Frontal plane biomechanics of the operated and non-operated knees before and after unilateral total knee arthroplasty.
BACKGROUND
After unilateral total knee arthroplasty, frontal plane loading patterns on the operated knee remain pathological in the long term, but it is unclear how they change in the early postoperative period. Additionally, researchers have suggested that the non-operated knee bears greater frontal plane loads postoperatively, but this effect is unclear. The objective of the present study was to compare the preoperative and early postoperative frontal plane loading patterns of both knees after unilateral total knee arthroplasty.


METHODS
Fifty patients with end-stage knee osteoarthritis were examined prior to and six weeks after surgery. Patients underwent a three-dimensional gait analysis that determined the frontal plane loading patterns of knee varus angle and knee adduction moment during gait, and completed self-evaluative questionnaires and functional tests.


RESULTS
There were no significant loading differences between limbs preoperatively. The operated knee showed large reductions in varus angle and adduction moment after surgery (all p<0.001). The non-operated knee showed no increases in varus angle or adduction moment, but did show a small reduction in the adduction moment (p<0.001). Both knees showed reduction in pain after surgery (p<0.001) and the operated Knee Society Score improved after surgery (p=0.01).


CONCLUSIONS
Total knee arthroplasty reduces frontal plane loading in the operated knee and does not worsen frontal plane loading in the non-operated knee. Therapy after surgery should focus on retaining the reduction in knee adduction moment in the operated knee and preventing further worsening loading patterns in the non-operated knee.
Biorobotics and Biomechanics Lab, Faculty of Mechanical Engineering, Technion Israel Institute of Technology, Haifa, Israel. Electronic address: eytan.debbi@aya.yale.edu.
Eytan M
EM
Debbi
Department of Orthopedic Surgery, Carmel Medical Center, Haifa, Israel.
Benjamin
B
Bernfeld
Department of Orthopedics and Talpiot Medical Leadership program, Sheba Medical Center, Tel Aviv, Israel.
Amir
A
Herman
Department of Physical Therapy, Faculty of Social Welfare and Health Studies, University of Haifa, Haifa, Israel.
Yocheved
Y
Laufer
Department of Orthopedics, Rambam Health Care Campus, Haifa, Israel.
Arnan
A
Greental
Department of Orthopedics, Rambam Health Care Campus, Haifa, Israel.
Amit
A
Sigal
Department of Orthopedic Surgery, Carmel Medical Center, Haifa, Israel.
Yaron
Y
Zaulan
Division of Orthopedics, Sourasky Medical Center, Tel Aviv, Israel.
Moshe
M
Salai
Biorobotics and Biomechanics Lab, Faculty of Mechanical Engineering, Technion Israel Institute of Technology, Haifa, Israel.
Amir
A
Haim
Biorobotics and Biomechanics Lab, Faculty of Mechanical Engineering, Technion Israel Institute of Technology, Haifa, Israel.
Alon
A
Wolf
D000368:Aged; D019645:Arthroplasty, Replacement, Knee; D001696:Biomechanical Phenomena; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000503:physiopathology* / Q000601:surgery*; D010146:Pain / Q000503:physiopathology / Q000517:prevention & control; D011184:Postoperative Period; D011795:Surveys and Questionnaires
Coronal; Frontal; Kinematics; Kinetics; Non-operated; Total knee arthroplasty