Analysis of a rotary task following total knee arthroplasty: Stair descent with a cross-over turn

Linda M. Denney, Lauren A. Ferris, Hongying Dai, Lorin P. Maletsky

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Leg loading and knee angle differences have been reported in total knee replacement individuals during straight gait; however, little is known about the impact on the knee during turning. Rotary motions may be difficult following total knee replacement surgery; therefore, some individuals may develop strategies or utilize pre-surgical strategies in order to maintain function. The primary aim of this study was to identify differences in individuals with a total knee replacement as compared to their healthy counterparts during stair descent followed by a cross-over turn. Ground reaction force, knee angle and moments were recorded on 10 total knee replacement and 12 healthy individuals during stair descent followed by a turn and compared to walking straight. Variables were analyzed for the affected, unaffected and healthy knees during the gait cycle. On initial contact, the total knee replacement group had less ground reaction force on the affected leg compared to the unaffected leg (p = 0.021) and had delayed contact (p = 0.044) and a slower loading rate (p = 0.020) compared to healthy group. During mid-stance, the affected leg had less ground reaction force compared to the healthy leg (p = 0.049). The affected stance leg had less knee flexion during mid-stance in both the straight trial (p = 0.002) and turn (p = 0.010). Moment differed between straight and turn trials but not between groups. Stair descent with or without a turn was approached in a precautionary manner by individuals with a total knee replacement. Slow approach, reduced impact and weight-bearing with a more extended knee on the affected leg may suggest a protective strategy to avoid risk of fall.

Original languageEnglish (US)
Pages (from-to)429-438
Number of pages10
JournalProceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine
Issue number5
StatePublished - May 2014
Externally publishedYes


  • Compensatory strategy
  • Ground reaction force
  • Knee flexion
  • Rotary instability
  • Total knee replacement

ASJC Scopus subject areas

  • Mechanical Engineering


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