Preoperative asymmetry in load distribution during quiet stance persists following total knee arthroplasty

Knee Surg Sports Traumatol Arthrosc. 2014 Mar;22(3):609-14. doi: 10.1007/s00167-013-2616-7. Epub 2013 Jul 24.

Abstract

Purpose: Preoperative function has been shown to persist posttotal knee arthroplasty. However, it remains unclear whether asymmetries are task specific. Therefore, we investigated postoperative asymmetries in loading during quiet stance and walking gait.

Methods: Ten patients with end-stage knee osteoarthritis scheduled for total knee arthroplasty were studied at baseline (preoperative), 6-week, 3- and 6-month postoperative. Load distribution and balance were quantified during quiet stance. Furthermore, dynamic loading was quantified during walking gait. Patient satisfaction was assessed using the Knee Osteoarthritis and injury Outcome Score.

Results: Preoperatively, load distribution was significantly different between limbs, with approximately 70% of the load through the contralateral or 'good' side. Asymmetries persisted and up to 6-month postoperative during quiet stance. No significant change was found in balance. During walking, preoperative loading asymmetry was present; however, no significant postoperative loading asymmetries were identified.

Conclusions: Total knee arthroplasty does not appear to significantly change load distribution or balance 6-month postoperative during quiet stance; however, during walking gait, symmetry appears to be restored. This could be potentially improved through enhanced rehabilitation.

Level of evidence: Therapeutic study, Level IV.

Publication types

  • Clinical Trial

MeSH terms

  • Aged
  • Arthroplasty, Replacement, Knee*
  • Female
  • Gait / physiology*
  • Humans
  • Knee Joint / physiopathology*
  • Knee Joint / surgery
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Osteoarthritis, Knee / physiopathology
  • Osteoarthritis, Knee / surgery*
  • Patient Satisfaction
  • Postoperative Period
  • Postural Balance / physiology*
  • Preoperative Period
  • Prospective Studies
  • Treatment Outcome
  • Walking / physiology*
  • Weight-Bearing