The Influence of Sex and Pre-operative Obesity on Biomechanics Two Years After Total Knee Arthroplasty: A Longitudinal Cohort Study – DocWire News


Posted: November 22, 2019 at 9:49 am

BACKGROUND:

Sex and obesity may influencekneebiomechanics associated with poor outcomes following primarytotal knee arthroplasty(TKA) however their long-term impact has not been investigated.

Does sex and/or pre-operative obesity influence change in gait biomechanics from pre-TKA to two-years after TKA, and dokneebiomechanics return to normal two-years after TKA?

In this longitudinal study, gait analysis was performed on 78 patients undergoing TKA forkneeosteoarthritis prior to surgery (baseline), and on 66 (85 %) of these who returned at the two year follow-up. Gait biomechanics were also collected on a reference sample of 40 asymptomatic participants.Kneevariables were analyzed according to time (pre- and post-TKA), sex (men and women), pre-operative obesity (obese vs non-obese), and group (TKA vs reference). Mixed linear regression models were used to examine the effects of TKA, obesity status, gender and all interactions.

There were two-year reductions in peakkneefrontal plane angle (mean difference -7.21; 95% confidence intervals -9.37 to -5.05), peakkneeadduction moment (KAM) (-17.64Nm; -23.04 to -12.24) and KAM impulse (-9.40Nm.s; -12.04 to -6.77) in males. These and other variables were unchanged in women. At two years, men exhibited a greater varus-valgus thrust excursion (4.9; 2.7-7.2), and a lower peakkneefrontal plane angle (-4.4; -7.1 to -1.7) and peak KAM (-13.1Nm; -20.9 to -5.4), compared to the reference sample. Biomechanics at two years did not differ between pre-operative obesity subgroups, or between female TKA patients and the reference sample.

Changes in gait biomechanics two years after TKA are influenced by sex but not obesity. Men but not women showed alteredkneebiomechanics two years following TKR and compared to a reference sample. It is unknown whether these altered biomechanics in men impact longer term clinical outcomes and satisfaction following surgery.

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The Influence of Sex and Pre-operative Obesity on Biomechanics Two Years After Total Knee Arthroplasty: A Longitudinal Cohort Study - DocWire News

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