Non-Sagittal Knee Joint Kinematics and Kinetics during Gait on Level and Sloped Grounds with Unicompartmental and Total Knee Arthroplasty Patients

Igor Komnik; Markus Peters; Johannes Funken; Sina David; Stefan Weiss; Wolfgang Potthast

doi:10.1371/journal.pone.0168566

Non-Sagittal Knee Joint Kinematics and Kinetics during Gait on Level and Sloped Grounds with Unicompartmental and Total Knee Arthroplasty Patients

PLoS One. 2016 Dec 21;11(12):e0168566. doi: 10.1371/journal.pone.0168566. eCollection 2016.

Authors

Igor Komnik¹, Markus Peters¹, Johannes Funken¹, Sina David¹, Stefan Weiss², Wolfgang Potthast¹

Affiliations

¹ Institute for Biomechanics and Orthopaedics, German Sport University Cologne, Cologne, Nordrhein-Westfalen, Germany.
² ARCUS Clinics Pforzheim, Pforzheim, Baden-Württemberg, Germany.

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.

MeSH terms

Activities of Daily Living
Aged
Arthroplasty, Replacement, Knee*
Biomechanical Phenomena
Female
Humans
Kinetics
Knee Joint / physiology*
Knee Joint / surgery
Locomotion
Male
Middle Aged
Range of Motion, Articular
Walking / physiology*

Grants and funding

The study was supported by ARCUS Clinics Pforzheim. All knee arthroplasty subjects, who participated in the current study, were 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 specific roles of SW are articulated in the “author contributions” section. 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. "Verein für Wissenschaft und Weiterbildung in der Orthopädie e.V." (English: “Science and Advanced Training Society in the field of orthopedics”) funded the knee arthroplasty subject’s accommodation and travel costs to Cologne (http://www.sportklinik.de/wissenschaft_publikation/). The funder did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.