Hoon Lee, MD, KOREA, REPUBLIC OF
High Incidence Of Torsional Deformities In Knee Osteoarthritis In Asian Population ePoster Presentation Xinyu Tao, MBBS, SINGAPORE Ashton Tan, MBBS, SINGAPORE Don Koh, MBBS, BSc, MRCS, MMED, SINGAPORE Kong Hwee Lee, MBBS, FRCS (Ortho), SINGAPORE Hamid Rahmatullah Bin Abd Razak, MBBS, FRCSEd (Ortho), FRCSGlasg (Tr & Orth), FAMS, SINGAPORE Junwei Soong, MBBS, MRCS (Edin), MMED (Ortho), FRCS (Edin), SINGAPORE
Changing amount of posterior tibial slope during unicompartmental knee arthroplasty does not affect short-term postoperative patients reported outcome measurement ePoster Presentation Ryo Tomita, MD, JAPAN Eiji Sasaki, MD, PhD, JAPAN Hikaru Kristi Ishibashi, MD, JAPAN Hitoshi Kudo, PhD, JAPAN Hironori Otsuka, MD, JAPAN Takahiro Tsushima, MD, PhD, JAPAN Yukiko Sakamoto, MD, PhD, JAPAN Yuka Kimura, MD, PhD, JAPAN Yasuyuki Ishibashi, MD, JAPAN
High ten years survivorship and functional results of robotic-arm-assisted lateral unicompartmental knee arthroplasty ePoster Presentation Guido Maritan, MD, ITALY Mattia Berti, MD, ITALY Federico Roman, MD, ITALY Emanuele Furlan, MD, ITALY
Visible fluid motion on manipulation as the new threshold for intraoperatively-determined knee arthroplasty component loosening – a Delphi study ePoster Presentation George Samuel Buijs, MD, NETHERLANDS Arthur Johan Kievit, MD, NETHERLANDS Alex Bastiaan Walinga, MD, NETHERLANDS Matthias U. Schafroth, MD, NETHERLANDS Michael T. Hirschmann, MD, Prof., SWITZERLAND Leendert Blankevoort, PhD, NETHERLANDS
The Effects Of The Flexion Gap Setting On Postoperative Outcomes Of Tka Using The Mako Robotic Arm ePoster Presentation Shuhei Sugioka, MD, JAPAN Masayoshi Okuda, MD, PhD, JAPAN Yuki Kawaguchi, PT, JAPAN Yasuhito Tanaka, Prof., JAPAN
An Isakos Funded Study - Physical Activity Outcomes In Patellofemoral Vs. Total Knee Replacements: A Randomised Control Trial For Isolated Patellofemoral Joint Osteoarthritis . ePoster Presentation Martinique Vella-Baldacchino, MD, MRCS, PG CERT (HEALTH LEADERSHIP), IOC DIp Spo, UNITED KINGDOM Julie Heegaard, MD, DENMARK Snorre Stephensen, MD, DENMARK Soeren Rytter , MD, DENMARK Per Wagner Kristensen, MD, DENMARK Zahid Asghar , PhD, UNITED KINGDOM Alex D Liddle, MBBS BSc DPhil FRCS(Orth), UNITED KINGDOM Justin Cobb, MCh FRCS, UNITED KINGDOM Anders Odgaard, DENMARK
Mid To Long-Term Results Of Medial Unicompartmental Knee Arthroplasty : Mobile Versus Fixed-Bearing ePoster Presentation Sumin Lim, MD, PhD, KOREA, REPUBLIC OF Jun-Young Chung, MD, KOREA, REPUBLIC OF Tae Hun Kim, MD, KOREA, REPUBLIC OF Jeong-Hyun Koh, MD, KOREA, REPUBLIC OF Jeong Sunwoo, MD, KOREA, REPUBLIC OF Myung-Sub Lee, MD, KOREA, REPUBLIC OF

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Gait Analysis Focusing On The Relationship Between Knee Biomechanics And Patient Outcome In Unilateral Total Knee Arthroplasty And Nonoperative Residual Osteoarthritis Knee

Gait Analysis Focusing On The Relationship Between Knee Biomechanics And Patient Outcome In Unilateral Total Knee Arthroplasty And Nonoperative Residual Osteoarthritis Knee

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Discussion

Knee Arthroplasty ePosters

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Gait Analysis Focusing On The Relationship Between Knee Biomechanics And Patient Outcome In Unilateral Total Knee Arthroplasty And Nonoperative Residual Osteoarthritis Knee

Gait Analysis Focusing On The Relationship Between Knee Biomechanics And Patient Outcome In Unilateral Total Knee Arthroplasty And Nonoperative Residual Osteoarthritis Knee

Introduction

Methods

Results

Discussion