Quantitative Gait Analysis After Unilateral Knee Arthroplasty for Patients with Bilateral Knee Osteoarthritis

The Knee, 2005

The aim of this prospective follow-up study was to determine if gait measurements and/or clinical measurements could detect differences in treatment outcome between two surgical interventions in patients with knee osteoarthritis (OA). The patients were followed for 5 years after surgery. Forty patients, 55 -70 years of age, with unilateral knee OA were included. The patients were treated either with a high tibial osteotomy (HTO) (n = 18) or a unicompartmental knee arthroplasty (UKA) (n = 22). Clinical outcome measures were the British Orthopaedic Association (BOA) score, pain during walking, passive range of knee motion (PROM) and patients' subjective opinion. The gait variables were free walking speed, step frequency, step length and single and double-stance phase for each leg. The patients were examined before surgery and 3 months, 1 year and 5 years after surgery. The time -distance variables of gait could detect differences in treatment outcome, 3 months after surgery, while the clinical outcome measures, as given here, could not detect any differences between the two groups of patients. Measurements of free walking speed could be recommended for clinical evaluation, after surgical interventions, in patients with knee OA. D

Orthopaedic surgery, 2016

To evaluate the effects of surgery and rehabilitation on patients undergoing total knee arthroplasty (TKA). Twelve patients and 12 healthy controls were enrolled and their clinical scores evaluated by a doctor. Gait data, including walking velocity, stride length, single support time, foot fall and swing power, were collected using a portable gait analyzer from 12 patients before and 6 weeks and 6 months after surgery and from 12 healthy controls. The gait data and clinical scores at selected time points were compared and correlations between gait characteristics and clinical scores assessed. Clinical knee and knee function scores increased significantly from before surgery to 6 weeks to 6 months after surgery (P < 0.001). The only significant differences identified were for single support time on the diseased side between before surgery and 6 months after surgery (P = 0.031) and for foot fall with the diseased side between 6 weeks and 6 months after surgery (P = 0.016). Foot fal...

Journal of Healthcare Engineering, 2017

Purpose. With the aim of investigating the spatiotemporal features of early gait pattern and knee kinematics after total knee arthroplasty and analyzing the association between outcomes of gait analyses and knee kinematic parameters, the relationship between walking and dynamic knee deformity at the early period after total knee arthroplasty was assessed in this study. Methods. Eighteen patients including 14 women and 4 men who underwent total knee arthroplasty were analyzed using three-dimensional gait analysis system to observe gait parameters and values of maximum knee flexion angle (MKFA) during swing phase and knee flexion angle (KFA) and knee valgus angle (KVA) at midstance phase. Results. 3D gait analysis showed that operated side exhibited significantly less total support time and single support time as well as significantly longer swing phase compared with the other side. During walking, the operated side had significantly smaller MKFA and greater KFA and KVA than the nonop...

BMC Musculoskeletal Disorders, 2015

Background: The aim of the study was to assess gait in total knee arthroplasty (TKA) patients, using a technique that can to be used on a routine basis in a busy orthopaedic clinic. Methods: A total of 103 subjects were recruited: 29 pre-op TKA patients; 17 TKA patients at 8 weeks post-op; 28 TKA patients at 52 weeks post-op; and 29 age-matched controls. Inertial measurement units (IMUs) were used to assess gait. Limb segment angles, knee angle and temporal parameters of gait were calculated. Specific gait parameters were quantified, and data analysed using MANOVA and discriminant analysis. Results: The gait of TKA patients as a group was only slightly improved at 12 months when compared with the pre-operative group, and both groups were significantly different to controls in several variables. Knee flexion range in stance was the most important variable in discriminating between patients and controls; knee flexion range in swing was the only variable that showed a significant difference between pre-and post-operative patients. When considered individually, only 1/29 patient was within the normal range for this variable pre-operatively, but 9/28 patients were within the normal range 12 months post-operatively. Conclusions: Even after 12 months after surgery, many TKA patients have not improved their gait relative to pre-operative patients. Routine gait assessment may be used to guide post-operative rehabilitation, and to develop strategies to improve mobility of these patients.

BioMed Research International, 2015

The effect of joint pathologies, such as unilateral knee osteoarthritis (UKOA) or low back pain (LBP), on bilateral gait symmetry has gained increased attention during the past decade. This study is the first to compare gait patterns between patients with UKOA and LBP in combination and with UKOA only. Temporal, kinematic, and kinetic variables were measured bilaterally during gait stance phase in 31 subjects with UKOA and LBP (Group I) and 11 subjects with only UKOA (Group II). Group I patients exhibited less hip rotation in the affected limb (A) than in the nonaffected (NA) limb during walking in contrast to Group II patients. Group I patients had minimal bilateral differences in hip abduction and flexion, but Group II patients displayed significantly larger values in the NA limb compared to the A limb for both parameters. Hip flexion patterns were significantly different between Groups I and II. Subjects in both groups adapted gait patterns that minimized vertical ground reaction force, knee flexion motion, and stance time on the UKOA affected limb. The distinct kinematic gait patterns that were revealed in this study may provide clinical value for assessment of patients with UKOA in conjunction with LBP.

