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Lower limb proprioception deficits persist following knee replacement surgery despite improvements in knee extension strength

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Knee pain and disability can persist following knee replacement surgery which may place patients at increased risk of falls. This study investigated the falls risk and the occurrence of falls of people with knee osteoarthritis (OA) before and at 12 months following knee replacement surgery.

Method

Thirty-five patients with knee OA were tested prior to undergoing knee replacement surgery and at 12 months following surgery using the short form Physiological Profile Assessment, which incorporates tests of vision, lower limb proprioception, knee extension strength, reaction time and postural sway. Physical activity, number of falls, fear of falling, pain, disability and health-related quality of life were also assessed.

Results

No significant differences were found between the number of falls pre- and post-surgery (n.s.), with 48.5 and 40% reporting at least one fall in the 12 months before and following the surgery, respectively. Improvements in knee strength, reaction time and fear of falling were evident following surgery, with no improvement in lower limb proprioception. Self-reported pain, function and stiffness were significantly improved, but health-related quality of life deteriorated following the surgery.

Conclusion

The number of falls experienced following knee replacement surgery remained relatively high, which may be attributed to the persistence of impaired lower limb proprioception. Although knee replacement surgery improves function and alleviates pain, people who undergo this procedure may need to engage in rehabilitation following the surgery to reduce the risk of falling.

Level of evidence

Therapeutic study investigating the result of treatment on patient outcomes, Level IV.

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Acknowledgments

This study was funded by the Clive and Vera Ramaciotti Foundation and the Arthritis Australia. HBM is currently a National Health and Medical Research Council fellow (Clinical Career Development Award, ID: 433049). The authors would like to thank Margaret Perrott for her assistance in the data collection.

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Authors and Affiliations

  1. Musculoskeletal Research Centre, Faculty of Health Sciences, La Trobe University, Bundoora, VIC, 3086, Australia

    Pazit Levinger, Hylton B. Menz, Adam D. Morrow, Elin Wee & Julian A. Feller

  2. Warringal Private Medical Centre, Heidelberg, VIC, 3084, Australia

    John R. Bartlett & Neil Bergman

Authors
  1. Pazit Levinger
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  2. Hylton B. Menz
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  3. Adam D. Morrow
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  4. Elin Wee
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  5. Julian A. Feller
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  6. John R. Bartlett
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  7. Neil Bergman
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Correspondence to Pazit Levinger.

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Levinger, P., Menz, H.B., Morrow, A.D. et al. Lower limb proprioception deficits persist following knee replacement surgery despite improvements in knee extension strength. Knee Surg Sports Traumatol Arthrosc 20, 1097–1103 (2012). https://doi.org/10.1007/s00167-011-1710-y

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  • DOI: https://doi.org/10.1007/s00167-011-1710-y

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