Preoperative quadriceps weakness preferentially predicts postoperative aberrant movement patterns during high-demand mobility following total knee arthroplasty.
Aged
Arthroplasty, Replacement, Knee
Exercise
/ physiology
Female
Follow-Up Studies
Humans
Knee Joint
/ physiology
Male
Middle Aged
Muscle Strength
/ physiology
Postoperative Period
Preoperative Period
Quadriceps Muscle
/ physiopathology
Range of Motion, Articular
/ physiology
Self Report
Walking
/ physiology
Biomechanics
Decline walking
Gait analysis
Quadriceps strength
Total knee arthroplasty
Journal
The Knee
ISSN: 1873-5800
Titre abrégé: Knee
Pays: Netherlands
ID NLM: 9430798
Informations de publication
Date de publication:
Jan 2019
Jan 2019
Historique:
received:
31
08
2018
revised:
01
12
2018
accepted:
16
12
2018
pubmed:
3
1
2019
medline:
9
4
2019
entrez:
3
1
2019
Statut:
ppublish
Résumé
Nearly all patients with total knee arthroplasty show aberrant movement patterns during tasks requiring greater joint demand compared to matched peers. Greater movement compensation leads to increased loading onto other joints, decreased functional capacity and limited reserve for independence later in life. Understanding how preoperative predictors contribute to postoperative aberrant movement patterns is needed to make better decisions for patients considering total knee arthroplasty. Forty-seven patients were tested preoperatively and six months following primary total knee arthroplasty. Demographic (age, sex, body mass), self-reported (knee pain, perception of physical performance, physical activity level), physical performance (quadriceps strength, lower limb power and timed stair climbing) and surgical metrics were collected as predictor variables. Three-dimensional models based on joint mechanic asymmetry during a decline walking task were collected at six months postoperatively. Decline walking is a preferred means to assess the surgical knee's contribution to limb performance during high-demand tasks. Bootstrap inclusion fraction was employed to compare the stability of each predictor variable prior to the final regression model. Preoperative quadriceps strength (β = 0.33; p = 0.04) showed a significant relationship with knee extensor angular impulse during loading phase. No other predictor variable had any meaningful relationship with aberrant movement patterns (p > 0.05). Our findings highlight patients' preoperative quadriceps strength as a meaningful predictor of postoperative performance. Preoperative quadriceps strength should be addressed when considering the knee's ability to contribute to higher demanding mobility tasks following surgery.
Sections du résumé
BACKGROUND
BACKGROUND
Nearly all patients with total knee arthroplasty show aberrant movement patterns during tasks requiring greater joint demand compared to matched peers. Greater movement compensation leads to increased loading onto other joints, decreased functional capacity and limited reserve for independence later in life. Understanding how preoperative predictors contribute to postoperative aberrant movement patterns is needed to make better decisions for patients considering total knee arthroplasty.
METHODS
METHODS
Forty-seven patients were tested preoperatively and six months following primary total knee arthroplasty. Demographic (age, sex, body mass), self-reported (knee pain, perception of physical performance, physical activity level), physical performance (quadriceps strength, lower limb power and timed stair climbing) and surgical metrics were collected as predictor variables. Three-dimensional models based on joint mechanic asymmetry during a decline walking task were collected at six months postoperatively. Decline walking is a preferred means to assess the surgical knee's contribution to limb performance during high-demand tasks. Bootstrap inclusion fraction was employed to compare the stability of each predictor variable prior to the final regression model.
RESULTS
RESULTS
Preoperative quadriceps strength (β = 0.33; p = 0.04) showed a significant relationship with knee extensor angular impulse during loading phase. No other predictor variable had any meaningful relationship with aberrant movement patterns (p > 0.05).
CONCLUSION
CONCLUSIONS
Our findings highlight patients' preoperative quadriceps strength as a meaningful predictor of postoperative performance. Preoperative quadriceps strength should be addressed when considering the knee's ability to contribute to higher demanding mobility tasks following surgery.
Identifiants
pubmed: 30600199
pii: S0968-0160(18)30768-3
doi: 10.1016/j.knee.2018.12.005
pmc: PMC6377852
mid: NIHMS1517202
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
79-87Subventions
Organisme : NCRR NIH HHS
ID : S10 RR026565
Pays : United States
Informations de copyright
Published by Elsevier B.V.
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