Abstract
After knee arthroplasty (KA) surgery, patients experience abnormal kinematics and kinetics during numerous activities of daily living. Biomechanical investigations have focused primarily on level walking, whereas walking on sloped surfaces, which is stated to affect knee kinematics and kinetics considerably, has been neglected to this day. This study aimed to analyze over-ground walking on level and sloped surfaces with a special focus on transverse and frontal plane knee kinematics and kinetics in patients with KA. A three-dimensional (3D) motion analysis was performed by means of optoelectronic stereophogrammetry 1.8 ± 0.4 years following total knee arthroplasty (TKA) and unicompartmental arthroplasty surgery (UKA). AnyBody™ Modeling System was used to conduct inverse dynamics. The TKA group negotiated the decline walking task with reduced peak knee internal rotation angles compared with a healthy control group (CG). First-peak knee adduction moments were diminished by 27% (TKA group) and 22% (UKA group) compared with the CG during decline walking. No significant differences were detected between the TKA and UKA groups, regardless of the locomotion task. Decline walking exposed apparently more abnormal knee frontal and transverse plane adjustments in KA patients than level walking compared with the CG. Hence, walking on sloped surfaces should be included in further motion analysis studies investigating KA patients in order to detect potential deficits that might be not obvious during level walking.
Highlights
In recent years, studies in the field of knee arthroplasty (KA) research have shown abnormal gait characteristics during various activities of daily living (ADL)[1,2,3]
No statistically significant differences were detected between the total knee arthroplasty (TKA) and UKA groups, regardless of the locomotion tasks and parameters investigated (Tables 2 and 3)
The TKA and UKA groups showed considerably lower peak internal rotation values for the operated knee compared with the control group (CG) during decline walking [6.8 ̊ (TKA, p = 0.012) and 4.4 ̊ (UKA)], whereby the difference was statistically significant only between the TKA group and the CG (Fig 1)
Summary
Studies in the field of KA research have shown abnormal gait characteristics during various activities of daily living (ADL)[1,2,3]. Motion Analysis with Knee Arthroplasty Patients during Walking on Sloped and Level Grounds operated in the mentioned institution. ARCUS Clinics Pforzheim provided support in the form of salary for the author SW, but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The graduate college of the German Sport University funded the PhD studies for the corresponding author IK in the form of salary (http://www.dshskoeln.de/visitenkarte/einrichtung/ graduiertenkolleg-mechanobiologie/). The funder did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript
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