Knee biomechanics early after knee replacement surgery predict abnormal gait patterns 12 months postoperatively

Area of Science:

• Orthopedics
• Biomechanics
• Gait Analysis

Background:

• Abnormal flexor moment patterns are common after total knee replacement (TKR).
• Predicting these abnormal gait patterns is crucial for effective rehabilitation.
• Early identification allows for timely therapeutic interventions.

Purpose of the Study:

• To determine if pre-operative and early post-operative (4 months) biomechanical gait measures can predict gait patterns at 12 months after TKR.
• To identify specific biomechanical predictors of abnormal gait post-TKR.

Main Methods:

• Thirty-two TKR patients were assessed for gait patterns (normal biphasic vs. abnormal flexor moment) at pre-surgery, 4 months, and 12 months post-surgery.
• Biomechanical gait parameters were collected and analyzed.
• Discriminant function analysis was used to identify predictors.

Main Results:

• The gait pattern at 4 months post-surgery was significantly associated with the 12-month pattern.
• Over 50% of patients with an abnormal flexor moment pattern at 4 months maintained it at 12 months.
• Peak knee flexion during early stance, peak knee extension, and peak knee extension moment at 4 months predicted the 12-month gait pattern.

Conclusions:

• Abnormal knee flexor moment patterns 12 months after TKR can be predicted by biomechanical gait analysis performed 4 months post-surgery.
• Interventions targeting active knee extension should be implemented early in the post-operative period to improve gait.
• Early biomechanical assessment aids in personalized TKR rehabilitation strategies.