# Contralateral Knee Osteoarthritis Among Older Adults after Primary Total Knee Arthroplasty

> **NIH NIH F32** · UNIVERSITY OF COLORADO DENVER · 2021 · $26,062

## Abstract

PROJECT SUMMARY/ABSTRACT
Approximately 3.5 million older adults will undergo total knee arthroplasty (TKA) annually by the year 2030. In
addition, nearly 30% of individuals who undergo unilateral TKA will develop end-stage knee osteoarthritis (OA)
and require a TKA on their contralateral (non-operated) side within just 3 years of their initial surgery. As such,
the contralateral knee of primary TKA patients represents a biomechanical model of accelerated progression of
knee OA, offering a unique opportunity to investigate biomechanical mechanisms of OA pathogenesis. One
proposed mechanism for rapid contralateral knee OA progression is aberrant movement patterns that increase
and concentrate loading on unhabituated knee cartilage. Specifically, smaller sagittal plane knee excursions, or
a more “stiff-knee” gait pattern, and higher joint loading—which together may distribute increased forces on a
reduced area of knee cartilage—are both common among individuals with knee OA and/or TKA and are
associated with knee OA severity and future contralateral TKA. Previous studies investigating aberrant
movement patterns and contralateral knee OA after TKA have notable limitations, relying either on diagnostic
(e.g., radiographic) imaging or biomechanical analyses, but not both. The F32 work will address shortcomings
in previous research and investigate the biomechanical mechanisms associated with contralateral knee OA
severity and progression, critical to understanding OA pathogenesis and ultimately designing effective
interventions. The purpose of this F32 award is 1) to determine how longstanding, aberrant movement patterns
might contribute to early, contralateral knee OA (before TKA), and 2) how persistent, aberrant movement
patterns after primary TKA might further contribute to accelerated contralateral knee OA progression.
Biomechanical motion analyses during gait will be collected for 150 patients (age 60-85 years) pre-operatively
and immediately after rehabilitation following TKA. Magnetic resonance imaging (MRI) will be performed at
baseline and 2 years after TKA. Aim 1 will determine if greater knee joint loading and less knee joint excursion
in the contralateral knee preoperatively are associated with greater contralateral knee OA (i.e., higher [worse]
semi-quantitative and quantitative MRI values). Aim 2 will determine if greater knee joint loading and less knee
joint excursion in the contralateral knee immediately after TKA rehabilitation are associated with contralateral
knee OA progression from baseline to 2 years after primary TKA. The proposed study is significant because of:
1) the large and growing population of people undergoing TKA; 2) the high incidence of contralateral knee OA
progression after unilateral TKA, potentially a direct consequence of unresolved aberrant movement patterns;
and 3) our current, inadequate understanding of the biomechanical mechanisms leading to the development
and progression of contralateral knee OA. This F32 ...

## Key facts

- **NIH application ID:** 10135665
- **Project number:** 5F32AG066274-02
- **Recipient organization:** UNIVERSITY OF COLORADO DENVER
- **Principal Investigator:** Jacob J Capin
- **Activity code:** F32 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $26,062
- **Award type:** 5
- **Project period:** 2020-05-31 → 2021-09-24

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10135665

## Citation

> US National Institutes of Health, RePORTER application 10135665, Contralateral Knee Osteoarthritis Among Older Adults after Primary Total Knee Arthroplasty (5F32AG066274-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10135665. Licensed CC0.

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