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Joint loading asymmetries in knee replacement patients observed both pre- and six months post-operation

Joint loading asymmetries in knee replacement patients observed both pre- and six months post-operation
Joint loading asymmetries in knee replacement patients observed both pre- and six months post-operation
Background
Studies have highlighted asymmetries in knee joint moments during activities of daily living in individuals with osteoarthritis and joint replacements. However, there is a need to investigate the forces at the knee joints in order to establish the extent of loading asymmetry.

Methods
Twenty healthy (mean, 62; range, 55-79 years of age) and 34 pre- to post-knee arthroplasty (mean, 64; range, 39-79 years of age) participants performed gait and sit-stand activities in a motion capture laboratory. Testing was conducted 4 weeks pre- and 6 months post- knee arthroplasty. Knee joint forces and moments were predicted using inverse dynamics and used to calculate peak loading and impulse data which were normalized to body weight. Comparisons were made in loading between affected and contralateral limbs, and changes from pre- to post-knee arthroplasty.

Findings
Pre-knee arthroplasty mean peak vertical knee forces were greater in the contralateral limb compared to the affected limb during both gait 3.5*body weight vs. 3.2*body weight and sit-stand 1.8*body weight vs. 1.5*body weight. During gait, peak knee adduction moment asymmetries significantly changed from pre- to post-knee arthroplasty (-0.3 to 0.8*% Body weight*m*Height), although differences in vertical knee forces remained. The sit-stand activity showed vertical ground reaction asymmetries slightly increased post- knee arthroplasty (from 0.06*body weight pre- to 0.08*body weight post). The healthy participants showed no noteworthy asymmetries.

Interpretation
This study showed loading asymmetry of the ground reaction and tibio-femoral forces between affected and contralateral limbs both pre- post-knee arthroplasty. Continued over reliance of the contralateral limb could lead to pathology.

knee arthroplasty, inverse dynamics, joint kinetics, asymmetry
0268-0033
Worsley, Peter
6d33aee3-ef43-468d-aef6-86d190de6756
Stokes, M.
71730503-70ce-4e67-b7ea-a3e54579717f
Barrett, D.S.
cbaaf354-cc75-42d4-980c-0a8797db5b4c
Taylor, M.
e368bda3-6ca5-4178-80e9-41a689badeeb
Worsley, Peter
6d33aee3-ef43-468d-aef6-86d190de6756
Stokes, M.
71730503-70ce-4e67-b7ea-a3e54579717f
Barrett, D.S.
cbaaf354-cc75-42d4-980c-0a8797db5b4c
Taylor, M.
e368bda3-6ca5-4178-80e9-41a689badeeb

Worsley, Peter, Stokes, M., Barrett, D.S. and Taylor, M. (2013) Joint loading asymmetries in knee replacement patients observed both pre- and six months post-operation. Clinical Biomechanics. (doi:10.1016/j.clinbiomech.2013.07.014). (PMID:23968817)

Record type: Article

Abstract

Background
Studies have highlighted asymmetries in knee joint moments during activities of daily living in individuals with osteoarthritis and joint replacements. However, there is a need to investigate the forces at the knee joints in order to establish the extent of loading asymmetry.

Methods
Twenty healthy (mean, 62; range, 55-79 years of age) and 34 pre- to post-knee arthroplasty (mean, 64; range, 39-79 years of age) participants performed gait and sit-stand activities in a motion capture laboratory. Testing was conducted 4 weeks pre- and 6 months post- knee arthroplasty. Knee joint forces and moments were predicted using inverse dynamics and used to calculate peak loading and impulse data which were normalized to body weight. Comparisons were made in loading between affected and contralateral limbs, and changes from pre- to post-knee arthroplasty.

Findings
Pre-knee arthroplasty mean peak vertical knee forces were greater in the contralateral limb compared to the affected limb during both gait 3.5*body weight vs. 3.2*body weight and sit-stand 1.8*body weight vs. 1.5*body weight. During gait, peak knee adduction moment asymmetries significantly changed from pre- to post-knee arthroplasty (-0.3 to 0.8*% Body weight*m*Height), although differences in vertical knee forces remained. The sit-stand activity showed vertical ground reaction asymmetries slightly increased post- knee arthroplasty (from 0.06*body weight pre- to 0.08*body weight post). The healthy participants showed no noteworthy asymmetries.

Interpretation
This study showed loading asymmetry of the ground reaction and tibio-femoral forces between affected and contralateral limbs both pre- post-knee arthroplasty. Continued over reliance of the contralateral limb could lead to pathology.

Text
Worsley et al Clin Biomech 2013.pdf - Other
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More information

e-pub ahead of print date: 6 August 2013
Keywords: knee arthroplasty, inverse dynamics, joint kinetics, asymmetry
Organisations: Faculty of Health Sciences, Bioengineering Group

Identifiers

Local EPrints ID: 355642
URI: http://eprints.soton.ac.uk/id/eprint/355642
ISSN: 0268-0033
PURE UUID: a20cb637-4144-4094-bb8b-7c9076976c87
ORCID for Peter Worsley: ORCID iD orcid.org/0000-0003-0145-5042
ORCID for M. Stokes: ORCID iD orcid.org/0000-0002-4204-0890

Catalogue record

Date deposited: 03 Sep 2013 10:27
Last modified: 03 Dec 2019 01:51

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