ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2018
Slow gait speed after bilateral total knee arthroplasty is associated with suboptimal improvement of knee biomechanics.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04850300 (Efficiency Assessment of the Methodology for the Follow-up of Patients With Knee Prostheses), which is not on this map. Cited by 19 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Efficiency Assessment of the Methodology for the Follow-up of Patients With Knee Prostheses
Who cites it
19 citing papers in PubMed.
- A small difference in recovery between total knee arthroplasty with and without tourniquet use the first 3 months after surgery: a randomized controlled study.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2019Trial
- Trial
- Asymmetrical biomechanics in knee osteoarthritis: a review of contralateral risk from primary disease to post-arthroplasty progression.EFORT open reviews · 2026Review
- Gait kinematics and kinetics in patients with different grades of meniscus injury: A cross-sectional study.PloS one · 2026Article
- Changes in knee pain and walking speed following primary, unilateral total knee arthroplasty and their association: A systematic review and meta-analysis.Osteoarthritis and cartilage open · 2025Review
- Peak, cumulative and rate of medial and lateral compartment joint loading during gait following total knee arthroplasty.Gait & posture · 2025Article
- Investigation of Biomechanical Differences in Level Walking between Patients with Bilateral and Unilateral Total Knee Replacements.Bioengineering (Basel, Switzerland) · 2024Article
- Article
- Do Interlimb Knee Joint Loading Asymmetries Persist throughout Stance during Uphill Walking Following Total Knee Arthroplasty?International journal of environmental research and public health · 2023Article
- Higher Pelvic Incidence Was Associated with a Higher Risk of Sagittal Malposition of Femoral Component and Poor Outcomes of Primary Total Knee Arthroplasty: A Retrospective Cohort Analysis.The journal of knee surgery · 2023Article
- Stepping beyond Counts in Recovery of Total Knee Arthroplasty: A Prospective Study on Passively Collected Gait Metrics.Sensors (Basel, Switzerland) · 2023Article
- Does total knee arthroplasty affect pelvic movements? A prospective comparative study.Revista da Associacao Medica Brasileira (1992) · 2023Article
- Observational
- Intersegmental Coordination in Patients With Total Knee Arthroplasty During Walking.Frontiers in bioengineering and biotechnology · 2022Article
- The Application of Biomechanics Combined with Human Body Structure in Volleyball Technical Analysis.Computational intelligence and neuroscience · 2022Article
- Influence of the Amount of Change in Quadriceps Tendon Young's Modulus on Amount of Change in Walking Speed before and after Total Knee Arthroplasty.Medicina (Kaunas, Lithuania) · 2021Article
- Gait Speed and Instrumental Activities of Daily Living in Older Adults After Hospitalization: A Longitudinal Population-Based Study.The journals of gerontology. Series A, Biological sciences and medical sciences · 2021Article
- Walking speed measurement technology: A review.Current geriatrics reports · 2021Article
- Effects of Knee Osteoarthritis on Hip and Ankle Gait Mechanics.Advances in orthopedics · 2019Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe aim of this study was to investigate gait speed changes 2 years after bilateral total knee arthroplasty (TKA) and identify kinetic and kinematic factors associated with such changes by comparing patients with age- and sex-matched controls.
methodsThe study group included 34 female patients with end-stage knee osteoarthritis (OA) who underwent bilateral TKA and 42 age- and sex-matched controls without knee pain or OA. Standard TKA was performed on all arthritic patients with placement of posterior stabilized fixed-bearing implants. Kinetic and kinematic parameters were evaluated using a commercial optoelectric gait analysis system. Gait speed, kinetic and kinematic changes and determinants of speed were assessed via principal component analysis and multiple regression analysis.
resultsThe average gait speed of an arthritic patient was 90.2 ± 18.4 cm/s and improved to 96.0 ± 12.3 cm/s after TKA (p = 0.032). However, the speed remained slower than that of controls (111.2 ± 8.2 cm/s, p < 0.001). With regard to kinetics, the peak knee extension moment (KEM) generated by the quadriceps was unchanged after TKA and weaker than that of controls (p < 0.001). The proportions of KEM contributing to the total sagittal moment were also smaller in the pre-/post-operative groups than in the control group (13-14% vs. 19%). On the other hand, the ankle plantar flexion moment (APFM) was increased after TKA (p = 0.007) and its proportion of the total sagittal moment was greater than in controls (46% vs. 42%). With regard to kinematics, knee range of motion (ROM) improved after TKA (p = 0.025), but was smaller than that of controls (p < 0.001). In controls, gait speed was determined principally by hip and knee joint moments. However, in the TKA group, speed was determined by the knee ROM and APFM.
conclusionsDespite showing improvement, the gait speed of TKA patients remained slower than that of controls. Slow gait speed after bilateral TKA was associated with suboptimal improvement of knee biomechanics. Quadriceps strengthening exercises and the achievement of greater ROM during gait are advised for the further improvement of gait speed. LEVEL OF EVIDENCE: Retrospective cohort study, Level III.
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