Alterations in neuromuscular patterns between pre and one-year post-total knee arthroplasty

Area of Science:

• Orthopedics
• Biomechanics
• Rehabilitation Science

Background:

• Total knee arthroplasty (TKA) is a common procedure for severe knee osteoarthritis.
• Objective functional and joint loading measures are crucial, especially for younger patients.
• Assessing neuromuscular activation pre- and post-TKA is vital for understanding surgical outcomes.

Purpose of the Study:

• To compare knee muscle neuromuscular activation patterns before and after TKA during level walking.
• To evaluate the impact of TKA on gait biomechanics and muscle function.

Main Methods:

• Surface electromyography (sEMG) recorded from seven periarticular muscles in 43 patients.
• Principal component analysis (PCA) extracted activation patterns from sEMG data.
• Statistical comparison of muscle activation patterns at one week pre- and one year post-TKA.

Main Results:

• Reduced quadriceps and hamstring activation amplitudes observed post-TKA, particularly during mid-late stance.
• Increased gastrocnemius activity and altered waveform shapes noted in the late stance phase.
• Post-surgical changes generally shifted towards patterns seen in asymptomatic individuals.

Conclusions:

• TKA surgery promotes improved neuromuscular strategies during walking, moving towards more typical patterns.
• Enhanced gait mechanics and reduced pain likely contribute to these positive post-surgical changes.
• Findings offer objective data for evaluating TKA techniques, prostheses, and patient management.