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Altered biomechanics in bilateral total knee replacement patients during stair negotiation
Many total knee replacement (TKR) patients need to have a contralateral knee replacement. Biomechanical differences between first and second replaced limbs of bilateral TKR have not been examined during stair negotiation. Additionally, it is unknown whether hip and ankle biomechanics of bilateral pa...
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| Published in: | The knee 2022-01, Vol.34, p.9-16 |
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| container_title | The knee |
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| creator | Yocum, Derek S. Valenzuela, Kevin A. Standifird, Tyler W. Cates, Harold E. Zhang, Songning |
| description | Many total knee replacement (TKR) patients need to have a contralateral knee replacement. Biomechanical differences between first and second replaced limbs of bilateral TKR have not been examined during stair negotiation. Additionally, it is unknown whether hip and ankle biomechanics of bilateral patients are altered. We examined hip, knee, and ankle biomechanics of first and second replaced limbs bilateral patients, as well as replaced and non-replaced limbs of unilateral patients, during stair ascent and descent.
Eleven bilateral TKR patients (70.09 ± 5.41 years, 1.71 ± 0.08 m, 91.78 ± 13.00 kg) and 15 unilateral TKR patients (64.93 ± 5.11 years, 1.75 ± 0.09 m, 89.18 ± 17.55 kg) were recruited. Patients performed three to five trials of stair ascent and descent. The second step, during ascent, was the step of interest when analyzing each limb. A 2 × 2 (limb × group) analysis of variance was performed to determine differences between limbs and groups.
During ascent, bilateral patients exhibited decreased peak loading-response knee extension (KEM) and push-off plantarflexion moments. Unilateral replaced limb KEM was lower than non-replaced limbs. During descent, bilateral patients descended the staircase significantly slower, had lower peak loading-response vertical ground reaction force and KEM, and push-off KEM. Bilateral patients had higher peak loading-response hip extension and push-off plantarflexion moments, and increased knee adduction ROM, compared with unilateral TKA patients.
Bilateral patients exhibited similar hip, knee, and ankle joint moments between first and second replaced limbs. Substantial differences in hip, knee, and ankle biomechanics during stair negotiation in bilateral patients compared with unilateral patients may indicate a more complex adaptation strategy present in these patients. |
| doi_str_mv | 10.1016/j.knee.2021.11.009 |
| format | article |
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Eleven bilateral TKR patients (70.09 ± 5.41 years, 1.71 ± 0.08 m, 91.78 ± 13.00 kg) and 15 unilateral TKR patients (64.93 ± 5.11 years, 1.75 ± 0.09 m, 89.18 ± 17.55 kg) were recruited. Patients performed three to five trials of stair ascent and descent. The second step, during ascent, was the step of interest when analyzing each limb. A 2 × 2 (limb × group) analysis of variance was performed to determine differences between limbs and groups.
During ascent, bilateral patients exhibited decreased peak loading-response knee extension (KEM) and push-off plantarflexion moments. Unilateral replaced limb KEM was lower than non-replaced limbs. During descent, bilateral patients descended the staircase significantly slower, had lower peak loading-response vertical ground reaction force and KEM, and push-off KEM. Bilateral patients had higher peak loading-response hip extension and push-off plantarflexion moments, and increased knee adduction ROM, compared with unilateral TKA patients.
