Quantitative gait analysis in unconstrained total knee arthroplasty patients

Westfäliche Wilhelms-Universität Münster, Klinik und Poliklinik fur Allgemeine Orthopädie, Albert-Schweitzer-Strasse 33, 48129 Muenster, Germany.
International Journal of Rehabilitation Research (Impact Factor: 1.28). 02/2002; 25(1):65-70. DOI: 10.1097/00004356-200203000-00010
Source: PubMed
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    • "Although the importance of the anterior cruciate ligament (ACL) regarding knee stability, physiologic kinematics, and proprioception is well recognized, to date no bicruciate retaining prosthesis has achieved general acceptance (Nowakowski, 2006). Non-physiologic knee kinematics are generally observed with the use of ACL-sacrificing implants for total knee arthroplasty (TKA), as documented by numerous in vivo studies (Bolanos et al., 1998; Fuchs et al., 2002; Ishii et al., 1998; Lewandowski et al., 1997; Stiehl et al., 1999, 2000). Dennis et al. (1996) found that knees with posterior cruciate retaining (PCR) prostheses perform similarly to non-replaced knees with (ACL) insufficiency. "
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    ABSTRACT: A novel tibial baseplate design (Transversal Support Tibial Plateau) as a new treatment concept for bi-cruciate retaining total knee arthroplasty is evaluated for mechanical stability and compared to other tibial baseplate designs. This concept should provide better primary stability and thus, less subsidence, than implantation of two separate unicondylar tibial baseplates. Different baseplates were implanted into synthetic bone specimens (Sawbones® Pacific Research Laboratories, Inc., Washington, USA), all uncemented. Using a standardized experimental setup, subsidence was achieved, enabling comparison of the models regarding primary stability. Overall implant subsidence was significantly increased for the two separate unicondylar tibial baseplates versus the new Transversal Support Tibial Plateau concept, which showed comparable levels to a conventional tibial baseplate. Reduced subsidence results in better primary stability. Linking of two separate baseplates appears to provide increased primary stability in terms of bony fixation, comparable to that of a conventional single tibial baseplate.
    Clinical biomechanics (Bristol, Avon) 08/2013; 28(8). DOI:10.1016/j.clinbiomech.2013.08.008 · 1.97 Impact Factor
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    • "However, despite the apparent success of TKR many patients continue to report difficulties in daily functional capabilities that cannot be readily explained by traditional clinical assessment methods [6]. Three dimensional motion analysis has been used by researchers to provide a more detailed evaluation of knee motion following TKR in comparison to unimpaired controls [7] [8] [9] [10] [11] [12] [13] [14] [15] [16] [17] [18] [19]. A finding common to most of these studies is that TKR patients walk with less knee flexion during the swing phase of gait than their control counterparts [8] [12] [16] [18] [19]. "
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    ABSTRACT: People who have undergone total knee replacement (TKR) experience difficulties in some daily activities including walking. Walking at faster speeds requires more knee flexion and may therefore present a greater challenge following TKR. The aim of this study was to compare the knee kinematics of patients following TKR and unimpaired controls during comfortable and fast walking speeds. Forty patients (22 women, 18 men) 12 months following TKR and 40 control participants (matched for age and sex) were assessed during walking at self-selected comfortable and fast speeds using three dimensional motion analysis. The group averages of spatiotemporal and peak kinematic characteristics in the sagittal, coronal and transverse movement planes were compared using univariate analysis of variance with walking speed as a co-variate. The TKR group walked with significantly reduced cadence (p < 0.001 at both speeds) and reduced stride length (p < 0.001 at both speeds), less knee flexion during stance and swing phases (p < 0.001 for both speeds) and less knee extension during stance phase (p < 0.024 for comfortable speed; p < 0.042 for fast speed). The TKR group also walked with less peak knee external rotation than controls at both speeds (p < 0.001 for both speeds). Both groups increased their velocity, cadence and stride length by a similar proportion when walking at fast speed. When walking at a faster speed, spatiotemporal gait parameters and knee motion are altered in a similar manner for both TKR patients and controls. However, at both walking speeds, TKR patients exhibit residual deficits 12 months following surgery.
    The Knee 06/2011; 18(3):151-5. DOI:10.1016/j.knee.2010.04.005 · 1.94 Impact Factor
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    • "# 96 Lehman (2004)* 97 Lamoth et al. (2006a) # 98 Lamoth et al. (2006b) # 99 Lee et al. (2007) # 100 Morone et al. (2009) § KOA/TKA 101 Wilson et al. (1996) + 102 Su et al. (1998) + 103 Otsuki et al. (1999) 16 Mizner et al. (2005) 104 Viton et al. (2000) + 105 Farquhar et al. (2008) + 106 Fuchs et al. (2002) + 107 Chen et al. (2003) + 108 Smith et al. (2004) + 109 Liikavainio et al. (2007) + 110 Levinger et al. (2008) 111 Milner (2008) 112 Yoshida et al. (2008) + 100 Morone et al. (2009) "

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