Early Spatiotemporal Patterns and Knee Kinematics during Level Walking in Individuals following Total Knee Arthroplasty (original) (raw)
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The Effect of Total Knee Arthroplasty on Knee Joint Kinematics and Kinetics During Gait
The Journal of Arthroplasty, 2011
This study determined how total knee arthroplasty (TKA) altered knee motion and loading during gait. Three-dimensional kinematic and kinetic gait patterns of 42 patients with severe knee osteoarthritis were collected 1 week prior and 1-year post-TKA. Principal component analysis extracted major patterns of variability in the gait waveforms. Overall and midstance knee adduction moment magnitude decreased. Overall knee flexion angle magnitude increased due to an increase during swing. Increases in the early stance knee flexion moment and late stance knee extension moment were found, indicating improved impact attenuation and function. A decrease in the early stance knee external rotation moment indicated alteration in the typical rotation mechanism. Most changes moved toward an asymptomatic pattern and would be considered improvements in motion, function, and loading. Keywords: total knee arthroplasty, principal component analysis, biomechanics, knee osteoarthritis, gait.
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...
Iranian Rehabilitation Journal, 2013
The aim of this study was to extract suitable spatiotemporal and kinematic parameters to determine how Total Knee Replacement (TKR) alters patients' knee kinematics during gait, using a rapid and simplified quantitative two-dimensional gait analysis procedure. Methods: Two-dimensional kinematic gait pattern of 10 participants were collected before and after the TKR surgery, using a 60 Hz camcorder in sagittal plane. Then, the kinematic parameters were extracted using the gait data. A student t-test was used to compare the group-average of spatiotemporal and peak kinematic characteristics in the sagittal plane. The knee condition was also evaluated using the Oxford Knee Score (OKS) Questionnaire to ensure that each subject was placed in the right group. Results: The results showed a significant improvement in knee flexion during stance and swing phases after TKR surgery. The walking speed was increased as a result of stride length and cadence improvement, but this increment was not statistically significant. Both post-TKR and control groups showed an increment in spatiotemporal and peak kinematic characteristics between comfortable and fast walking speeds. Conclusion: The objective kinematic parameters extracted from 2D gait data were able to show significant improvements of the knee joint after TKR surgery. The patients with TKR surgery were also able to improve their knee kinematics during fast walking speed equal to the control group. These results provide a good insight into the capabilities of the presented method to evaluate knee functionality before and after TKR surgery and to define a more effective rehabilitation program.
Comparative gait analysis of patients with different design of total knee arthroplasty
Srpski arhiv za celokupno lekarstvo, 2021
Introduction/Objective. The essence of the treatment of degenerative knee joint diseases is pain relief, restoring motion range and stability of knee joints. Methods. In this study, 35 patients participated after having surgery of the knee joint. The patients had a posterior-stabilized (PS) endoprosthesis in one joint, and a posterior cruciate ligament retaining (CR) endoprosthesis in the other. Kinematic data was collected using a 3D optical system for tracking fluorescent markers in time. Based on these data, the following parameters were determined: degree of flexion, mediolateral (ML) translation, lateral gap, medial gap, and the angle of change between the transtibial and transfemoral axes. Results. The results show a more pronounced flexion degree with the PS prosthesis compared to the CR prosthesis. Also, the results show negligible values of the ML translation, lateral gap, and medial gap in both types of prostheses. Using the non-parameter Wilcoxon test, a substantial diffe...
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.
Gait Analysis Before and After Total Knee Replacement
Engineering and Technology Journal
Total knee replacement is a surgical procedure for treatment of knee Osteoarthritis, Rheumatoid arthritis and posttraumatic arthritis. The main goals of TKR are relieve the pain, restore function, mobility and restore normal limb alignment for the patients. The aim of the study to investigate the gait dynamic improvements following TKR surgery by compare the dynamic parameter preoperative and post-operative and then comparing the results with the normal gait parameters. The gait analysis was performed on five patients before and after they underwent unilateral TKR surgery. After three months from the total knee replacement there was a remarked increase in the function and decrease in pain. The varus and valgus malalignment will be return to normal alignment after operation, which is one of the main goals of the TKR. Post-operative cadence is higher than pre-operative for four patients, post-operative speed is faster than pre-operative for four patients and post-operative stride length is larger than preoperative for four patients. The patients continue to walk with significant gait abnormalities by examining the kinetics and the kinematics of the operated limb, the results show the knee function not fully restored three months after unilateraL TKR surgery.