Bilateral patients exhibited similar hip, knee, and ankle joint moments between first and second replaced limbs. Substantial differences in hip, knee, and ankle biomechanics during stair negotiation in bilateral patients compared with unilateral patients may indicate a more complex adaptation strategy present in these patients.</description><identifier>ISSN: 0968-0160</identifier><identifier>EISSN: 1873-5800</identifier><identifier>DOI: 10.1016/j.knee.2021.11.009</identifier><identifier>PMID: 34875499</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Ankle ; Arthroplasty ; Arthroplasty, Replacement, Knee ; Biomechanical Phenomena - physiology ; Gait ; Gait - physiology ; Hip ; Humans ; Knee Joint - physiology ; Knee Joint - surgery ; Negotiating ; Range of Motion, Articular - physiology ; Stair ascent ; Stair descent ; Walking</subject><ispartof>The knee, 2022-01, Vol.34, p.9-16</ispartof><rights>2021 Elsevier B.V.</rights><rights>Copyright © 2021 Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c356t-c92f1c5d2281ab2463c0af25fc00301ed09e9fa602b22efca1fb116e57603f573</citedby><cites>FETCH-LOGICAL-c356t-c92f1c5d2281ab2463c0af25fc00301ed09e9fa602b22efca1fb116e57603f573</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,786,790,27957,27958</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34875499$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yocum, Derek S.</creatorcontrib><creatorcontrib>Valenzuela, Kevin A.</creatorcontrib><creatorcontrib>Standifird, Tyler W.</creatorcontrib><creatorcontrib>Cates, Harold E.</creatorcontrib><creatorcontrib>Zhang, Songning</creatorcontrib><title>Altered biomechanics in bilateral total knee replacement patients during stair negotiation</title><title>The knee</title><addtitle>Knee</addtitle><description>Many total knee replacement (TKR) patients need to have a contralateral knee replacement. Biomechanical differences between first and second replaced limbs of bilateral TKR have not been examined during stair negotiation. Additionally, it is unknown whether hip and ankle biomechanics of bilateral patients are altered. We examined hip, knee, and ankle biomechanics of first and second replaced limbs bilateral patients, as well as replaced and non-replaced limbs of unilateral patients, during stair ascent and descent.
Eleven bilateral TKR patients (70.09 ± 5.41 years, 1.71 ± 0.08 m, 91.78 ± 13.00 kg) and 15 unilateral TKR patients (64.93 ± 5.11 years, 1.75 ± 0.09 m, 89.18 ± 17.55 kg) were recruited. Patients performed three to five trials of stair ascent and descent. The second step, during ascent, was the step of interest when analyzing each limb. A 2 × 2 (limb × group) analysis of variance was performed to determine differences between limbs and groups.
During ascent, bilateral patients exhibited decreased peak loading-response knee extension (KEM) and push-off plantarflexion moments. Unilateral replaced limb KEM was lower than non-replaced limbs. During descent, bilateral patients descended the staircase significantly slower, had lower peak loading-response vertical ground reaction force and KEM, and push-off KEM. Bilateral patients had higher peak loading-response hip extension and push-off plantarflexion moments, and increased knee adduction ROM, compared with unilateral TKA patients.
Bilateral patients exhibited similar hip, knee, and ankle joint moments between first and second replaced limbs. Substantial differences in hip, knee, and ankle biomechanics during stair negotiation in bilateral patients compared with unilateral patients may indicate a more complex adaptation strategy present in these patients.</description><subject>Ankle</subject><subject>Arthroplasty</subject><subject>Arthroplasty, Replacement, Knee</subject><subject>Biomechanical Phenomena - physiology</subject><subject>Gait</subject><subject>Gait - physiology</subject><subject>Hip</subject><subject>Humans</subject><subject>Knee Joint - physiology</subject><subject>Knee Joint - surgery</subject><subject>Negotiating</subject><subject>Range of Motion, Articular - physiology</subject><subject>Stair ascent</subject><subject>Stair descent</subject><subject>Walking</subject><issn>0968-0160</issn><issn>1873-5800</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNp9kD1PwzAQhi0EglL4AwwoI0vCnZO4icRSVXxJlVhgYbEc51xc8lFsF4l_j6sCI4tP1j33nu5h7AIhQ0Bxvc7eB6KMA8cMMQOoD9gEq1melhXAIZtALao0knDCTr1fA4Coi_KYneRFNSuLup6w13kXyFGbNHbsSb-pwWqf2CH-OxU7qkvCGOK7W5U42nRKU09DSDYq2Fh90m6dHVaJD8q6ZKDVGGxsjcMZOzKq83T-U6fs5e72efGQLp_uHxfzZarzUoRU19ygLlvOK1QNL0SuQRleGg2QA1ILNdVGCeAN52S0QtMgCipnAnJTzvIpu9rnbtz4sSUfZG-9pq5TA41bL7mAKpooECPK96h2o_eOjNw42yv3JRHkzqlcy92hcudUIsroNA5d_uRvm57av5FfiRG42QMUr_y05KTXUY2m1jrSQbaj_S__G8H7iUA</recordid><startdate>202201</startdate><enddate>202201</enddate><creator>Yocum, Derek S.