A Biomechanical Foot-Worn Device Improves Total Knee Arthroplasty Outcomes |
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Authors: | Eytan M. Debbi Benjamin Bernfeld Amir Herman Moshe Salai Yocheved Laufer Alon Wolf |
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Affiliation: | 6. Division of Orthopaedic Surgery, Sourasky Medical Center, Tel Aviv, Israel;7. Department of Orthopaedic Surgery, Rambam Medical Center, Haifa, Israel;8. Department of Orthopaedic Surgery, Ha’Emek Medical Center, Afula, Israel;1. Biorobotics and Biomechanics Lab, Faculty of Mechanical Engineering, Technion-Israel Institute of Technology, Haifa, Israel;2. Department of Orthopaedic Surgery, Carmel Medical Center, Haifa, Israel;3. Department of Orthopedics and Talpiot Medical Leadership Program, Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel;4. Division of Orthopaedic Surgery, Sourasky Medical Center, Tel Aviv, Israel;5. Department of Physical Therapy, Faculty of Social Welfare and Health Studies, University of Haifa, Haifa, Israel |
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Abstract: | BackgroundBiomechanics after total knee arthroplasty (TKA) often remain abnormal and may lead to prolonged postoperative recovery. The purpose of this study is to assess a biomechanical therapy after TKA.MethodsThis is a randomized controlled trial of 50 patients after unilateral TKA. One group underwent a biomechanical therapy in which participants followed a walking protocol while wearing a foot-worn biomechanical device that modifies knee biomechanics and the control group followed a similar walking protocol while wearing a foot-worn sham device. All patients had standard physical therapy postoperatively as well. Patients were evaluated throughout the first postoperative year with clinical measures and gait analysis.ResultsImproved outcomes were seen in the biomechanical therapy group compared to the control group in pain scores (88% vs 38%, P = .011), function (86% vs 21%, P = .001), knee scores (83% vs 38%, P = .001), and walking distance (109% vs 47%, P = .001) at 1 year. The therapy group showed healthier biomechanical gait patterns in both the sagittal and coronal planes at 1 year.ConclusionA postoperative biomechanical therapy improves outcomes following TKA and should be considered as an additional therapy postoperatively. |
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Keywords: | total knee arthroplasty biomechanics clinical outcomes gait analysis sagittal and coronal plane kinematics and kinetics of the knee |
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