Gait kinematic analysis of the osteoarthritic knee : pre- and post- total knee arthroplasty
2015
Pour l'honneur qu'il m'a fait pour sa participation à mon jury de thèse en qualité de rapporteur de mon travail, pour le temps consacré à la lecture de cette thèse. Je suis particulièrement honorée de sa présence dans ce jury de soutenance. Je lui exprime ici ma plus haute considération. Monsieur le Professeur Frédéric Farizon Pour avoir accepté d'être rapporteur et membre de jury de cette thèse. Je le remercie pour l'intérêt et la considération qu'il a porté à ces travaux. Je lui adresse mes sincères remerciements ainsi que ma profonde gratitude. Monsieur le Professeur Philippe Neyret, Je tenais à vous remercier de l'accueil que vous m'avez réservé et du temps que vous m'avez consacré lors de mon parcours professionnel. Cette expérience sera très importante pour ma carrière et les tâches auxquelles vous m'avez associée m'ont vraiment permis de consolider mes connaissances et d'en développer de nouvelles. Monsieur le Professeur Sébastien Lustig, Sans vous, cette thèse n'aurait pas été possible. Je vous remercie pour votre patience et vos encouragements qui m'ont portée dans les moments difficiles, pour vos idées et suggestions PLAN ABSTRACT CHAPTER I. INTRODUCTION Hill, Iwaki and coworkers [10] applied MRI scans to 13 unloaded knees and 7 loaded knees for the description of the surface geometry and relative movements of the femur and the tibia. According to this study, during flexion in the unloaded knee, medially, the mean AP position of the femoral condyle did not change from 110° to-5°. Laterally, the femoral condyle rolled
Gait analysis of patients following totalcondylar knee arthroplasty
Acta chirurgica Iugoslavica, 2015
The aim of this study was to evaluate total knee arthroplasty success, throw gait analysis of patients who were underwent a surgery according to objective indicators. Material and methods: Fourteen patients were participated in our study who suffered from a certain type of gonarthrosis. Data were gathered(collected) using a commercial OptiTrack system for motion recording using six infrared cameras. Markers were placed on patients? lower extremities, on previously determined anatomical regions. After recording the data were processed using computing environment MATLAB. Results: Observing our lab results we noticed a significant reduction in range of motion (ROM) of arthritic knees in relation to the healthy knees. ROM reduction is primarily related to flexion and extension, as well as to medial and lateral translation. Following the TKA, ROM increases, and these values get close to the values that were measured in a healthy knee. The results were presented using graphs for a healthy...
PLOS ONE, 2023
Recovery of function is among a patient's main expectations when undergoing total knee arthroplasty (TKA). However, normal gait knee function is not always completely restored, which can affect patient satisfaction and quality of life. Computer-assisted surgery (CAS) allows surgeons to evaluate passive knee kinematics intra-operatively. Understanding associations between knee kinematics measured during surgery and during daily activities, such as walking, could help define criteria for success based on knee function and not only on the correct alignment of the implant or the leg. This preliminary study compared passive knee kinematics measured during surgery with active kinematics measured during walking. Eight patients underwent a treadmill gait analysis using the KneeKG™ system both before surgery and three months afterwards. Knee kinematics were measured during CAS both before and after TKA implantation. The anatomical axes of the KneeKG™ and CAS systems were homogenised using a two-level, multi-body kinematics optimisation with a kinematic chain based on the calibration measured during CAS. A Bland-Altman analysis was performed before and after TKA for adduction-abduction angle, internal-external rotation, and anterior-posterior displacement over the whole gait cycle, at the single stance phase and at the swing phase. Homogenising the anatomical axes between CAS and treadmill gait led to limited median bias and limits of agreement (post-surgery-0.6 ± 3.6 deg,-2.7 ± 3.6 deg, and-0.2 ± 2.4 mm for adduction-abduction, internal-external rotation and anterior-posterior displacement, respectively). At the individual level, correlations between the two systems were mostly weak (R 2 < 0.3) over the whole gait cycle, indicating low kinematic consistency between the two measurements. However, correlations were better at the phase level, especially the swing phase. The multiple sources of differences did not enable us to conclude whether they came from anatomical and biomechanical differences or from measurement system errors.
The Journal of Arthroplasty, 1997
The functional behavior of two kinematically different knee arthroplasty systems within each subject was studied by gait analysis (three-dimensional kinematics, kinetics, dynamic electromyography) in five elderly patients, 2 to 5 years after bilateral surgery. Clinical results were good, yet gait velocity was reduced (range, 0.57-1.1 m/s), with a shortened stride length and a decreased duration of single-limb stance in all subjects. Force plate recordings revealed an undynamic gait with slow loading, reduced modulation of the vertical forces, and poor fore/aft shears. Sagittal plane knee motion during gait was reduced in all subjects, with trunk and pelvic compensation patterns for foot clearance. Muscle activity around the knee was prolonged bilaterally, with activity modulation related to the motion pattern. Although the stride parameters were quite symmetric, there was a marked asymmetry of the motion pattern, with a side-to-side difference of peak knee flexion during stance and swing phase of up to 15 °. This finding, however, was not clearly related to the type of prosthesis. Even within one subject, significant sideto-side variability may persist, which leads to asymmetry of the motion pattern, unrelated to the kinematic design of the implant. Other factors, such as the patella-extensor mechanism, ligament balancing, leg-length discrepancy, proprioception, continuation of a preoperative habit, or a contralateral influence, may explain part of the asymmetry seen in these subjects. Key words: gait analysis, knee prosthesis, biomechanics.