Abstract:
Total knee replacement (TKR) has been used in the last forty years to treat severe arthritis and other diseases of the knee joint. The TKR allows years of continued everyday mobility that would be impossible without the surgery. Physicians and physical therapists suggest that moderate to rigorous physcial activity be avoided, in order to reduce the risk of loosening the implant to the point that it becomes ineffective and must be replaced. Few studies have reported quantitative measures of the actual effect of various recreational activities on the TKR. This study sought to describe various kinematic and kinetic changes in the involved leg during four typical recreational activities: slow walking, fast walking, golf swing, and bowling. Four female and four male subjects with TKR performed three trials each of the four activities. Subjects were videotaped for later analysis of kinematic variables: maximum and minimum angular displacement, range of motion (ROM), and peak angular velocity. All trials were performed on a force plate which collected three kinetic values: peak vertical, anteroposterior, and mediolateral ground reaction forces (GRF). Maximum angular displacement and ROM were significantly less in the golf swing than in the other activities. The peak angular velocities were significantly different in all comparisons except between slow and fast walking. Golf swing peak vertical GRF's were significantly greater than in the other activities, but peak anteroposterior force was less than in the other three activities. Only the greater peak vertical force in the golf swing would indicate that any of these activities may place greater stresses on the knee replacement than everyday walking.