Walking, chair rising, and stair climbing after total knee arthroplasty: patellar resurfacing versus nonresurfacing

Abstract

During the past decade, the technology and design of knee joint prostheses has progressed considerably. However, there is still much controversy on whether resurfacing the patella during routine total knee arthroplasty (TKA) is necessary. This study compares the biomechanics of the lower limb in patients after TKA with and without patellar resurfacing during level walking, stair climbing, and chair rising. Eighteen patients who underwent TKA by two different surgeons using the same prosthesis were studied after full rehabilitation while walking, stair climbing, and chair rising. Patients were divided between those who were resurfaced and those who were not resurfaced. An aged-matched control population was recruited for comparison. The Hospital for Special Surgery Knee Rating Scale was used to gather clinical information. Kinematic and kinetic parameters were collected using a 5-camera Motion Analysis System and an AMTI OR6-5 force platform. For level walking, patients were asked to walk at a self-selected speed down an 8-m walkway. For stair climbing, patients were asked to climb a 4-step staircase without handrail support and for chair rising, patients were asked to rise from a chair that was positioned at the height of their knee joint line. Five trials for each side were recorded for averaging and statistical analysis. Temporal-spatial parameters and kinematic and kinetic variables at the knee joint were tested for significance using the repeated measures analysis of variance (ANOVA). There were no significant differences in the biomechanics of walking, stair climbing, or chair rising between patients after TKA with and without a resurfaced patella.