2021

We aimed to compare the spatiotemporal parameters and joint kinematics during unperturbed and perturbed gait between individuals with osteoarthritis (OA) who did or did not undergo total knee replacement (TKR) one year post a baseline evaluation. OA subjects scheduled for TKR (TKR group; n = 14) and not scheduled for TKR (NTKR group; n = 17) were age-matched. Outcome measures included: joint range of motion, timed up and go, joint pain levels, Oxford score, and the Activities-specific Balance Confidence Scale. In addition, spatiotemporal gait parameters and joint kinematics were recorded during perturbed and unperturbed gait. After one year, most of the TKR group (71%), but only 41% of the NTKR group, increased their gait velocity by more than 0.1m/sec, which is the meaningful clinical important difference for gait velocity. After perturbation of the contralateral limb, the TKR group showed a greater decrease in the maximal extension of the OA hip compared to the NTKR group (p = 0.0...

2015

Pour l'honneur qu'il m'a fait pour sa participation à mon jury de thèse en qualité de rapporteur de mon travail, pour le temps consacré à la lecture de cette thèse. Je suis particulièrement honorée de sa présence dans ce jury de soutenance. Je lui exprime ici ma plus haute considération. Monsieur le Professeur Frédéric Farizon Pour avoir accepté d'être rapporteur et membre de jury de cette thèse. Je le remercie pour l'intérêt et la considération qu'il a porté à ces travaux. Je lui adresse mes sincères remerciements ainsi que ma profonde gratitude. Monsieur le Professeur Philippe Neyret, Je tenais à vous remercier de l'accueil que vous m'avez réservé et du temps que vous m'avez consacré lors de mon parcours professionnel. Cette expérience sera très importante pour ma carrière et les tâches auxquelles vous m'avez associée m'ont vraiment permis de consolider mes connaissances et d'en développer de nouvelles. Monsieur le Professeur Sébastien Lustig, Sans vous, cette thèse n'aurait pas été possible. Je vous remercie pour votre patience et vos encouragements qui m'ont portée dans les moments difficiles, pour vos idées et suggestions PLAN ABSTRACT CHAPTER I. INTRODUCTION Hill, Iwaki and coworkers [10] applied MRI scans to 13 unloaded knees and 7 loaded knees for the description of the surface geometry and relative movements of the femur and the tibia. According to this study, during flexion in the unloaded knee, medially, the mean AP position of the femoral condyle did not change from 110° to-5°. Laterally, the femoral condyle rolled

Iranian Rehabilitation Journal, 2013

The aim of this study was to extract suitable spatiotemporal and kinematic parameters to determine how Total Knee Replacement (TKR) alters patients' knee kinematics during gait, using a rapid and simplified quantitative two-dimensional gait analysis procedure. Methods: Two-dimensional kinematic gait pattern of 10 participants were collected before and after the TKR surgery, using a 60 Hz camcorder in sagittal plane. Then, the kinematic parameters were extracted using the gait data. A student t-test was used to compare the group-average of spatiotemporal and peak kinematic characteristics in the sagittal plane. The knee condition was also evaluated using the Oxford Knee Score (OKS) Questionnaire to ensure that each subject was placed in the right group. Results: The results showed a significant improvement in knee flexion during stance and swing phases after TKR surgery. The walking speed was increased as a result of stride length and cadence improvement, but this increment was not statistically significant. Both post-TKR and control groups showed an increment in spatiotemporal and peak kinematic characteristics between comfortable and fast walking speeds. Conclusion: The objective kinematic parameters extracted from 2D gait data were able to show significant improvements of the knee joint after TKR surgery. The patients with TKR surgery were also able to improve their knee kinematics during fast walking speed equal to the control group. These results provide a good insight into the capabilities of the presented method to evaluate knee functionality before and after TKR surgery and to define a more effective rehabilitation program.

The Journal of Arthroplasty, 2003

This study characterized the footstep pattern and knee kinematics during walking in 12 patients who had undergone unicompartmental knee arthroplasty for unilateral medial compartment osteoarthritis. Patients had all achieved a successful recovery and were tested at least 1 year after surgery. Gait analysis was conducted during self-selected comfortable and fast walking conditions using a 3-dimensional motion analysis system and electronic walkway. Results showed that patients were able to increase their walking speed by 28% by increasing both stride length and cadence. All but one patient showed a biphasic pattern of flexion-extension motion about the treated knee. In 8 of 12 patients, significant increases in knee flexion were seen in the treated limb compared with the contralateral limb, the cause and ramifications of which are yet to be determined.

The Journal of Arthroplasty, 2011

This study determined how total knee arthroplasty (TKA) altered knee motion and loading during gait. Three-dimensional kinematic and kinetic gait patterns of 42 patients with severe knee osteoarthritis were collected 1 week prior and 1-year post-TKA. Principal component analysis extracted major patterns of variability in the gait waveforms. Overall and midstance knee adduction moment magnitude decreased. Overall knee flexion angle magnitude increased due to an increase during swing. Increases in the early stance knee flexion moment and late stance knee extension moment were found, indicating improved impact attenuation and function. A decrease in the early stance knee external rotation moment indicated alteration in the typical rotation mechanism. Most changes moved toward an asymptomatic pattern and would be considered improvements in motion, function, and loading. Keywords: total knee arthroplasty, principal component analysis, biomechanics, knee osteoarthritis, gait.