Can isokinetic test be a supportive tool for unilateral knee arthroplasty decision?

Objectives: This study analyzed whether the isokinetic muscle strength of bilateral knee osteoarthritis patients undergoing unilateral total knee arthroplasty (TKA) is a predictor for prior surgery side. Patients and methods: In the prospective study conducted between April 2021 and December 2021, 58 knees of 29 unilateral TKA candidates (6 males, 23 females; mean age: 66.7 +/- 7.4 years; range, 53 to 81 years) were enrolled. The patients were divided into surgical (n=29)and nonsurgical (n=29) groups. The knees of patients with bilateral knee osteoarthritis (Stage III or IV) according to the Kellgren-Lawrence (KL) scale were scheduled for unilateral TKA. An isokinetic testing system was used to assess knee flexor and extensor muscle strength (peak torque) at angular velocities of 60 degrees/sec and 180 degrees/sec (five cycles per velocity). The radiological (X-ray-based KL scale and magnetic resonance imaging-based quadriceps angle) and clinical findings (isokinetic test and Visual Analog Scale pain scores) in both groups were compared. Results: The mean symptom duration was 10 +/- 5.4 years. The KL score and quadriceps angle showed no significant differences (p=0.056 and p=0.663, respectively). Isokinetic test results were in accordance with the clinical results of the surgery group. In the isokinetic evaluation, both the 60 degrees/sec concentric extension (35.00 vs. 46.00, p=0.002) and flexion peak torque (18.00 vs. 26.00, p=0.001) values were significantly lower in the surgical group than in the nonsurgical group. Conclusion: Isokinetic testing can be a supportive tool for assessing the prior side of TKA in patients with bilateral knee osteoarthritis. Further studies are required to support these findings.

Automated summary

This study analyzed whether the isokinetic muscle strength of bilateral knee osteoarthritis patients undergoing unilateral total knee arthroplasty (TKA) is a predictor for prior surgery side. The results showed that the isokinetic test results were in accordance with the clinical results of the surgery group, and the surgical group had significantly lower muscle strength than the nonsurgical group.