An Objective Model of Joint and Muscle Function Outcome after Total Knee Arthroplasty Surgery

An estimated four million (16%) adult Canadians live with arthritis and the demand for total knee replacement surgery is increasing at a similar alarming rate, particularly among younger individuals who desire more active lifestyles. The surgery is limited in its ability to provide significant improvements in joint and muscle function post-operatively to all patients, which has consequences in terms of lack of participation, satisfaction and therefore general health. Out Team of basic and clinical scientists has worked together over the past decade to develop a longitudinal framework of knee osteoarthritis (OA) severity, progression and response to treatment. We have discovered that there is considerable variability in terms of joint and muscle function between patients after knee replacement surgery, with some patient gait patterns very close to normal, and others continuing to display the altered patterns characteristic of the pre-operative state. We have discovered preliminary links between joint motion captured within the operating room using computer-assisted surgery and pre and post-operative joint function. This is evidence that patient-specific factors that can be captured prior to and during surgery may be used to inform both surgical and pre/post surgical rehabilitation strategies to optimize management for patients on an individual level. Our current goal is to develop a comprehensive model of the links between joint movement, loading and muscular control at the pre and post-operative states and within the operating room, and to characterize alterations in these factors at each stage relative to a large model of asymptomatic (i.e. 'normal') patterns to assess the degree of alteration on an average and individual level. Sex-specific alteration (women vs men) will also be examined.