Stair negotiation is one of the more difficult daily activities reported by total knee replacement (TKR) patients. Dissatisfied TKR patients have reported increased difficulty with stair negotiation, however it is unknown what the underlying mechanical issues are for this population. Therefore, the purpose of this research was to examine the knee joint biomechanics of dissatisfied TKR patients during stair descent. Nine dissatisfied TKR patients (34.6±14.3 months from surgery), 15 satisfied TKR patients (29.3±12.8 months from surgery), and 15 healthy participants performed stair descent trials on a five-step instrumented staircase at a preferred gait speed. The dissatisfied group showed lower knee extension and abduction moments in their replaced limb. The 2nd peak vertical ground reaction force (VGRF) and 1st and 2nd peak knee internal rotation moments showed lower moments for replaced limbs compared to non-replaced limbs. First peak VGRF was reduced for dissatisfied group compared to satisfied and healthy groups. The dissatisfied TKR group had significantly increased pain levels on their replaced limb compared to all other groups and limbs. The dissatisfied group had reduced gait speed compared to the satisfied and healthy groups. Increased pain levels lead to reduced descent speed and peak loading-response and pushoff sagittal plane knee joint moments in dissatisfied total knee replacement patients during stair descent. This creates an asymmetry in the extension loading response moment for the dissatisfied group, with the non-replaced limb showing increased joint moments whereas the satisfied and healthy groups do not have that imbalance.
Listed In: Biomechanics