title: The effect of knee flexion contracture following total knee arthroplasty on the energy cost of walking.
abstract: This study evaluated the energy cost of walking (Cw) with knee flexion contractures (FC) simulated with a knee brace, in total knee arthroplasty (TKA) recipients (n=16) and normal controls (n=15), and compared it to baseline (no brace). There was no significant difference in Cw between the groups at baseline but TKA recipients walked slower (P=0.048) and with greater knee flexion in this condition (P=0.003). Simulated FC significantly increased Cw in both groups (TKA P=0.020, control P=0.002) and this occurred when FC exceeded 20° in the TKA group and 15° in the controls. Reported perceived exertion was only significantly increased by FC in the control group (control P<0.001, TKA P=0.058). Simulated knee FCs less than 20° do not increase Cw or perceived exertion in TKA recipients.
authors.affiliation: Mater Research, Mater Health Services, South Brisbane, Australia.
authors.forename: Michael T
authors.initials: MT
authors.lastname: Murphy
authors.forename: Tina L
authors.initials: TL
authors.lastname: Skinner
authors.forename: Andrew G
authors.initials: AG
authors.lastname: Cresswell
authors.forename: Ross W
authors.initials: RW
authors.lastname: Crawford
authors.forename: Simon F
authors.initials: SF
authors.lastname: Journeaux
authors.forename: Trevor G
authors.initials: TG
authors.lastname: Russell
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D001696:Biomechanical Phenomena; D003286:Contracture / Q000209:etiology / Q000503:physiopathology*; D004734:Energy Metabolism; D005260:Female; D005684:Gait / Q000502:physiology; D006801:Humans; D007592:Joint Diseases / Q000503:physiopathology / Q000601:surgery*; D007719:Knee Joint / Q000503:physiopathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D010101:Oxygen Consumption; D005082:Physical Exertion / Q000502:physiology*; D016059:Range of Motion, Articular; D016138:Walking / Q000502:physiology*
keywords: energy cost; flexion contracture; gait; total knee arthroplasty