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J Arthroplasty. 2017 Aug;32(8):2404-2410. doi: 10.1016/j.arth.2017.03.008. Epub 2017 Mar 16.

Influence of Body Mass Index on Sagittal Knee Range of Motion and Gait Speed Recovery 1-Year After Total Knee Arthroplasty.

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Willy Taillard Laboratory of Kinesiology, Geneva University Hospitals and Geneva University, Geneva, Switzerland; Division of Orthopaedics and Trauma Surgery, Geneva University Hospitals, Faculty of Medicine, Geneva, Switzerland.
Division of Orthopaedics and Trauma Surgery, Geneva University Hospitals, Faculty of Medicine, Geneva, Switzerland.
Laboratoire d'Exploration Fonctionnelle Clinique du Mouvement, CHRU de Besançon, Besançon, France; Centre d'Investigation Clinique INSERM CIT 808, CHRU de Besançon, Besançon, France.
Department of Kinesiology, Faculty of Medicine, Laval University, Quebec, Canada; Centre for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Quebec, Canada.



The purpose of this prospective study was to investigate the influence of body mass index (BMI) on gait parameters preoperatively and 1 year after total knee arthroplasty (TKA).


Seventy-nine patients were evaluated before and 1 year after TKA using clinical gait analysis. The gait velocity, the knee range of motion (ROM) during gait, their gains (difference between baseline and 1 year after TKA), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), quality of life, and patient satisfaction were assessed. Nonobese (BMI <30 kg/m2) and obese patients (BMI ≥30 kg/m2) were compared. Healthy controls were also assessed. Univariate and multivariate linear regression analyses were used to assess the association between gait speed and ROM gains. Adjustment was performed for gender, age, and WOMAC pain improvement.


At baseline, gait velocity and knee ROM were significantly lower in obese compared with those in the nonobese patients (0.99 ± 0.27 m/s vs 1.11 ± 0.18 m/s; effect size, 0.53; P = .021; and ROM, 41.33° ± 9.6° vs 46.05° ± 8.39°; effect size, 0.52; P = .022). Univariate and multivariate linear regressions did not show any significant relation between gait speed gain or knee ROM gain and BMI. At baseline, obese patients were more symptomatic than nonobese (WOMAC pain: 36.1 ± 14.0 vs 50.4 ± 16.9; effect size, 0.9; P < .001), and their improvement was significantly higher (WOMAC pain gain, 44.5 vs 32.3; effect size, 0.59; P = .011).


These findings show that all patients improved biomechanically and clinically, regardless of their BMI.


body mass index (BMI); gait; knee kinematic; longitudinal study; osteoarthritis (OA); total knee arthroplasty (TKA)

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