Kinematics following gait perturbation in adults with knee osteoarthritis: Scheduled versus not scheduled for knee arthroplasty

Objective: To compare recovery kinematics following trip-simulated perturbation during gait between three groups: adults without knee Osteoarthritis (OA) and adults with OA, scheduled and not scheduled for Total Knee Replacement (TKR). Methods: People with OA scheduled for TKR (TKR group; N = 19) and not scheduled (NTKR group; N = 17) were age-matched with People without OA (N = 19). Outcome measures included: joint range of motion (ROM), Timed Up and Go (TUG), joint pain levels, Oxford score, Instrumental Activities of Daily Living Questionnaire, and the Activities-specific Balance Confidence Scale. Also, spatiotemporal gait parameters and joint kinematics were recorded during perturbed and unperturbed gait. The perturbed gait data were normalized by unperturbed gait data. Results: There were no differences between the two OA groups in the four questionnaire scores and joint ROM. The TUG score of the TKR group was higher than that of the NTKR group. There were no statistically significant between-group differences in the normalized spatiotemporal parameters. The OA groups showed statistically significant lower anterior pelvic tilt ranges and higher maximal hip adduction of the contralateral limb compared to the Non-OA group. When the contralateral limb was perturbed, the TKR group showed significantly lower pelvic rotation range compared to the NTKR and Non-OA groups. When the OA limb was perturbed, the maximal hip flexion of the injured limb was significantly lower and the maximal knee flexion higher in the OA groups compared with the Non-OA group. Conclusion: The recovery strategy from trip-simulated perturbation of individuals with OA differs from that of individuals without OA. This may emphasize the importance of devising a treatment plan that focuses on improving balance and reactions to gait perturbation.