The Effect of Knee Flexion Contracture Following Total Knee Arthroplasty on the Energy Cost of Walking

This study evaluated the energy cost of walking (Cw) with knee flexion contractures (FC) simulated with a knee brace, in total knee arthroplasty (TKA) recipients (n = 16) and normal controls (n = 15), and compared it to baseline (no brace). There was no significant difference in Cw between the groups at baseline but TKA recipients walked slower (P = 0.048) and with greater knee flexion in this condition (P = 0.003). Simulated FC significantly increased Cw in both groups (TKA P = 0.020, control P = 0.002) and this occurred when FC exceeded 20° in the TKA group and 15° in the controls. Reported perceived exertion was only significantly increased by FC in the control group (control P < 0.001, TKA P = 0.058). Simulated knee FCs less than 20° do not increase Cw or perceived exertion in TKA recipients.