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Abnormal Movement Following Knee Surgery May Result in More Surgery

Nearly a quarter of people who have total knee arthroplasty (TKA) are likely to need a second surgery on their other knee within 5 years and this may be the result of abnormal walking patterns after surgery, according to a study published in Journal of Orthopaedic Research.

“If we can change the way someone moves or improve their walking ability after surgery while also reducing the need for a second knee replacement, we may also be able to reduce healthcare costs and other issues that arise with having to undergo surgery,” said lead author Joseph Zeni, MD, Rutgers School of Health Professions, New Brunswick, New Jersey.

The study looked at whether movement patterns after TKA were associated with future surgery as a result of unbalanced movement that put more pressure on the other knee.

The study included 158 individuals who underwent unilateral TKA and completed 3 dimensional motion analysis 6 to 24 months after surgery. All patients were followed for a mean of 5.89 years after baseline testing to determine if they had undergone a contralateral TKA.

Results showed that individuals who underwent contralateral TKA had less knee flexion excursion (P = .032) and less knee extension excursion (P = .035) at baseline on the operated side during walking.

Individuals who underwent contralateral TKA also had less knee flexion excursion on the contralateral limb at baseline (P = .017). For every additional degree of knee flexion excursion on the contralateral knee at baseline, there was a 9.1% reduction in risk of future contralateral TKA.

Individuals who walked with stiffer gait patterns were more likely to undergo future contralateral TKA.

“Often surgeons, patients, and therapists are concerned with restoring normal range of motion and reducing pain after surgery,” said Dr. Zeni. “Our results suggest that normalising movement patterns, so that one leg is not favoured over another should also be a goal of post-operative rehabilitation.”

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