Skip to main content

Advertisement

SpringerLink
Log in

Postural stability in relation to anthropometric and functional characteristics in women with knee osteoarthritis following total knee arthroplasty

  • Knee Arthroplasty
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

Due to the controversial information about postural stability in patients with lower limb joints osteoarthritis (OA), the following main questions are raised: how serious is the postural stability disturbance and which factors have an impact on postural stability before and after total knee arthroplasty (TKA).

Materials and methods

Force plate was used to assess postural stability and custom-made dynamometer was used to assess isometric maximal voluntary contraction (MVC) force of leg extensor muscles; besides, knee pain and knee range of motion (ROM) was evaluated in 14 female patients (aged 46–68 years) with knee OA 1 day before, and 3 and 6 months following TKA and once in healthy controls (aged 48–70). Relationship between postural stability during standing and selected anthropometric and functional characteristics were investigated with Spearman’s correlation coefficients.

Results

Remarkable reduction of knee pain and improvement in active ROM for the operated leg were shown after unilateral TKA. MVC force of leg extensor muscles achieved the preoperative level half a year after TKA. The centre of pressure (COP) of sway displacement in anterioposterior (AP) and mediolateral direction and the equivalent area of COP sway for the operated leg did not differ before, 3 and 6 months after TKA and compared to the non-operated leg. The trace speed was 6 months after TKA equal to the preoperative level. Only the COP of sway displacement in AP direction is significantly greater in knee OA patients both before and after TKA compared with healthy controls.

Conclusions

Knee OA patients’ postural stability characteristics did not differ significantly both before and after TKA. Compared to healthy controls, the COP of sway displacement in AP direction is mostly disturbed. Correlation analysis confirms that increased postural sway is associated with an increased equivalent area of COP. In knee OA patients higher body mass index ensures reduced trace speed and lower knee ROM.

Level of evidence

Prospective comparative study, Level II.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Hassan BS, Mockett S, Doherty M (2001) Static postural sway, proprioception, and maximal voluntary quadriceps contraction in patients with knee osteoarthritis and normal control subjects. Ann Rheum Dis 60:612–618

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  2. Hinman RS, Bennell KL, Metcalf BR, Crossley KM (2002) Balance impairments in individuals with symptomatic knee osteoarthritis: a comparison with matched controls using clinical tests. Rheumatology 41:1388–1394

    Article  CAS  PubMed  Google Scholar 

  3. Hurley MV, Scott DV, Rees J, Newham DL (1997) Sensimotor changes and functional performance in patients with knee osteoarthritis. Ann Rheum Dis 56:641–648

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  4. Masui T, Hasegawa Y, Yamaguchi J, Kanoh T, Ishiguro N, Suzuki S (2006) Increasing postural sway in rural-community-dwelling elderly persons with knee osteoarthritis. J Orthop Sci 11:353–358

    Article  PubMed  Google Scholar 

  5. Schwartz I, Kandel L, Sajina A, Litinezki D, Herman, Matta Y (2012) Balance is an important factor for quality of life and function after primary total knee replacement. J Bone Joint Surg Br 94-B:782–786

    Article  Google Scholar 

  6. Lyytinen T, Liivakaino T, Bragge T, Hakkarainen M, Jarjalainen PA, Arokoski JPA (2010) Postural control and thigh muscle activity in men with knee osteoarthritis. J Electromyogr Kinesiol 20:1066–1074

    Article  PubMed  Google Scholar 

  7. Swanik CB, Lephart SM, Rubash HE (2004) Proprioception, kinesthesia, and balance after total knee arthroplasty with cruciate-retaining and posterior stabilized prosthesis. J Bone Joint Surg 86-A:328–334

    PubMed  Google Scholar 

  8. Arokoski JPA, Leinonen V, Arokoski MH, Aalto H, Valtonen H (2006) Postural control in male patients with hip osteoarthritis. Gait Posture 23:45–50

    Article  PubMed  Google Scholar 

  9. Cho SD, Hwang CH (2012) Improved single-limb balance after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-012-2144-x

    PubMed Central  Google Scholar 

  10. Hunt MO, McManus FJ, Hinman RS, Bennell KL (2010) Predictors of single-leg standing in individuals with medial knee osteoarthritis. Arthritis Care Res 62:496–500

    Article  Google Scholar 

  11. Chiari L, Rocchi L, Cappello A (2002) Stabilometric parameters are affected by anthropometry and foot placement. Clin Biomech 17:666–677

    Article  Google Scholar 

  12. Argatov I (2013) A subject-specific postural instability parameter. Gait Posture 37:141–143

    Article  CAS  PubMed  Google Scholar 

  13. Roddy E, Zhang W, Doherty M et al (2005) Evidence-based recommendations for the role of exercise in the management of osteoarthritis of the hip or knee—the MOVE consensus. Rheumatology 44:67–73