</creator><creator>Valenzuela, Kevin A.</creator><creator>Standifird, Tyler W.</creator><creator>Cates, Harold E.</creator><creator>Zhang, Songning</creator><general>Elsevier B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202201</creationdate><title>Altered biomechanics in bilateral total knee replacement patients during stair negotiation</title><author>Yocum, Derek S. ; Valenzuela, Kevin A. ; Standifird, Tyler W. ; Cates, Harold E. ; Zhang, Songning</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356t-c92f1c5d2281ab2463c0af25fc00301ed09e9fa602b22efca1fb116e57603f573</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Ankle</topic><topic>Arthroplasty</topic><topic>Arthroplasty, Replacement, Knee</topic><topic>Biomechanical Phenomena - physiology</topic><topic>Gait</topic><topic>Gait - physiology</topic><topic>Hip</topic><topic>Humans</topic><topic>Knee Joint - physiology</topic><topic>Knee Joint - surgery</topic><topic>Negotiating</topic><topic>Range of Motion, Articular - physiology</topic><topic>Stair ascent</topic><topic>Stair descent</topic><topic>Walking</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yocum, Derek S.</creatorcontrib><creatorcontrib>Valenzuela, Kevin A.</creatorcontrib><creatorcontrib>Standifird, Tyler W.</creatorcontrib><creatorcontrib>Cates, Harold E.</creatorcontrib><creatorcontrib>Zhang, Songning</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The knee</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yocum, Derek S.</au><au>Valenzuela, Kevin A.</au><au>Standifird, Tyler W.</au><au>Cates, Harold E.</au><au>Zhang, Songning</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Altered biomechanics in bilateral total knee replacement patients during stair negotiation</atitle><jtitle>The knee</jtitle><addtitle>Knee</addtitle><date>2022-01</date><risdate>2022</risdate><volume>34</volume><spage>9</spage><epage>16</epage><pages>9-16</pages><issn>0968-0160</issn><eissn>1873-5800</eissn><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><abstract>Many total knee replacement (TKR) patients need to have a contralateral knee replacement. Biomechanical differences between first and second replaced limbs of bilateral TKR have not been examined during stair negotiation. Additionally, it is unknown whether hip and ankle biomechanics of bilateral patients are altered. We examined hip, knee, and ankle biomechanics of first and second replaced limbs bilateral patients, as well as replaced and non-replaced limbs of unilateral patients, during stair ascent and descent.
Eleven bilateral TKR patients (70.09 ± 5.41 years, 1.71 ± 0.08 m, 91.78 ± 13.00 kg) and 15 unilateral TKR patients (64.93 ± 5.11 years, 1.75 ± 0.09 m, 89.18 ± 17.55 kg) were recruited. Patients performed three to five trials of stair ascent and descent. The second step, during ascent, was the step of interest when analyzing each limb. A 2 × 2 (limb × group) analysis of variance was performed to determine differences between limbs and groups.
During ascent, bilateral patients exhibited decreased peak loading-response knee extension (KEM) and push-off plantarflexion moments. Unilateral replaced limb KEM was lower than non-replaced limbs. During descent, bilateral patients descended the staircase significantly slower, had lower peak loading-response vertical ground reaction force and KEM, and push-off KEM. Bilateral patients had higher peak loading-response hip extension and push-off plantarflexion moments, and increased knee adduction ROM, compared with unilateral TKA patients.
Bilateral patients exhibited similar hip, knee, and ankle joint moments between first and second replaced limbs. Substantial differences in hip, knee, and ankle biomechanics during stair negotiation in bilateral patients compared with unilateral patients may indicate a more complex adaptation strategy present in these patients.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>34875499</pmid><doi>10.1016/j.knee.2021.11.009</doi><tpages>8</tpages></addata></record> |
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| source | ScienceDirect Freedom Collection 2022-2024 |
| subjects | Ankle Arthroplasty Arthroplasty, Replacement, Knee Biomechanical Phenomena - physiology Gait Gait - physiology Hip Humans Knee Joint - physiology Knee Joint - surgery Negotiating Range of Motion, Articular - physiology Stair ascent Stair descent Walking |
| title | Altered biomechanics in bilateral total knee replacement patients during stair negotiation |
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