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: 1.14). 02/2002; 25(1):65-70. DOI: 10.1097/00004356-200203000-00010
Source: PubMed
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    ABSTRACT: Patients with lateral osteoarthritis of the knee suffer not only from pain but also impaired gait and limited mobility. Common treatment options are total knee replacement and lateral unicompartmental knee arthroplasty (UKA). The domed lateral mobile-bearing Oxford Uni is a new treatment option for patients with isolated osteoarthritis of the lateral compartment of the knee joint. We used instrumented gait analysis and clinical scores to study patients before and after lateral UKA. Nineteen patients suffering from lateral osteoarthritis underwent implantation of a mobile-bearing lateral UKA. They were examined in a gait analysis before the operation and after an average follow-up time of 7 months. Gait analysis was performed on a treadmill with six infrared cameras to identify gait characteristics (e.g. velocity, stride time, stride length, knee abduction or hip adduction). Mean velocity changed from 0.58 to 0.73 m/s. Significant advancements were also found in knee abduction and hip adduction. Time and length of strides improved significantly as well as the clinical scores American Knee Society Score, Oxford-12, FFb-H-OA and Devane Score. Patients with lateral osteoarthritis of the knee showed an impaired gait with an increased knee abduction and hip adduction angle. Implantation of a lateral mobile UKA can restore normal axis of the leg and improve gait and function of the knee. Instrumented gait analysis is a suitable measuring instrument to quantify and qualify the post-operative change of gait. LEVEL OF EVIDENCE: II.
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    ABSTRACT: The aim of the present study was to investigate the gait and muscle strength characteristics in total knee arthroplasty (TKA) patients with patellofemoral pain syndrome (PFPS) before and six months after surgery. Eight patients (4 men and 4 women) aged 58–77 years with PFPS following unilateral TKA who had primary degenerative knee OA participated in the study before and six months after reoperation. In patients was registered the active range of motion (AROM) of knee extension and flexion, hip abduction and adduction. Isometric maximal voluntary contraction (IMVC) force of knee flexors, extensors, abductors and adductors was measured and gait kinematic characteristics and kinetic characteristics of knee joint were recorded. Knee flexion AROM in the involved leg was significantly lower (p<0.05) as compared to the uninvolved leg pre- and post-surgery. The patients had greater (p<0.05) hip abduction AROM and significant increase (31%, p<0.05) of IMVC force of the involved legʼs hip abductors postoperatively as compared before surgery. Six months after surgery 38 H. Gapeyeva et al. a significant (p<0.05) improvement of gait spatiotemporal characteristics (increase of swing time and stride length (p<0.05), together with decrease of stance time and cadence, as well increase of stride length) was noted in the involved leg. In TKA patients 6 months after reoperation due to PFPS the knee joint function in involved leg was significantly improved and the positive changes in gait with comfortable velocity took place as compared before surgery.
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    ABSTRACT: The purpose of this study was to work out an objective and sensitive method for the early postoperative period following total knee arthroplasty (TKA) in which analysis of the gait parameters is possible and also to investigate the influence of different surgical approaches for TKA on the gait during stepping in the first three months of the postoperative period. Three groups of patients: age-matched healthy elderly patients as a control group, patients operated upon by the conventional technique and finally by the minimally invasive technique combined with computer-assisted navigation. All three groups included ten patients. The motions of knee, shoulder and pelvis were measured by ZEBRIS ultrasound-based system preoperatively plus six and 12 weeks postoperatively. From the joint motion, the variability of cadence, and the variability of knee joint motion and that of pelvis and shoulder girdle was determined. Osteoarthritis (OA) of the knee joint and TKA using both operation techniques significantly influenced the variability of stepping parameters compared to the controls. In the early postoperative period a significant difference was detected between the two groups of the operated patients in all parameters. Our data prove that our method seems appropriate to provide objective measurement of the gait in the early postoperative period. The variability of motion of the patient groups approaches that of the healthy control group steadily, but does not reach them.
    International Orthopaedics 10/2013; 38(3). · 2.02 Impact Factor