Document Detail

Does total knee arthroplasty change frontal plane knee biomechanics during gait?
MedLine Citation:
PMID:  22125248     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Dynamic knee varus angle and adduction moments have been reported to be reduced after TKA. However, it is unclear whether this reduction is maintained long term.
QUESTIONS/PURPOSES: We therefore asked whether (1) the dynamic knee adduction angle and moment remain reduced 1 year after TKA, (2) if changes in adduction moment are related to static alignment and varus angle during gait 6 months and 1 year after TKA, and (3) if these changes in loading pattern are related to changes in Knee Society scores.
METHODS: We performed gait analysis on 15 patients (17 TKAs) before surgery and 6 months and 1 year after TKA. Weightbearing radiographs were used to assess coronal plane knee alignment.
RESULTS: TKA corrected static knee alignment from 2.2° (2.5°) varus to 3.5° (2.7°) valgus at 6 months. Peak varus angle during gait was reduced from 9.7° (6.5°) to 3.6° (5.8°) at 6 months and 5.2° (7.6°) at 1 year. Peak adduction moment was reduced to 85% of the preoperative level at 6 months but increased to 94% of the preoperative level at 1 year. We observed a correlation between the increase in dynamic varus angle and increase in adduction moment from the 6-month to 1-year followups.
CONCLUSIONS: TKA improves knee adduction moment at 6 months, but this effect is lost with time (1 year).
CLINICAL RELEVANCE: Despite restoration of static knee alignment, knee adduction moment remains high presumably predisposing to medial polyethylene wear as noted by retrieval studies.
Karl F Orishimo; Ian J Kremenic; Ajit J Deshmukh; Stephen J Nicholas; Jose A Rodriguez
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Publication Detail:
Type:  Journal Article     Date:  2011-11-29
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  470     ISSN:  1528-1132     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-03-06     Completed Date:  2012-05-16     Revised Date:  2013-06-27    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1171-6     Citation Subset:  AIM; IM    
Nicholas Institute of Sports Medicine and Athletic Trauma, Lenox Hill Hospital, 100 E 77th Street, 2nd Floor, New York, NY 10075, USA.
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MeSH Terms
Arthroplasty, Replacement, Knee*
Biomechanics / physiology*
Gait / physiology*
Knee / physiology*,  surgery
Knee Joint / physiology*,  surgery
Middle Aged
Osteoarthritis, Knee / physiopathology,  surgery*
Range of Motion, Articular / physiology

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