Walking ability following knee arthroplasty (original) (raw)
Related papers
Gait assessment as a functional outcome measure in total knee arthroplasty: a cross-sectional study
BMC Musculoskeletal Disorders, 2015
Background: The 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. Methods: A 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. Results: The 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. Conclusions: Even 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.
The Knee, 2008
The absence of uniformity, the use of different terminologies, and the diversity of methods used to translate numerical data into clinical outcomes have been described as potential problems when dealing with clinical knee scores for total knee arthroplasty (TKA). Gait analysis is believed to provide more objective parameters. The aim of the present study was to obtain information about the correlation between the outcome in terms of locomotion and the clinical knee score after TKA. Thirty consecutive patients awaiting TKA were involved in the study. One day prior to surgery and 3 months postoperatively, data pertaining to the Hospital for Special Surgery Score (HSS) and the Knee Society Score (KSS) (subgroups 'pain', 'knee', 'function' and 'total sum') were analyzed for correlations with kinematic and temporospatial parameters of gait analysis. At a significance-level of p ≤ 0.001 moderate correlations (0.4 b r b 0.6) were found preoperatively, particularly between 'max knee flexion swing' and the function-subscores of HSS and KSS and the 'KSS total'. High correlations (0.6 b r b 0.8) were ascertained for 'stride length' and 'gait velocity' with 'KSS function'. High correlations were also determined between 'stride length' and 'KSS total' and between 'gait velocity' and 'HSS function'. The only correlation found postoperatively was between 'max pelvic obliquity stance' and 'KSS knee' (r = 0.770, p b 0.001). We conclude that the 'function' subscores of KSS and HSS are highly suitable to assess the functional capacity of patients scheduled for TKA. However, because no adequate correlations between knee scores and gait parameter were found postoperatively, we cannot recommend the abandonment of gait analysis when monitoring the functional benefit of TKA.
The Knee, 2005
The aim of this prospective follow-up study was to determine if gait measurements and/or clinical measurements could detect differences in treatment outcome between two surgical interventions in patients with knee osteoarthritis (OA). The patients were followed for 5 years after surgery. Forty patients, 55 -70 years of age, with unilateral knee OA were included. The patients were treated either with a high tibial osteotomy (HTO) (n = 18) or a unicompartmental knee arthroplasty (UKA) (n = 22). Clinical outcome measures were the British Orthopaedic Association (BOA) score, pain during walking, passive range of knee motion (PROM) and patients' subjective opinion. The gait variables were free walking speed, step frequency, step length and single and double-stance phase for each leg. The patients were examined before surgery and 3 months, 1 year and 5 years after surgery. The time -distance variables of gait could detect differences in treatment outcome, 3 months after surgery, while the clinical outcome measures, as given here, could not detect any differences between the two groups of patients. Measurements of free walking speed could be recommended for clinical evaluation, after surgical interventions, in patients with knee OA. D
Orthopaedic surgery, 2016
To evaluate the effects of surgery and rehabilitation on patients undergoing total knee arthroplasty (TKA). Twelve patients and 12 healthy controls were enrolled and their clinical scores evaluated by a doctor. Gait data, including walking velocity, stride length, single support time, foot fall and swing power, were collected using a portable gait analyzer from 12 patients before and 6 weeks and 6 months after surgery and from 12 healthy controls. The gait data and clinical scores at selected time points were compared and correlations between gait characteristics and clinical scores assessed. Clinical knee and knee function scores increased significantly from before surgery to 6 weeks to 6 months after surgery (P < 0.001). The only significant differences identified were for single support time on the diseased side between before surgery and 6 months after surgery (P = 0.031) and for foot fall with the diseased side between 6 weeks and 6 months after surgery (P = 0.016). Foot fal...
