Gait assessment as a functional outcome measure in total knee arthroplasty: a cross-sectional study

Abstract

BackgroundThe 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.MethodsA 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.ResultsThe 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.ConclusionsEven 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.

Which osteoarthritic gait features recover following Total Knee Replacement surgery?

“…There are numerous challenges to the adoption of three-dimensional gait analysis (3DGA) techniques within routine clinical assessment. Marker-based motion capture is typically considered infeasible when considering the resources required and volume of patients [6].…”

“…Longitudinal studies adopting 3DGA techniques have identified a number of abnormal biomechanical parameters which do not recover following TKR surgery [6,8,17,18,[9][10][11][12][13][14][15][16]. Of these studies, many do not include biomechanical parameters of the hip and ankle [6,[12][13][14][15][16], and/or exclude parameters within the frontal [6,[14][15][16][17] or transverse [6,8,17,[9][10][11][12][13][14][15][16] plane.…”

Lower Extremity Kinematic Profile of Gait of Patients After Ankle Fracture: A Case-Control Study

“…Recent studies have shown that inertial measurement units are accurate and reproducible in the measurement of joint and limb segment ROM in the assessment of gait in aging patients (11) and in knee osteoarthritis (12). Inertial measurement units are comparatively easy to use, requiring no specialist facilities, and have the potential to be used within a busy clinic or rehabilitation unit (13).…”

Sensor‐based gait analysis as a simple tool to measure gait in haemophilia patients

“…Compared to healthy controls, sagittal plane ROM was significantly different in haemophilia patients with confirmed lower limb arthropathy. In patients with solitary knee arthropathy, variables previously reported as discriminative of knee osteoarthritis were affected, thus indicating that sensor-based gait analysis is able to detect joint-specific arthropathy [4,7].…”

“…Long-term consequences of haemarthroses in haemophilia are chronic synovitis, cartilage damage and eventually irreversible arthropathy, leading to gait alterations [1]. Gait analysis may be useful in haemophilia care as it integrates the effect of multiple-joint arthropathy and muscle bleeds during weight-bearing situations which is more clinically relevant than static or passively active examination [2][3][4]. Conventional gait analysis is often optical-based which is time-consuming and therefore expensive.…”