Motion analysis after total knee arthroplasty

Abstract

The aim of this study is to evaluate the functional performance after total knee replacement (TKR). Two groups of patients, one with mobile (n=9) and one with fixed bearing (n=8) total knee prosthesis, were compared by means of motion analysis. A group of healthy subjects (n=8), matched by age, were used as controls. Kinematics, kinetics and electromyography data were collected during physiological daily activities such as walking and squatting. During walking, both groups of patients showed a speed of progression, a maximum knee extension moment (stance phase) and a maximum knee flexion (swing phase) significantly lower than the control group. Moreover, during the swing phase a co-contraction of the antagonistic muscles of the inferior limb was present. During squatting, both groups of patients showed a peak of knee flexion significantly lower than the control group. Motion pattern after TKR is unphysiological but the abnormalities seem to be independent from the differences in the implant designs.

Gait analysis of fixed bearing and mobile bearing total knee prostheses during walking: Do mobile bearings offer functional advantages?

“…Concurrent with the previous research [14], [15], [16] and [17], few biomechanical differences were found between FB and MB prostheses. The FB and MB groups could not be distinguished following an adequate period of rehabilitation at nine months post-surgery [12], [22] and [23], with no parameter reaching significance in the spatiotemporal, kinematic, and kinetic results.…”

“…We also used the same implant manufacturer with the same femoral components, in addition to both prostheses being posterior stabilised with the patella resurfaced, limiting potential confounding factors. The predominant limitation of the current study is that of a small sample size, although comparable to the previous literature [15] and [17]. A power calculation was undertaken at the investigation outset, which suggested a total sample size of 21, inclusive of the FB, MB, and control groups.…”

“…Despite the advantageous findings for MB prostheses, Sosio et al [15] found no differences in knee flexion at heel contact, maximum knee flexion in stance, maximum knee extension in stance, and maximum knee flexion in swing between FB and MB groups. Tibesku et al [14] found little mean differences in maximum and ROM in stance and swing, not exceeding that of the 0.5 standard deviation between groups, although the authors did not statistically compare FB and MB groups, but rather analysed the progression from pre-surgery to post-surgery.…”

“…The addition of pre-surgery testing is imperative in validating post-surgery findings. Although useful, it is difficult to make informed clinical decisions from retrospectively designed studies due to the omission of pre-surgery analyses [15] and [17]. We also used the same implant manufacturer with the same femoral components, in addition to both prostheses being posterior stabilised with the patella resurfaced, limiting potential confounding factors.…”

“…Previous findings have been inconclusive in the comparison of FB and MB prostheses by means of gait analysis, with four previous authors assessing walking [14], [15], [16] and [17]. The differences in study design, instrumentation, and methods between the studies make it difficult to extract meaningful conclusions.…”