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Courses of change in knee adduction moment and lateral thrust differ up to 1 year after TKA

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

Abstract

Purpose

In total knee arthroplasty (TKA), dynamic knee loading may loosen the artificial joint and bone or cause polyethylene wear after prolonged use. TKA decreases knee adduction moment at 6 months, but this effect is lost by 1 year post-operatively. However, lateral thrust after TKA has not been clarified. We hypothesized that like knee adduction moment, lateral thrust would return to baseline levels by 1 year post-operatively.

Methods

Participants were 15 patients who underwent TKA for medial knee OA. Japanese Orthopaedic Association (JOA) score, numeric rating scale, and gait analysis (measurement of peak knee adduction moment, knee varus angle at peak knee adduction moment, lateral thrust, and gait speed) were performed preoperatively (baseline) and 3 weeks, 3 and 6 months, and 1 year post-operatively.

Results

JOA score improved from 55 ± 9.8 to 78 ± 12.1 at 1 year post-operatively, and pain decreased significantly from baseline at each follow-up (p < 0.001). Significant increases in gait speed were observed at 6 months and 1 year (p < 0.001). Peak knee adduction moment during stance phase was significantly lower at 3 weeks, 3 months, and 6 months compared to baseline (p < 0.05), but no significant changes were seen at 1 year. Knee varus at peak knee adduction moment did not differ significantly between any measurement points, while lateral thrust was decreased at 6 months and 1 year compared to baseline (p < 0.05).

Conclusions

Temporal courses of changes up to 1 year after TKA differed between knee adduction moment and lateral thrust, so our hypothesis was rejected.

Level of evidence

IV.

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Acknowledgments

We wish to thank all Hiroshima University Hospital Orthopedic Surgery staff for their assistance in our study.

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Authors and Affiliations

  1. Clinical Practice and Support Department, Hiroshima University Hospital, Hiroshima, Japan

    Noboru Shimada, Kazuhiko Hirata, Yasuhiko Hiate, Naoya Orita, Daisuke Iwaki & Yoshihiro Ito

  2. Institute of Biomedical and Health Sciences, Graduate School of Health Sciences, Hiroshima University, Hiroshima, Japan

    Masataka Deie

  3. Department of Rehabilitation Medicine, Hiroshima University Hospital, Hiroshima, Japan

    Hiroaki Kimura

  4. Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Sydney, Australia

    Evangelos Pappas

  5. Department of Orthopedic Surgery, Hiroshima University, Hiroshima, Japan

    Mitsuo Ochi

Authors
  1. Noboru Shimada
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  2. Masataka Deie
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  3. Kazuhiko Hirata
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  4. Yasuhiko Hiate
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  7. Yoshihiro Ito
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  8. Hiroaki Kimura
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  9. Evangelos Pappas
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Corresponding author

Correspondence to Masataka Deie.

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Shimada, N., Deie, M., Hirata, K. et al. Courses of change in knee adduction moment and lateral thrust differ up to 1 year after TKA. Knee Surg Sports Traumatol Arthrosc 24, 2506–2511 (2016). https://doi.org/10.1007/s00167-015-3688-3

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  • DOI: https://doi.org/10.1007/s00167-015-3688-3

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