Journal international de médecine physique et de réadaptation
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Whole Body Gait Function during Stair Ascending and Level Walking in Patients Following Total Knee Arthroplasty

Verena Fenner, Henrik Behrend and Markus S Kuster

The ability to climb stairs is a highly demanding task for the musculoskeletal system, and gait adaptations after total knee arthroplasty (TKA) might be more pronounced during stair climbing than during level walking. The purpose of this study was to compare full body kinematics and kinetics between patients with good functioning TKA and a healthy control group during stair ascending and level walking. Eighteen patients after TKA (67.8 ± 8.1 yrs) and 20 age-matched healthy controls (66.1 ± 6.4 yrs) participated in this study. Full body kinematic and kinetic data was collected during stair ascending and level walking. Patients after TKA showed differences in sagittal plane knee moments during both stair ascending and level walking compared to the controls. The hip of the patients was more externally rotated in both conditions (p<0.001), although there were no differences in the passive range of motion (p=0.630). The trunk angles only showed a few deviations between patients and controls. Differences between patients and controls were found more often during level walking than during stair ascending. The study shows that considering adjacent joints gives more additional information for treatment recommendations than the additional analysis of the trunk when comparing patients after TKA to healthy seniors. To reduce the higher knee flexion moment during stair ascending in patients, we recommend the strengthening of the calf muscles. It seems that stair ascending does not provide additional information to guide actual treatment recommendations compared to level walking alone.