• Anne J Smith, D G Lloyd, and D J Wood.
• School of Surgery and Pathology (Orthopaedics)/Human Movement and Exercise Science, University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia.
• J. Orthop. Res. 2004 Mar 1;22(2):260-6.

AbstractThis study tested if abnormal sagittal knee joint loading patterns after total knee arthroplasty (TKA) were present pre-surgery, and if patterns with higher external knee flexion moments were related to the presence and severity of post-surgery anterior knee pain. Gait analysis and clinical evaluation were performed on 34 patients (41 arthroplasties) both before and 12-18 months after TKA, and on 20 healthy age-matched controls at matched velocities. The majority of knees with abnormal flexor or extensor sagittal knee joint loading patterns post-surgery (18 of 26, 69%) also displayed these patterns pre-surgery. Knee joint loading in the early mid-stance phase of walking prior to surgery was identified by stepwise regression as a significant predictor of the presence (exp(beta)=2.9, CI: 1.2-6.8, p=0.017) and severity of post-surgery anterior knee pain (R2=0.314, p=0.019). Therefore, the frequency and severity of anterior knee pain after TKA can be partially explained by retained pre-surgery gait patterns that had higher external flexion moments in the early mid-stance phase, which place higher forces on the patellofemoral joint.

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