Evolution of knee kinematics three months after total knee replacement

In patients with debilitating knee osteoarthritis, total knee replacement is the most common surgical procedure. Numerous studies have demonstrated that knee kinematics one year after total knee replacement are still altered compared to the healthy joint. However, little is known regarding impairments and functional limitations of patients several months after total knee replacement. The aim of this study was to describe the evolution of the knee gait kinematic in patients with knee osteoarthritis before and three months after a total knee replacement. Ninety patients who were to undergo total knee replacement were included in this study. Twenty-three subjects were recruited as the control group. Three-dimensional gait analysis was performed before and three months after surgery. The spatio-temporal parameters and three-dimensional knee kinematics for the operated limb were evaluated during a comfortable gait and compared between groups (the before and after surgery groups and the control group). Three months after surgery, patients always walk with a slower gait velocity and lower knee flexion-extension movements compared to the control group. However, a degree of progress was observed in term of the stride and step length, gait velocity and knee alignment in the coronal plane. Our results suggest that the disability is still significant for most patients three months after total knee replacement. A better understand of the impairments and functional limitations following surgery would help clinicians design rehabilitation programs. Moreover, patients should be informed that rehabilitation after total knee replacement is a long process.