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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 8/2016

01-08-2016 | Knee

Quadriceps strength asymmetry predicts loading asymmetry during sit-to-stand task in patients with unilateral total knee arthroplasty

Authors: Ali H. Alnahdi, Joseph A. Zeni, Lynn Snyder-Mackler

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 8/2016

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Abstract

Purpose

This study aimed to examine interlimb differences in muscle strength and sit-to-stand (STS) kinetics in persons who underwent unilateral total knee arthroplasty (TKA) and to determine whether knee pain, quadriceps or hip abductor weakness contributes to altered STS performance. It was hypothesized that the operated limb would have weaker muscles, lower mechanical loading and that operated knee pain and muscle strength symmetry would predict loading symmetry between limbs during STS.

Methods

One hundred and forty-two patients, 6 or 12 months post-unilateral TKA, underwent 3D motion analysis (VICON) of the STS task and isometric strength testing of the quadriceps and hip abductors. Knee pain was also quantified using a question from the Knee Outcome Survey-Activities of Daily Living Scale.

Results

The operated limb had weaker quadriceps (P < 0.001), lower hip (P = 0.004) and knee extension moments (P < 0.001), and lower vertical ground reaction forces (P < 0.001). Operated knee pain and quadriceps strength symmetry were related to symmetry in knee extension moment (P < 0.04), and vertical ground reaction forces (P < 0.02) 6 months after surgery, while quadriceps strength symmetry was related to symmetry in vertical ground reaction forces (P = 0.03), 1 year after surgery.

Conclusion

Patients with unilateral TKA unload the operated limb and shift the mechanical load to the joints of the contralateral limb even 1 year after surgery. Knee pain and quadriceps strength asymmetry may play a role in the asymmetrical loading during STS post-TKA. Clinicians should consider addressing these modifiable impairments to resolve the loading asymmetry.

Level of evidence

III.
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Metadata
Title
Quadriceps strength asymmetry predicts loading asymmetry during sit-to-stand task in patients with unilateral total knee arthroplasty
Authors
Ali H. Alnahdi
Joseph A. Zeni
Lynn Snyder-Mackler
Publication date
01-08-2016
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 8/2016
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-015-3827-x

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