Verification of biomechanical factors of gait related to medial knee loading in patients 6 Months after total knee arthroplasty |
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| Institution: | 1. Department of Physical Therapy, Faculty of Social Work Studies, Josai International University, 1 Gumyo, Togane-City, Chiba-Prefecture, 283-8555, Japan;2. Department of Physical Therapy for Adults, Chiba Rehabilitation Center, 1-45-2 Hondacho Midori-ku, Chiba-City, Chiba-Prefecture, 266-0005, Japan;3. Department of Physical Therapy, Faculty of Health Sciences, Juntendo University, 2-1-1 Hongou Bunkyo-ku, Tokyo, 113-8421, Japan;4. Department of Orthopedic Surgery, Chiba Rehabilitation Center, 1-45-2 Hondacho Midori-ku, Chiba-City, Chiba-Prefecture, 266-0005, Japan;1. Department of Orthopaedics, ACS Medical College and Hospital, Dr MGR Educational and Research Institute, Chennai, 600056, Tamil Nadu, India;2. Department of Orthopaedics, Atal Bihari Vajpayee Institute of Medical Sciences, Dr Ram Manohar Lohia Hospital, New Delhi, 110001, India;3. Department of Orthopaedics, Indraprastha Apollo Hospitals, New Delhi, 110076, India;1. Department of Physiology, Christian Medical College, Vellore, India;2. Centre for Stem Cell Research, (A Unit of InStem, Bengaluru), Christian Medical College, Vellore, India;3. Department of Orthopaedics, Christian Medical College, Vellore, India;1. Department of Orthopaedic Surgery and Rehabilitation Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, USA;2. Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Keelung Branch, Keelung, 204, Taiwan;3. School of Medicine, Chang Gung University, Taoyuan, 333, Taiwan;4. Department of Orthopaedic Surgery, Brigham and Women''s Hospital, Boston, MA, USA |
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| Abstract: | BackgroundThe knee adduction moment (KAM) is considered an index for estimating the knee mechanical load, and increased KAM peak and KAM impulse are related to increased medial knee load and progression of knee joint degeneration. We aimed to verify the biomechanical factors of gait related to medial knee loading in patients 6 months after TKA.MethodsThirty-nine women who underwent TKA were enrolled. A three-dimensional gait analysis was performed 6 months postoperatively to generate data on the lower limb joint angle, moment, and power at the backward component (braking phase) and forward component (propulsion phase) peaks of the ground reaction force. Medial knee loading was evaluated using the time-integrated value of KAM during the stance period (KAM impulse). The higher the value of the KAM impulse, the higher the medial knee joint load. The relationships between the KAM impulse and the data for biomechanical factors were evaluated using partial correlation analysis with gait speed as a control factor.ResultsIn the braking phase, the KAM impulse positively correlated with the knee adduction angle (r = 0.377) and negatively correlated with the toe-out angle (r = ?0.355). The KAM impulse positively correlated with the knee adduction angle (r = 0.402), the hip flexion moment (r = 0.335), and the hip adduction moment (r = 0.565) and negatively correlated with the toe-out angle (r = ?0.357) in the propulsive phase.ConclusionThe KAM impulse 6 months after TKA was related to the knee adduction angle, hip flexion moment, hip adduction moment, and toe-out angle. These findings may provide fundamental data for controlling variable medial knee joint load after TKA and implementing patient management strategies to ensure implant durability. |
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| Keywords: | Total knee arthroplasty Gait analysis Medial knee loading Knee adduction moment impulse |
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