Knee biomechanics during downhill walking on different slopes in total knee replacement older adults

Downhill walking is an inevitable part of daily living and causes higher knee joint loading compared to level walking in young healthy populations. The purpose of this study was to compare knee biomechanics of the replaced limb to the non-replaced limb of TKR patients and healthy controls during walking on level ground and declined surfaces of 5°, 10° and 15°. The results from this study demonstrated that the replaced limb of TKR patients had lower peak loading-response knee extension moment (KEM) than healthy and non-replaced limb. Greater peak KEM was found in downhill walking compared to level walking. These results indicate that downhill walking may increase overall knee joint loading and therefore may not be appropriate to be included in early stage rehabilitation protocols following TKR surgery. However, increased slope does not seem to affect medial compartment loading.