Pre-surgery knee joint loading patterns during walking predict the presence and severity of anterior knee pain after total knee arthroplasty

被引:114
作者
Smith, AJ
Lloyd, DG
Wood, DJ
机构
[1] Univ Western Australia, Sch Human Movement & Exercise Sci, Crawley, WA 6009, Australia
[2] Univ Western Australia, Sch Surg & Pathol Orthopaed Human Movement & Exer, Crawley, WA 6009, Australia
[3] Univ Western Australia, Sch Surg & Pathol Orthopaed, Crawley, WA 6009, Australia
基金
英国医学研究理事会;
关键词
total knee arthroplasty; patellofemoral joint; gait analysis;
D O I
10.1016/S0736-0266(03)00184-0
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
This study tested if abnormal sagittal knee joint loading patterns after total knee arthroplasty (TKA) were present pre-surgery, and if patterns with higher external knee flexion moments were related to the presence and severity of post-surgery anterior knee pain. Gait analysis and clinical evaluation were performed on 34 patients (41 arthroplasties) both before and 12-18 months after TKA, and on 20 healthy age-matched controls at matched velocities. The majority of knees with abnormal flexor or extensor sagittal knee joint loading patterns post-surgery (18 of 26, 69%) also displayed these patterns pre-surgery. Knee joint loading in the early mid-stance phase of walking prior to surgery was identified by stepwise regression as a significant predictor of the presence (exp(beta) = 2.9 CI: 1.2-6.8, p = 0.017) and severity of post-surgery anterior knee pain (R-2 = 0.314, p = 0.019). Therefore, the frequency and severity of anterior knee pain after TKA can be partially explained by retained pre-surgery gait patterns that had higher external flexion moments in the early mid-stance phase, which place higher forces on the patellofemoral joint. (C) 2003 Orthopaedic Research Society. Published by Elsevier Ltd. All rights reserved.
引用
收藏
页码:260 / 266
页数:7
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