Knee biomechanics early after knee replacement surgery predict abnormal gait patterns 12 months postoperatively

Abstract

An abnormal flexor moment pattern is often evident following total knee replacement (TKR) surgery. We investigated whether such a pattern at 12 months post-surgery could be predicted using biomechanical gait measures assessed before surgery and at 4 months post-surgery. Thirty two TKR patients were evaluated and classified as normal (biphasic pattern) or abnormal (flexor moment pattern) at each time point. Biomechanical parameters collected before surgery and at 4 months post-surgery were then explored for their ability to predict gait patterns at 12 months post-surgery. The gait pattern at 4 months was significantly associated with the 12 month post-surgery gait pattern, with over half of those with a flexor moment pattern at 4 months retaining this pattern at 12 months. Discriminant function analysis indicated that peak knee flexion during early stance, peak knee extension, and peak knee extension moment at 4 months post-surgery were independent predictors of the gait pattern at 12 months. Thus, an abnormal knee flexor moment pattern at 12 months post-surgery can be predicted by biomechanical analysis 4 months after surgery. Therefore, interventions aimed at improving active extension may need to be implemented early after surgery to restore a normal gait pattern.

Predicting the location of the hip joint centres, impact of age group and sex

“…31, details in supplementary material). To assess intra-assessor repeatability, identification of all landmarks was repeated three times on the same 10 subjects (20 limbs).…”

Joint loading and proximal tibia subchondral trabecular bone microarchitecture differ with walking gait patterns in end-stage knee osteoarthritis

“…Previous research has identified distinct walking gait patterns in knee OA patients 10,11 . However, whether also joint loading indices (KAM, KAM impulse, static alignment) vary among these gait patterns, has not yet been explored.…”

Clinical Evaluation and Gait Characteristics before and after Total Knee Arthroplasty Based on a Portable Gait Analyzer

“…They found that TKA produced no change in static foot posture but did significantly alter hindfoot kinematics during gait. In that same year, they investigated whether biomechanical gait variables assessed before and at 4 months after surgery could predict an abnormal flexor moment pattern at 12 months after surgery. Interventions aimed at improving active extension may need to be implemented as early as possible after surgery to restore to a normal gait pattern and their data may help in achieving that goal.…”