The effect of total knee replacement surgery on gait stability

Area of Science:

• Biomedical Engineering
• Orthopedics
• Kinesiology

Background:

• Knee osteoarthritis (OA) is a prevalent condition leading to pain and functional limitations.
• Gait instability is a common consequence of knee OA, affecting daily activities and quality of life.
• Total knee replacement (TKR) is a surgical intervention aimed at alleviating pain and restoring function in severe OA.

Purpose of the Study:

• To investigate the effects of knee pain and TKR surgery on gait stability in knee OA patients.
• To compare gait parameters between TKR patients and healthy controls before and after surgery.

Main Methods:

• Gait spatio-temporal measures and center of mass (COM) kinematics were assessed in 21 TKR subjects and 21 controls.
• Data were collected during level walking and obstacle crossing at two time points: pre-surgery (P1) and 6 months post-surgery (P2).
• Pain and disability levels were also recorded for all participants.

Main Results:

• TKR patients reported higher pain and disability than controls at both P1 and P2.
• TKR patients exhibited slower walking speeds, slower obstacle negotiation, and shorter stride lengths compared to controls.
• Post-surgery, TKR patients showed significantly reduced COM-COP separation distance and peak anterior inclination angle.
• Pain correlated significantly with sagittal plane gait measures, but not frontal plane measures.

Conclusions:

• Total knee replacement surgery and associated pain predominantly affect sagittal plane gait stability variables.
• TKR patients adopt a conservative gait strategy, likely to minimize kinetic demands on the operated limb.
• The findings highlight the complex interplay between pain, surgical intervention, and gait biomechanics in knee OA.