Lower extremity gait kinematics outcomes after knee replacement demonstrate arthroplasty-specific differences between unicondylar and total knee arthroplasty: A pilot study |
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| Institution: | 1. Department of Rehabilitation Sciences, KU Leuven Campus Bruges, Spoorwegstraat 12, 8200 Bruges, Belgium;2. Department of Rehabilitation Sciences, KU Leuven, Tervuursevest 101, 3001 Heverlee, Belgium;3. Department of Development and Regeneration, KULAK, Etienne Sabbelaan 53, 8500 Kortrijk, Belgium;4. Department of Computer Science, KU Leuven Campus Bruges, Spoorwegstraat 12, 8200 Bruges, Belgium;5. Department of Orthopaedic Surgery, AZ Sint-Lucas, Sint-Lucaslaan 29, 8310 Bruges, Belgium;1. Research and Development Section, Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, USA;2. DoD-VA Extremity Trauma and Amputation Center of Excellence, USA;3. Department of Surgery, Uniformed Services University of the Health Sciences & Walter Reed National Military Medical Center, Bethesda, MD, USA;4. Department of Rehabilitation Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA;1. Department of Kinesiology, Brock University, St. Catharines, ON, Canada;2. Centre for Neuroscience, Brock University, St. Catharines, ON, Canada;1. Faculty of Health Sciences, Univeristy of Malta, Msida, Malta;2. Faculty of Health Sciences, University of Malta, Msida, Malta;1. Department of Orthopaedics, University Hospital RWTH Aachen, Aachen, Germany;2. Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Aachen, Germany;1. Department of Orthopaedics and Trauma Surgery, University Hospital Bonn, Sigmund-Freud-Strasse 25, 53127 Bonn, Germany;2. Department of Orthopaedic Surgery, University Hospital of Tübingen, Hoppe-Seyler-Strasse 3, D-72076 Tübingen, Germany;3. Dres. Falck and Gesicki, Horemer 4, D-72076 Tübingen, Germany;4. Dr. C. I. Leichtle, Königstraße 50, D-72108 Rottenburg, Germany;1. Department of Mechanical Engineering & Research Centre for Biomedical Engineering, Universitat Politècnica de Catalunya, Av. Diagonal, 647 08028 Barcelona, Spain;2. School of Medical Sciences and Health of Juiz de Fora, SUPREMA, Alameda Salvaterra, 200 - Salvaterra, 36033-003, Juiz de Fora, MG, Brazil;3. Biomedical Engineering Program, COPPE, Universidade Federal do Rio de Janeiro, Av. Pedro Calmon, 550 - Cidade Universitária, 21941-901, Rio de Janeiro, RJ, Brazil |
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| Abstract: | BackgroundThe aim of the present study is to compare sagittal gait kinematics of ankle, knee and hip joints between subjects with unicondylar and total knee arthroplasty and age matched healthy controls. Since unicondylar knee replacement is a less invasive procedure, which more closely preserves knee joint anatomy, we hypothesized that one year post unicondylar knee arthroplasty patients would demonstrate more normal gait patterns than patients with total knee arthroplasty.Research questionDo unicondylar and total knee arthroplasty patients display similar gait kinematics one year after surgery?MethodsFourteen subjects (8 posterior stabilized and 6 medial unicondylar knee replacements) that were one year post surgery, and 6 healthy control subjects underwent a 3D gait analysis and a physical examination (range of motion, muscle strength). Statistical parametric mapping was used to compare gait kinematics of the lower limbs between groups. Additionally, differences in peak angles and clinical outcomes were assessed using a one-way ANOVA between subjects analysis.ResultsBoth knee replacement groups showed reduced knee flexion range of motion and reduced muscle strength at the operated leg compared to the control group. Subjects with TKA demonstrated reduced knee flexion at loading response and midstance of the gait cycle. Both UKA and TKA demonstrated significantly less knee flexion during swing.SignificanceThe results of this study demonstrate arthroplasty-specific differences in muscle strength, range of motion and gait kinematics of the lower limb one year after knee surgery. Future planning of post-surgery follow-up should addresses these arthroplasty-specific weaknesses and gait deviations. |
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| Keywords: | Gait analysis Kinematics Knee replacement Total knee arthroplasty Unicondylar knee arthroplasty |
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