Comparative Analysis of Knee Biomechanics in Total Knee Arthroplasty Patients Across Daily Activities

Total knee arthroplasty (TKA) is a commonly conducted surgery to relieve pain and enhance mobility in patients with end-stage knee osteoarthritis. Patient-reported outcome measures are often used whereas biomechanical variables are too complicated for clinicians and patients to assess functional improvement. There is a need for a simplified integrated knee biomechanics index (KBI) to compare improvements in TKA patients across various daily activities and examine the relationships between clinical functional tests and daily activities. Age-, gender-, and BMI-matched three groups (20 each in posterior stabilized TKA, bi-cruciate stabilized TKA, and healthy controls) were recruited and tested pre-op and 6-month post-op to perform walking on level, slope, and stairs, and two clinical tests (timed-up-go, 10-time sit-to-stand). Knee joint kinematics and kinetics variables were calculated from motion data and ground reactions captured at 120 Hz and 1200 Hz, respectively. KBI was developed based on these variables relative to healthy controls. The longitude comparison of KBI and the differences of KBI across various daily activities were identified using repeated-measure ANOVA. Pearson correlation analysis was used to compare clinical tests and KBI of daily activities. KBIs of five daily activities were significantly increased following TKA follow-up. KBI improvement during level walking was significantly higher than those during stair ascending and descending. Significant correlations were found between timed-up-go test time and KBIs for stair ascending and descending.