Knee biomechanics and contralateral knee osteoarthritis progression after total knee arthroplasty
| Autor: | Jesse C. Christensen, Jeremy R. Crenshaw, Moiyad Aljehani, Lynn Snyder-Mackler, Joseph A. Zeni, Allison M. Brown |
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| Rok vydání: | 2022 |
| Předmět: |
musculoskeletal diseases
medicine.medical_specialty Knee Joint Knee biomechanics Radiography Biophysics Total knee arthroplasty Osteoarthritis Logistic regression Article Physical medicine and rehabilitation Contralateral knee medicine Humans Knee Orthopedics and Sports Medicine Arthroplasty Replacement Knee business.industry Rehabilitation Biomechanics Osteoarthritis Knee musculoskeletal system medicine.disease Gait Biomechanical Phenomena business |
| Zdroj: | Gait Posture |
| ISSN: | 0966-6362 |
| DOI: | 10.1016/j.gaitpost.2021.10.020 |
| Popis: | Background Despite the success rate of Total Knee Arthroplasty (TKA), many patients undergo contralateral TKA. It is possible that altered gait mechanics after unilateral TKA play a role in the progression of contralateral OA progression. Research question The purpose of this study was to identify biomechanical predictors of radiographic OA progression in the contralateral (non-surgical) knee after unilateral (primary/initial) TKA. In addition, this study quantified for patients who had contralateral OA progression. Methods Biomechanical outcomes were collected 6–24 months after unilateral primary TKA and were used to predict changes in contralateral OA severity at follow-up. Participants were divided into “Progressor” and “Non-Progressor” groups based on changes in Kellgren-Lawrence (KL) OA grade and Joint Space Width (JSW) between baseline and follow-up testing sessions. Biomechanical factors during walking were peak knee adduction moment, knee flexion/extension excursions, knee angle at initial foot contact, and peak knee flexion/extension. Multiple independent t-tests were used to examine the magnitude of differences in biomechanical variables between the groups. Logistic regression was used to examine the association between the biomechanical predictors and change in KL scores and JSW. Results The mean time between surgery and follow-up x-rays was 8.8 (2.4) years. Of 40 participants, 62.5–78% had contralateral radiographic knee OA progression by follow-up. There were no significant differences in the biomechanical variables between groups. For the regression analysis, none of the biomechanical variables were found to be predictors for contralateral OA progression. Significance Although abnormal biomechanics are known risk factors for primary knee OA, it is possible that the mechanisms that result in OA progression of the contralateral limb are different than primary knee OA progression. Future work should evaluate other objective measures of OA progression and determine if cumulative measures of joint loading are related to OA worsening. |
| Databáze: | OpenAIRE |
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