We report a study of 28 women with severe primary gonarthrosis followed for 1 year. Variations in bone mineral density and in functional behaviour of knee extensors and flexors were studied before and after implantation of uncemented total knee prosthesis. A functional deficit was noted in the extensor apparatus, which increased in the first 6 months following surgery. This strength was not improved 1 year following the arthroplasty, but it was more efficient as shown by the reduction of muscle fatigue. Flexor strength was conserved and a pathological muscle balance was maintained, reaching maximum efficiency over a smaller joint range.Résumé Etude des variations de la densité minérale osseuse et du comportement des extenseurs et fléchisseurs du genou avant et après implantation d'une prothèse totale non cimentée chez 28 femmes souffrant d'une gonarthrose primaire sévère et suivies pendant une année. Un déficit fonctionnel de l'appareil de l'extenseur à été noté avant l'intervention et a augmenté dans les six premiers mois suivant la chirurgie. La force d'extension n'était pas améliorée une année après l'arthroplastie, mais l'action était meilleure à cause d'une moindre fatiguabilité du muscle. La force des fléchisseurs a été conservée et un équilibre musculaire a été maintenu, en arrivant à l'efficacité maximale sur une plus petite amplitude articulaire.
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