{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T00:33:49Z","timestamp":1792456429472,"version":"4.5.0"},"reference-count":30,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,12,17]],"date-time":"2018-12-17T00:00:00Z","timestamp":1545004800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R56 AG 048943"],"award-info":[{"award-number":["R56 AG 048943"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100002369","name":"University of Delaware Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100002369","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal Orthopaedic Research"],"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:label\/><jats:p>Osteoarthritis (OA) progression in the contralateral limb after unilateral total knee arthroplasty (TKA) may be related to altered and asymmetrical movement patterns that overload the contralateral joints. The purpose of this study was to determine if biomechanical factors after unilateral TKA were associated with future contralateral TKA. One hundred and fifty\u2010eight individuals who underwent unilateral TKA completed three dimensional motion analysis 6\u201324 months after unilateral TKA (baseline). Subjects were re\u2010contacted for follow\u2010up (mean 5.89 years after baseline testing) to determine if they had undergone a contralateral TKA. Biomechanical variables from gait at baseline were compared between those who did and did not undergo contralateral TKA at follow\u2010up using one\u2010way ANOVAs. Odds ratios were calculated for variables found to be significant in the ANOVA models. Individuals who underwent contralateral TKA had less knee flexion excursion (10.5\u00b0 vs. 12.1\u00b0; <jats:italic>p<\/jats:italic>\u2009=\u20090.032) and less knee extension excursion (8.2\u00b0 vs. 9.6\u00b0; <jats:italic>p<\/jats:italic>\u2009=\u20090.035) at baseline on the operated side during walking. Individuals who underwent contralateral TKA also had less knee flexion excursion on the contralateral limb at baseline (11.9\u00b0 vs. 14.0\u00b0; <jats:italic>p<\/jats:italic>\u2009=\u20090.017). For every additional degree of knee flexion excursion on the contralateral knee at baseline, there was a 9.1% reduction in risk of future contralateral TKA. Individuals who walked with stiffer gait patterns were more likely to undergo future contralateral TKA. Clinical Significance: Altered movement patterns after surgery may increase the risk for contralateral TKA. Knee excursion is an important metric to include in outcome studies and may serve as a target of rehabilitation after TKA. \u00a9 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 37:397\u2013402, 2019.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jor.24175","type":"journal-article","created":{"date-parts":[[2018,11,2]],"date-time":"2018-11-02T11:14:18Z","timestamp":1541157258000},"page":"397-402","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":45,"title":["Stiff knee gait may increase risk of second total knee arthroplasty"],"prefix":"10.1002","volume":"37","author":[{"suffix":"Jr.","given":"Joseph A.","family":"Zeni","sequence":"first","affiliation":[{"name":"Rutgers The State University of New Jersey School of Health Professions Department of Rehabilitation and Movement Sciences Doctor of Physical Therapy Program \u2212 North 65 Bergen Street \u2212 Office 714A Newark New Jersey 07107"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Portia","family":"Flowers","sequence":"additional","affiliation":[{"name":"University of North Carolina at Chapel Hill Thurston Arthritis Research Center Chapel Hill 27599 North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Bade","sequence":"additional","affiliation":[{"name":"University of Colorado Anschutz Medical Campus Physical Therapy Program Aurora Colorado 80045"},{"name":"Veterans Affairs Geriatric Research Education and Clinical Center Eastern Colorado Healthcare System 13611 East Colfax Aurora Colorado 80045"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"Cheuy","sequence":"additional","affiliation":[{"name":"University of Colorado Anschutz Medical Campus Physical Therapy Program Aurora Colorado 80045"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Stevens\u2010Lapsley","sequence":"additional","affiliation":[{"name":"University of Colorado Anschutz Medical Campus Physical Therapy Program Aurora Colorado 80045"},{"name":"Veterans Affairs Geriatric Research Education and Clinical Center Eastern Colorado Healthcare System 13611 East Colfax Aurora Colorado 80045"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynn","family":"Snyder\u2010Mackler","sequence":"additional","affiliation":[{"name":"University of Delaware Department of Physical Therapy, Biomechanics and Movement Science Program Newark Delaware 09713"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,12,17]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.10649"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2012.10.008"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2012.10.008"},{"key":"e_1_2_6_5_1","first-page":"1822","article-title":"The risk of contralateral total knee arthroplasty after knee replacement for osteoarthritis","volume":"30","author":"McMahon M","year":"2003","journal-title":"J Rheumatol"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2007.371"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780400420"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2474-14-219"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-116-7-535"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/oby.20835"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.61.7.617"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.knee.2008.12.007"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/jor.21323"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.61.7.617"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2009.02.001"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.20012"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2009.01.005"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-009-0892-9"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2012.3763"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2012.11.008"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-015-3827-x"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2014.11.001"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1023\/B:ABME.0000017541.82498.37"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2009.02.001"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1302\/2046-3758.410.2000420"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2003.08.007"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2015.5540"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gaitpost.2015.09.025"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2013.12.014"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2474-11-86"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2006.04.014"}],"container-title":["Journal of Orthopaedic Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fjor.24175","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jor.24175","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,12]],"date-time":"2023-09-12T05:01:30Z","timestamp":1694494890000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jor.24175"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,12,17]]},"references-count":30,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2019,2]]}},"alternative-id":["10.1002\/jor.24175"],"URL":"https:\/\/doi.org\/10.1002\/jor.24175","archive":["Portico"],"relation":{},"ISSN":["0736-0266","1554-527X"],"issn-type":[{"value":"0736-0266","type":"print"},{"value":"1554-527X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,12,17]]},"assertion":[{"value":"2017-10-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-10-03","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-12-17","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}