Knee biomechanics and contralateral knee osteoarthritis progression after total knee arthroplasty.
Moiyad Saleh Aljehani, Jesse C Christensen, Lynn Snyder-Mackler and 3 others
PMID 34775230WHAT IT FOUND
Walking mechanics did not predict knee osteoarthritis progression in the opposite knee after total knee replacement.
Despite high rates of radiographic worsening over eight years, neither knee loading nor motion explained which patients progressed.
Key findings
01No biomechanical variables, including knee adduction moment or flexion excursion, significantly predicted contralateral osteoarthritis progression.
02Radiographic progression was common, affecting 62.5% of participants by Kellgren-Lawrence grade and 78% by joint space narrowing over an average follow-up of roughly eight years.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The sample size was small (40-42 participants), which may have reduced the study's power to detect subtle associations. Participants were selected from a previous study, introducing potential selection bias. Biomechanical data were collected only during controlled over-ground walking, ignoring cumulative loading from daily activities and other tasks. The study did not account for other known risk factors for osteoarthritis progression, such as physical activity levels, diabetes, or knee alignment varus/valgus status. There was a discrepancy in the number of participants included in the two different radiographic analyses (KL vs JSW) due to image quality issues.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that gait mechanics are irrelevant to knee health. The study only found that specific biomechanical measures during walking did not predict radiographic progression in the contralateral knee. It does not rule out that gait affects symptoms, function, or the operated knee, nor does it exclude the role of cumulative daily loading.