Rising from chair after total knee arthroplasty

Objective. This study was performed to determine the biomechanics of chair rising by patients after successful total knee arthroplasty (TKA). Design. Relative full body joint positions and ground reaction forces were measured by a motion analysis system and two force plates. Background. Chair-rise produces increased joint forces and moments compared with level walking, and it is difficult to rise from a chair for most patients with neurological or musculoskeletal abnormalities. Previous motion studies of patients after TKA had focused on gait analysis and stair climbing. Methods. Twelve patients after successful TKA were studied while performing sit-to-stand transfer from a chair at four chair heights without the use of arm rests. The results of this group were compared with those of 12 healthy elderly subjects and 14 osteoarthritic patients before TKA. Results. Compared with the healthy elderly group during chair rising, the patients after TKA had increased horizontal mass center velocity, increased vertical hip joint forces, the maximum sound-side hip extension moment, but decreased vertical mass center velocity. Conclusion. Compensatory mechanisms of chair rising were adopted by the arthritic patients before and after TKA. The mechanisms include increased forward body bending and more weight shift on the sound side. Relevance Osteoarthritic patients after successful TKA had nearly normal biomechanics in rising from a higher chair. Therefore, they are better advised to use chairs of at least the same height as their lower leg segment. (C) 1998 Elsevier Science Ltd. All rights reserved.