    Article  CAS  PubMed  Google Scholar 

  14. Lin DH, Lin YF, Chai HM, Han YC, Jan MH (2007) Comparison of proprioceptive functions between computerized proprioception facilitation exercise and closed kinetic chain exercise in patients with knee osteoarthritis. Clin Rheumatol 26:520–528

    Article  PubMed  Google Scholar 

  15. Hurley MV (2003) Muscle dysfunction and effective rehabilitation of knee osteoarthritis: what we know and what we need to find out. Arthritis Care Res 49:444–452

    Article  Google Scholar 

  16. Hart DJ, Doyle DV, Spector TD (1999) Incidence and risk factors for radiographic knee osteoarthritis in middle-aged women. Arthritis Rheumatol 14:17–24

    Article  Google Scholar 

  17. Slemenda C, Heilman DK, Brandt KD, Katz BP, Mazzuca SA, Braunstein EM, Byrd D (1998) Reduced quadriceps strength relative to body weight: a risk factor for knee osteoarthritis in women? Arthritis Rheumatol 11:1951–1959

    Article  Google Scholar 

  18. Doyle TL, Newton RU, Burnett AF (2005) Reliability of traditional and fractal dimension measures of quiet stance centre of pressure in young, healthy people. Arch Phys Med Rehabil 86:2034–2040

    Article  PubMed  Google Scholar 

  19. Salavati M, Hadian MR, Mazaheri M, Negahban H, Ebrahimi I, Talebian S, Jafari AH, Sanjari MA, Sohani SM, Parnianpour M (2009) Test-retest reliability of center of pressure measures of postural stability during quiet standing in a group with musculoskeletal disorders consisting of low back pain, anterior cruciate ligament injury and functional ankle instability. Gait Posture 29:460–464

    Article  PubMed  Google Scholar 

  20. Menegoni F, Galli M, Tacchini E, Vismara L, Cavigioli M, Capodaglio P (2009) Gender-specific effect of obesity on balance. Obesity 17:1951–1956

    Article  PubMed  Google Scholar 

  21. Britton AR, Murray DW, Bulstrode CJ, McPherson K, Denham RA (1997) Pain levels after total hip replacement. J Bone Joint Surg 79-B:93–98

    Article  Google Scholar 

  22. Hue OA, Seynnes O, Ledrole D, Colson SS, Bernard P-L (2004) Effects of a physical activity program on postural stability in older people. Aging Clin Exp Res 16:1–7

    Article  Google Scholar 

  23. Gauchard GC, Vancon G, Meyer P, Mainard D, Perrin PP (2010) On the role of knee joint in balance control and postural strategies: effect of total knee replacement in elderly subjects with knee osteoarthritis. Gait Posture 32:155–160

    Article  PubMed  Google Scholar 

  24. Greve J, Alonso A, Bordini ACPG, Camanho GL (2007) Correlation between body mass index and postural balance. Clin Sci 6:717–720

    Google Scholar 

  25. Horak FB (2006) Postural orientation and equilibrium: what do we need to know about neural control of balance to prevent falls? Age Ageing 35(S2):7–11

    Google Scholar 

Download references

Acknowledgments

The authors are very grateful to Professor Tiit Haviko, Dr. Aare Märtson and physiotherapist Galina Schneider for their contribution to subject’s operative treatment and postoperative rehabilitation. We are also indebted to Herje Aibast and Monika Rätsepsoo for their assistance with data collection. We acknowledge that this study was partly supported by the Estonian Ministry of Education and Research project No. SF0180030s07 and Estonian Science Foundation project No 7939.

Conflict of interest

The authors confirm that there are no potential conflicts of interest including any personal or other relationships with other people or organizations associated with the work submitted that could inappropriately influence their work.

Author information

Authors and Affiliations

  1. Institute of Exercise Biology and Physiotherapy, University of Tartu, 5 Jakobi Street, 51014, Tartu, Estonia

    Doris Vahtrik, Jaan Ereline, Helena Gapeyeva & Mati Pääsuke

Authors
  1. Doris Vahtrik
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jaan Ereline
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Helena Gapeyeva
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mati Pääsuke
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Doris Vahtrik.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Vahtrik, D., Ereline, J., Gapeyeva, H. et al. Postural stability in relation to anthropometric and functional characteristics in women with knee osteoarthritis following total knee arthroplasty. Arch Orthop Trauma Surg 134, 685–692 (2014). https://doi.org/10.1007/s00402-014-1940-9

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00402-014-1940-9

Keywords

Search

Navigation