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

• Published in: Journal of orthopaedic research Vol. 30; no. 3; pp. 371 - 376
• Main Authors: Levinger, Pazit, Menz, Hylton B., Morrow, Adam D., Perrott, Margaret A., Bartlett, John R., Feller, Julian A., Bergman, Neil B.
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01.03.2012
• Subjects: Aged; Arthroplasty, Replacement, Knee; Biomechanical Phenomena; Female; Forecasting; Gait; gait pattern; Humans; knee biomechanics; Knee Joint - physiology; Male; Middle Aged; Postoperative Complications - physiopathology; total knee replacement
• ISSN: 0736-0266; 1554-527X
• DOI: 10.1002/jor.21545

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. © 2011 Orthopaedic Research Society Published by Wiley Periodicals, Inc. J Orthop Res 30:371–376, 2012