Arthritis & Rheumatism, 2003
Objective. To identify preoperative predictors of locomotor ability 2 months after total knee arthroplasty (TKA). Methods. Sixty-five participants scheduled for a first TKA were recruited. The dependent variable was the distance covered during the 6-minute gait test 2 months after TKA. The independent variables, measured before surgery, were grouped into 3 categories: 1) personal; 2) organic system, and 3) capability variables. Multiple regression analyses were conducted to determine the best predictors of the dependent variable. Modified cross-validation of the model combining predictors from the three categories was obtained with 10 random samples derived from the original cohort by resampling with replacement. Results. Predictors were identified in the 3 categories: 1) gender, number of comorbidities, body mass index, 2) knee pain, flexion and strength, lower limb mechanical power, and 3) preoperative 6-minute gait distance. When these variables were modeled together only the preoperative 6-minute gait distance and knee pain and flexion remained significant (adjusted R 2 ؍ 0.66). Conclusion. Using variables easily measured before surgery, it is possible to predict with good accuracy locomotor ability 2 months after TKA.
Knee Surgery, Sports Traumatology, Arthroscopy, 2016
generated comprehensive measures of kinematic and kinetic gait deviations, respectively. Participants completed the Five Times Sit-to-Stand (5STS) test, and the self-reported questionnaire Knee Injury and Osteoarthritis Outcome Score (KOOS), at baseline prior to surgery and 1 year after TKA. Results Kinetic gait deviations of both the operated and non-operated limb persisted in patients with knee osteoarthritis at 1 year after surgery, while kinematic gait patterns were comparable to controls. Performance on the 5STS and KOOS scores in patients with knee osteoarthritis improved significantly 1 year after surgery (effect size 0.5-1.5), but did not reach the level of controls. Ten patients with knee Abstract Purpose The current literature lacks sufficient information about improvements in gait patterns and function after total knee arthroplasty (TKA) and whether patients return to full function. This study evaluated change in gait, performancebased function, and self-reported function 1 year after TKA in patients with symptomatic knee osteoarthritis and how these aspects interrelate. Methods A total of 28 patients (64 % female) with knee osteoarthritis, with a mean age of 66 (±7) years, and 25 age-and gender-matched controls participated in this prospective cohort study. Three-dimensional gait analysis
BMC Musculoskeletal Disorders, 2013
Background: The Six-minute walk (6MW) and Timed-Up-and-Go (TUG) are short walk tests commonly used to evaluate functional recovery after total knee arthroplasty (TKA). However, little is known about walking capacity of TKA recipients over extended periods typical of everyday living and whether these short walk tests actually predict longer, more functional distances. Further, short walk tests only correlate moderately with patient-reported outcomes. The overarching aims of this study were to compare the performance of TKA recipients in an extended walk test to healthy age-matched controls and to determine the utility of this extended walk test as a research tool to evaluate longer term functional mobility in TKA recipients. Methods: The mobility of 32 TKA recipients one year post-surgery and 43 healthy age-matched controls were assessed using the TUG, 6MW and 30-minute walk (30MW) tests. The latter test was repeated one week later. Self-reported function was measured using the WOMAC Index and a physical activity questionnaire. Results: 30MW distance was significantly shorter amongst TKA recipients (mean 2108 m [95% CI 1837 to 2381 m]; Controls 3086 m [2981 to 3191 m], P < 0.001). Test-retest repeatability was high (ICC = 0.97, TKA; 0.96, Controls). Amongst TKA recipients, the 30MW distance correlated strongly with the shorter tests (6MW, r = 0.97, P < 0.001; TUG, r = −0.82, P < 0.001). Multiple regression modeling found 6MW distance to be the only significant predictor (P < 0.001) of 30MW distance, explaining 96% of the variability. The TUG test models were moderate predictors of WOMAC function (55%) and physical activity (36%) and were stronger predictors than 6MW and 30 MW tests.
Pain and walking as outcome evaluation after knee replacement
Knee, 1997
In a previous study, walking ability and pain were believed to be a more simple and accurate index for measuring outcome after knee replacement than the global scoring system proposed by the American Knee Society. In this study a common scale was calculated for this and two other measures. First the five-category pain severity scale was combined with walking ability, and then the five-category walking ability was combined with pain measured on a visual analogue scale. The visual analogue scale measure had a poor association with the other indexes but is recommended because it's more informative and valid.