Sex Differences in Gait After Total Knee Arthroplasty

Area of Science:

• Orthopedics
• Biomechanics
• Biomedical Engineering

Background:

• Pre-operative walking biomechanics differ between males and females.
• It remains unclear if these sex-specific patterns persist after total knee arthroplasty (TKA).
• Understanding post-TKA biomechanics is crucial for assessing surgical outcomes.

Purpose of the Study:

• To compare post-TKA knee biomechanics in males and females.
• To evaluate if sex-specific biomechanical profiles are maintained after TKA.
• To compare TKA patient biomechanics with unimpaired controls.

Main Methods:

• Observational cohort study including 85 TKA patients (44 females, 41 males) and 39 controls (21 females, 18 males).
• Participants were assessed at least 12 months post-unilateral TKA.
• Three-dimensional motion analysis was used to capture walking biomechanics at comfortable speeds.

Main Results:

• Significant differences in key walking biomechanics were observed between males with TKA and male controls (P < .01).
• No significant biomechanical differences were found between females with TKA and female controls.
• Females with TKA exhibited biomechanics closer to those of unimpaired females.

Conclusions:

• Sex-specific biomechanical profiles are maintained following total knee arthroplasty.
• Females with TKA demonstrate biomechanics closer to normal compared to males.
• Future research should analyze TKA outcomes separately for males and females to avoid underestimation of female outcomes.