Investigating Pre-Operative Joint-Level Biomechanics in Partial versus Total Knee Arthroplasty
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Objective
The purpose of this study was to investigate preoperative joint-level kinematics across multiple functional tasks including preferred-pace walking, fast-paced walking, and sit-to-stand, alongside self-reported pain and function in cohorts scheduled for partial (PKA) versus total knee arthroplasty (TKA).
Methods
Patients with end-stage knee osteoarthritis were recruited from St. Joseph’s Healthcare Hamilton. Self-reported measures including Oxford Knee Score, self-reported average pain, quality of life, and depression were collected. Functional tasks including preferred-pace walking, fast-paced walking, and sit-to-stand were collected and recorded using markerless motion capture. Joint-level kinematics were evaluated using linear mixed models using main effects of surgery type and walking condition, along with interaction effects.
Results
This study included 15 patients scheduled for PKA, and 56 patients scheduled for TKA. No significant differences were observed when evaluating differences between cohorts through self-reported measures, nor at single gait speed conditions or sit-to-stand. However, when evaluating the differences in walking patterns between preferred and fast pace, the PKA group exhibited a significant change in stride length, peak stance knee flexion, peak swing knee flexion, knee excursion, peak stance hip flexion, and overall hip range of motion between preferred and fast-paced walking compared to the TKA group.
Conclusion
These findings highlight that multi-speed gait assessments rather than single-speed walking or sit-to-stand tasks are likely a more sensitive approach for detecting biomechanical differences in OA patients and may have broader applicability to other clinical populations.
