Stair dimension affects knee kinematics and kinetics in patients with good outcome after TKA similarly as in healthy subjects

Trinler, Ursula; Baty, Florent; Mündermann, Annegret; Fenner, Verena; Behrend, Henrik; Jost, Bernhard; Wegener, Regina

doi:10.1002/jor.23181

Cited by 12 publications

(8 citation statements)

References 39 publications

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“…The age-matched controls and SR subject's kinematics and kinetics are comparable to previous studies on stair descent in healthy individuals. 35,36 TKA patient's results broadly match previous studies on stair descent. 36,37 However, MR subjects had lower extension moments than controls in contrast to previous work that found no difference in extension moment between TKA and controls at 1-year and 2.1-year postoperative time points, respectively.…”

Section: Discussionsupporting

confidence: 82%

“…35,36 TKA patient's results broadly match previous studies on stair descent. 36,37 However, MR subjects had lower extension moments than controls in contrast to previous work that found no difference in extension moment between TKA and controls at 1-year and 2.1-year postoperative time points, respectively. 36,37 The pooled preoperative TKA patients had reduced knee extension moment comparable to previous work on stair descent in OA subjects.…”

Section: Discussionsupporting

confidence: 82%

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Comparison of Knee Kinematics and Kinetics during Stair Descent in Single- and Multi-Radius Total Knee Arthroplasty

et al. 2019

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Despite continuing advances, nearly 20% of patients remain dissatisfied with their total knee arthroplasty (TKA) outcomes. Single-radius (SR) and multiradius (MR) TKA designs are two commonly used knee replacement designs based on competing theories of the flexion/extension axis of the knee. Our aim was to characterize stair descent kinematics and kinetics in SR and MR TKA subjects. We hypothesized that 1 year after TKA, patients who received SR TKA will more closely replicate the knee kinematics and kinetics of healthy age-matched controls during stair descent, than will MR TKA patients. SR subjects (n = 12), MR subjects (n = 12), and age-matched controls (n = 12) descended four stairs affixed to force platforms, while 10 infrared cameras tracked markers attached to the body to collect kinematic and kinetic data. Both patient groups had improvements in stair descent kinetics and kinematics at the 1-year postoperative time point. However, SR TKA subjects were indistinguishable statistically from age-matched controls, while MR TKA subjects retained many differences from controls. Similar to previous reports for level walking, the SR knee design performs closer to healthy controls than MR knees during stair descent. This study demonstrates that patients who receive SR TKA have more improved kinematic normalization during stair descent postoperatively than those who received an MR TKA.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionsupporting

confidence: 82%

Comparison of Knee Kinematics and Kinetics during Stair Descent in Single- and Multi-Radius Total Knee Arthroplasty

et al. 2019

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“…First, the dependency can be taken into account through statistical methods. Mixed models have been used to correct for the correlation among multiple included gait cycles within the subjects [ 51 ]. Similarly, both sides for each subject can be included using mixed models, as this analysis takes into account the intra-subject variability (random effect) [ 52 ].…”

Section: Discussionmentioning

confidence: 99%

Muscle weakness has a limited effect on motor control of gait in Duchenne muscular dystrophy

et al. 2020

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Our aim was to determine if synergy weights and activations are altered in Duchenne muscular dystrophy (DMD) and if these alterations could be linked to muscle weakness. Methods In 22 children with DMD and 22 typical developing (TD) children of a similar age, surface electromyography (sEMG) of the gluteus medius, rectus femoris (REF), medial hamstrings, tibialis anterior, and medial gastrocnemius (GAS) were recorded during gait. Muscle weakness was assessed with maximal voluntary isometric contractions (MVIC). Synergies were calculated with non-negative matrix factorization. The number of synergies explaining �90% of the variance in the sEMG signals (N90), were extracted and grouped with k-means cluster analysis. We verified differences in weights with a Mann-Whitney U test. Statistical non-parametric mapping (Hotelling's T 2 test and two-tailed t-test) was used to assess group differences in synergy activations. We used Spearman's rank correlation coefficients and canonical correlation analysis to assess if weakness was related to modifications in weights and activations, respectively. Results For both groups, average N90 was three. In synergy one, characterized by activity at the beginning of stance, the DMDs showed an increased REF weight (p = 0.001) and decreased GAS weight (p = 0.007). Synergy activations were similar, with only a small difference detected in mid-swing in the combined activations (p<0.001). Weakness was not associated with these differences.

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“…Investigations into TKA function during complete gait cycles using skinmarker-based motion analysis have been successful in determining global segment kinematics, thereby allowing the estimation of external joint moments [2][3][4]. However, this approach is known to be strongly affected by soft tissue artefacts [5,6] and does not allow an accurate quantification of tibiofemoral antero-posterior (A-P) translation and internal/external rotation [6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Knee implant kinematics are task-dependent

Schütz

Postolka

Gerber

et al. 2019

J. R. Soc. Interface.

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Although total knee arthroplasty (TKA) has become a standard surgical procedure for relieving pain, knowledge of the in vivo knee joint kinematics throughout common functional activities of daily living is still missing. The goal of this study was to analyse knee joint motion throughout complete cycles of daily activities in TKA subjects to establish whether a significant difference in joint kinematics occurs between different activities. Using dynamic videofluoroscopy, we assessed tibio-femoral kinematics in six subjects throughout complete cycles of walking, stair descent, sit-to-stand and stand-to-sit. The mean range of condylar anterior–posterior translation exhibited clear task dependency across all subjects. A significantly larger anterior–posterior translation was observed during stair descent compared to level walking and stand-to-sit. Local minima were observed at approximately 30° flexion for different tasks, which were more prominent during loaded task phases. This characteristic is likely to correspond to the specific design of the implant. From the data presented in this study, it is clear that the flexion angle alone cannot fully explain tibio-femoral implant kinematics. As a result, it seems that the assessment of complete cycles of the most frequent functional activities is imperative when evaluating the behaviour of a TKA design in vivo .

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Stair dimension affects knee kinematics and kinetics in patients with good outcome after TKA similarly as in healthy subjects

Cited by 12 publications

References 39 publications

Comparison of Knee Kinematics and Kinetics during Stair Descent in Single- and Multi-Radius Total Knee Arthroplasty

Comparison of Knee Kinematics and Kinetics during Stair Descent in Single- and Multi-Radius Total Knee Arthroplasty

Muscle weakness has a limited effect on motor control of gait in Duchenne muscular dystrophy

Knee implant kinematics are task-dependent

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