Total knee arthroplasty for patients with medial knee osteoarthritis improves trunk movement during gait

J Back Musculoskelet Rehabil. 2020;33(5):727-734. doi: 10.3233/BMR-181383.

Abstract

Background: Previous studies have indicated that the kinematics of the knee joint affect the trunk and pelvis during gait. However, the factors that influence trunk movement in knee osteoarthritis patients during gait after surgery remain unclear.

Objective: To examine the effect of total knee arthroplasty (TKA) on trunk movement during gait by comparing knee osteoarthritis patients with healthy controls.

Methods: Fourteen medial knee osteoarthritis patients who underwent initial unilateral TKA and 11 controls participated in this study. Knee and hip joint flexion and trunk and pelvic tilts during gait were acquired using a three-dimensional motion analysis system. Knee joint range of motion, pain, and kinematic data were collected preoperatively and 1 year postoperatively for knee osteoarthritis patients.

Results: Knee extension limitation and pain significantly improved postoperatively compared with preoperative stages. Preoperatively, the peak anterior trunk tilt during the stance phase was significantly larger in osteoarthritis patients than in controls. The peak anterior trunk tilt during the stance phase was significantly smaller postoperatively than at preoperative stages.

Conclusions: These results suggest that after TKA, the trunk movements of knee osteoarthritis patients were approximately equal to those of controls, with improvement in clinical outcomes such as knee extension limitation and pain.

Keywords: Knee osteoarthritis; gait analysis; pelvic alignment; sagittal alignment; spinal alignment; total knee arthroplasty.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Knee*
  • Biomechanical Phenomena / physiology
  • Female
  • Gait / physiology*
  • Humans
  • Knee / physiopathology
  • Knee Joint / physiopathology
  • Knee Joint / surgery*
  • Male
  • Osteoarthritis, Knee / physiopathology
  • Osteoarthritis, Knee / surgery*
  • Postoperative Period
  • Range of Motion, Articular / physiology*
  • Torso / physiopathology