Article

Previous research suggests that most people who have undergone total knee
replacement (TKR) walk with a sagittal knee moment profile and peak knee moments
that are different from normal. However, most previous research has consisted of
small samples of patients with prostheses that are no longer in use. The aim of
this study was to compare the peak knee moments and patterns of the moment
waveforms of walking at different speeds between a large cohort of TKR patients
with the Genesis-II PS prosthesis (Smith and Nephew, Memphis, USA) and matched
control participants. Forty patients 12months following TKR and 40 control
participants were assessed during walking at self-selected comfortable and fast
speeds using motion analysis. Individual sagittal plane knee moment graphs were
assessed for the presence of a biphasic pattern. Peak sagittal and coronal plane
knee moments were compared between groups using a univariate ANOVA with walking
speed as a covariate. A biphasic moment pattern was present in 87% and 92% of TKR
patients when walking at comfortable and fast speeds, respectively. The knee
flexor (p<0.001 at both speeds), extensor (p=0.004 at comfortable speed and
p<0.001 at fast speed) and adductor (p<0.001 at both speeds) moments were reduced
in the TKR patients. The high proportion of TKR patients with biphasic moment
patterns was unexpected, but suggests that modern prostheses can result in more
normal outcomes. Nonetheless, the peak knee moments of patients were reduced
compared to controls. Although these reductions may be beneficial to the survival
of the prosthesis, these abnormalities may also indicate suboptimal functional
outcome from TKR.
CI - Crown Copyright 2010. Published by Elsevier B.V. All rights reserved.

Langue : ANGLAIS