A Biomechanical Foot-Worn Device Improves Total Knee Arthroplasty Outcomes

Abstract

Background: Biomechanics after total knee arthroplasty (TKA) often remain abnormal and may lead to prolonged postoperative recovery. The purpose of this study is to assess a biomechanical therapy after TKA.

Methods: This is a randomized controlled trial of 50 patients after unilateral TKA. One group underwent a biomechanical therapy in which participants followed a walking protocol while wearing a foot-worn biomechanical device that modifies knee biomechanics and the control group followed a similar walking protocol while wearing a foot-worn sham device. All patients had standard physical therapy postoperatively as well. Patients were evaluated throughout the first postoperative year with clinical measures and gait analysis.

Results: Improved outcomes were seen in the biomechanical therapy group compared to the control group in pain scores (88% vs 38%, P = .011), function (86% vs 21%, P = .001), knee scores (83% vs 38%, P = .001), and walking distance (109% vs 47%, P = .001) at 1 year. The therapy group showed healthier biomechanical gait patterns in both the sagittal and coronal planes at 1 year.

Conclusion: A postoperative biomechanical therapy improves outcomes following TKA and should be considered as an additional therapy postoperatively.

Keywords: biomechanics; clinical outcomes; gait analysis; kinematics and kinetics of the knee; sagittal and coronal plane; total knee arthroplasty.