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Investigating Pre-Operative Joint-Level...
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Investigating Pre-Operative Joint-Level Biomechanics in Partial versus Total Knee Arthroplasty

Abstract

Abstract Objective The purpose of this study was to investigate preoperative joint-level kinematics across multiple functional tasks including preferred-pace walking, fast-paced walking, and sit-to-stand, alongside self-reported pain and function in cohorts scheduled for partial (PKA) versus total knee arthroplasty (TKA). Methods Patients with end-stage knee osteoarthritis were recruited from St. Joseph’s Healthcare Hamilton. Self-reported measures including Oxford Knee Score, self-reported average pain, quality of life, and depression were collected. Functional tasks including preferred-pace walking, fast-paced walking, and sit-to-stand were collected and recorded using markerless motion capture. Joint-level kinematics were evaluated using linear mixed models using main effects of surgery type and walking condition, along with interaction effects. Results This study included 15 patients scheduled for PKA, and 56 patients scheduled for TKA. No significant differences were observed when evaluating differences between cohorts through self-reported measures, nor at single gait speed conditions or sit-to-stand. However, when evaluating the differences in walking patterns between preferred and fast pace, the PKA group exhibited a significant change in stride length, peak stance knee flexion, peak swing knee flexion, knee excursion, peak stance hip flexion, and overall hip range of motion between preferred and fast-paced walking compared to the TKA group. Conclusion These findings highlight that multi-speed gait assessments rather than single-speed walking or sit-to-stand tasks are likely a more sensitive approach for detecting biomechanical differences in OA patients and may have broader applicability to other clinical populations.

Authors

Shishis MR; Gafoor F; Ruder MC; Di Bacco VE; Madden K; Adili A; Kobsar D

Publication date

September 22, 2025

DOI

10.1101/2025.09.21.25336261

Preprint server

medRxiv
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