Influence of Preoperative Physical Function on Gait 1 Month After Total Knee Arthroplasty

Abstract

Background: This study aimed to identify the preoperative physical performance factors that predict gait speed and endurance 1 month after total knee arthroplasty (TKA). Methods: This prospective cohort study included all patients who underwent unilateral primary TKA in December 2014-2016. Before and at 1 month after TKA, gait variables, bilateral isometric knee extensor and flexor strength, and range of motion (ROM) (flexion and extension) of the operated knee were measured; further, a 6-minute walk test (6MWT), a Timed Up and Go (TUG) test, and a stair-climbing test (SCT) were conducted. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the EuroQoL 5-dimension (EQ-5D) questionnaire, and the visual analogue scale (VAS) of knee pain were also completed. Results: A total of 84 patients were included. Bivariate analyses showed that postoperative gait speed significantly and positively correlated with preoperative gait speed, gait cadence, ROM of knee flexion, and 6MWT, but significantly and negatively correlated with age and preoperative TUG test, SCT-descent, WOMAC-Function score, and VAS score. The postoperative 6MWT significantly and positively correlated with preoperative gait cadence and 6MWT, but significantly and negatively with preoperative body mass index (BMI), TUG test, SCT-ascent, and WOMAC-Function score. Linear regression analyses showed that age, preoperative ROM of knee flexion, and TUG test were independent predictors of postoperative gait speed, while preoperative BMI and 6MWT predicted postoperative 6MWT. Conclusion: These preoperative predictive factors will be useful in developing pre-and postoperative rehabilitation strategies aimed at improving gait function in the early stages after TKA.

Physical Performance Correlates with Self-Reported Physical Function and Quality of Life in Patients at 3 Months after Total Knee Arthroplasty

“…The degree of extension beyond zero for hyperextension during this assessment was recorded as a negative value. 20 , 21 )…”

“…The degree of extension beyond zero for hyperextension during this assessment was recorded as a negative value. 20,21) Gait analysis: A wireless inertial sensing device (G-WALK; BTS Bioengineering S.p.A., Milan, Italy) was used to measure the spatiotemporal variables of gait. The patients wore a semi-elastic back-belt device on the waist to measure the acceleration of the anteroposterior, mediolateral, and vertical axes and were instructed to walk barefoot along an 8-m pathway at a comfortable speed.…”

“…The variables measured included the peak torques (PTs) of the extensor and flexor, the ratio of hamstring to quadriceps strength (H/Q ratio), and the difference in the strengths of the extensors and flexors between the operated and non-operated knees, expressed as percentages of the strengths of the non-operated knee. 21,23)…”

Advances in the application of wearable sensors for gait analysis after total knee arthroplasty: a systematic review

“…We finally identified 25 articles (823 patients), including unilateral [ 10 – 21 ], bilateral [ 14 ], cruciate-retaining [ 4 ] and posterior-stabilized [ 4 , 18 ], bi-condylar [ 22 ], bi-cruciate retaining and bi-cruciate stabilized [ 23 , 24 ], fixed-bearing prostheses and mobile-bearing prostheses [ 25 ], medial-pivot [ 18 ], posterior stabilized [ 24 ], minimally invasive [ 26 ], revision [ 17 ] and primary TKA [ 11 , 16 , 17 , 27 , 28 ], as well as “unknown techniques” [ 29 – 31 ] (Table 2 ).…”

“…Frequencies were less than 100 Hz in 2 articles [ 11 , 30 ]. No frequency was reported in 7 studies [ 21 , 23 – 26 , 28 , 31 ]. The most common location of sensors was the torso ( n = 17) [ 4 , 11 , 15 , 18 – 30 , 32 ], followed by the foot ( n = 7) [ 12 , 15 , 17 , 21 , 22 , 24 , 29 ], thigh ( n = 7), lower leg ( n = 6) [ 13 , 16 , 22 , 25 , 31 , 33 ] and head ( n = 1) [ 18 ].…”