Changed gait pattern in patients with total knee arthroplasty but minimal influence of tibial insert design

Saari, Tuuli; Tranberg, Roy; Zügner, Roland; Uvehammer, Johan; Kärrholm, Johan

doi:10.1080/00016470510030661

Cited by 61 publications

(43 citation statements)

References 28 publications

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“…This marker set was a modification of Helen Hayes marker set 12 and been used previously by our group. [13][14][15] The marker positions were partly chosen to limit the effect of subcutaneous fat. The room coordinate system was defined with one axis in the direction of walking and parallel to the floor.…”

Section: Methodsmentioning

confidence: 99%

Hip and knee joint rotations differ between patients with medial and lateral knee osteoarthritis: Gait analysis of 30 patients and 15 controls

et al. 2006

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The motions and moments in the hip and knee in female patients on the waiting list for knee prosthesis surgery with medial (n ¼ 15) or lateral (n ¼ 15) osteoarthritis (OA) were compared with a control group (n ¼ 15). We hypothesized that not only the kinematics and kinetics of the knee but also of the hip would differ between patients the medial and lateral groups. At midstance, patients with lateral OA showed slightly (28) more maximal (peak) adduction ( p ¼ 0.015) of the hip joint and patients with medial OA had 78 more abduction (p < 0.001) than did controls. In patients with lateral OA, the femur was positioned in about 78 more maximum external rotation (p ¼ 0.001), but femur position did not differ between medial OA and controls ( p ! 0.8). There was a tendency to higher internal hip rotation moment in lateral OA compared to controls ( p ¼ 0.021). The maximum values of the internal knee abduction moments were 52% higher in medial OA ( p ¼ 0.005) and 63% lower in lateral OA ( p < 0.001) compared to controls. Cases with medial OA had 98 more, whereas those with lateral OA had 68 less external tibial rotation than controls (medial vs. lateral OA, p ¼ 0.001). We found an association between presence of lateral OA of the knee and the biomechanics of the hip joint. It remains to be evaluated if the changed biomechanics of the hip joint is a reason for development of lateral OA or an observation that is a result of this disease. ß

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Section: Methodsmentioning

confidence: 99%

Hip and knee joint rotations differ between patients with medial and lateral knee osteoarthritis: Gait analysis of 30 patients and 15 controls

et al. 2006

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“…This is congruent with our study, with notable variability present in both groups. No major differences in the studied parameters of the gait cycle were determined by the femoral design, as seen for the tibia design [26]. However, TKA patients showed a slower gait [26], but the speed during the swing phase of the contralateral limb in our series was better (expressed as % of normal values) in the SR group than in the MR group.…”

Section: Discussionmentioning

confidence: 52%

Functional Performance with a Single-radius Femoral Design Total Knee Arthroplasty

Gómez‐Barrena

Fernandez-García

Fernández-Bravo

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Background Better muscular recovery of the extensor mechanism after TKA is claimed by femoral designs based on a sagittal single radius. Questions/purposes We aimed to compare postoperative knee performance through the Knee Society scores, flexor and extensor muscle function, stability, and gait of a series of patients receiving a posterior stabilized, cemented TKA, with a single-radius femoral design. Methods We compared a series of patients treated with a single-radius femoral design TKA to a simultaneous series of patients receiving a multiradius femoral design. Both groups were similar in demographics and preoperative Knee Society scores. The clinical pathways were identical. Outcome assessment included Knee Society scores, isokinetic assessment, stabilometry, and gait cycle analysis. ResultsWe observed higher functional Knee Society scores (86.6 ± 1.89 versus 80.3 ± 1.90), fewer physiotherapy sessions (19.9 ± 4.65 versus 22.2 ± 3.34), and less time with two crutches (3.5 ± 1.2 versus 5.2 ± 1.04 weeks) for patients receiving the single-radius design. Isokinetic evaluation showed decreased flexion peak torque (40.3 ± 7.9 versus 48.7 ± 9.6), increased extension peak torque (77.2 ± 16.1 versus 69.1 ± 14.4), and lower flexor/ extensor ratio (0.5 ± 0.08 versus 0.7 ± 0

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“…Previous work using parameterization analyses have also found decreased hip extension angles in TKA subjects compared to a control group [12,19]. Saari et al (2005) indicated that abnormal flexion and extension of the knee in TKA subjects might cause reduced hip extension in order to maintain balance during walking.…”

Section: Discussionmentioning

confidence: 99%

“…Saari et al (2005) indicated that abnormal flexion and extension of the knee in TKA subjects might cause reduced hip extension in order to maintain balance during walking. However, our results indicate that reduced hip extension occurs with no significant differences in knee flexion/extension angles between groups.…”

Section: Discussionmentioning

confidence: 99%

“…Kramers de-Quervain et al (1997) found that TKA subjects demonstrated slower gait velocities, decreased single stance time, and decreased knee range of motion during the stance and swing phase. Significant decreases in gait velocity and stride length in TKA groups compared to control groups is predominant in past studies [8,11,12], although a few studies reported no significant differences in these variables [13,14].…”

Section: Introductionmentioning

confidence: 97%

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Examining Gait Patterns after Total Knee Arthroplasty Using Parameterization and Principal Component Analysis

Roy

Chester²,

McGibbon³

2013

OJO

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The use of parameterization in assessing gait waveforms has been widely accepted, although it is recognized that this approach excludes the majority of information contained in the waveform. Waveform analysis techniques, such as principal component analysis (PCA), have gained popularity in recent years as a more effective approach to extracting important information from human movement waveforms, but are more challenging to interpret. Few studies have compared these two different approaches to determine which yields the most relevant information. This study compared the kinematic patterns during gait of six total knee arthroplasty (TKA) subjects (10 TKA knees), to a group of 10 agematched asymptomatic control subjects (19 control knees). An eight-camera Vicon M-cam system was used to track movement and compute joint angles. Group differences in parameterization (max and min peaks) values and principal component scores were tested using one-way ANOVA and Kruskal-Wallis tests. Using parameterization, the TKA group was characterized by reduced hip extension, increased hip flexion, increased anterior pelvic tilt, increased trunk tilt, and reduced sagittal ankle angles compared to the control group. Waveform analysis, by means of PCA, showedmagnitude shifts in sagittal ankle waveforms between groups, rather than solely reporting differences in peaks. Waveform analysis also indicated a significant shift in the magnitude of the entire waveform for hip angles, pelvic tilt, and trunk tilt, indicating no change in range of motion between groups, but rather a change in the way in which range of motion is achieved at the hip. This study has identified several gait variables that were significantly different between the TKA and control groups. Our results suggest that waveform analysis is effective at identifying magnitude shifts as sources of variability between groups, which would not necessarily be analyzed using conventional parameterization techniques unless one knew a priori where the variability would exist.

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Changed gait pattern in patients with total knee arthroplasty but minimal influence of tibial insert design

Abstract: In patients with a similar degree of degenerative joint disease and within the limits of the constraints offered by the prostheses under study, the choice of joint area constraint has little influence on the gait pattern.

Cited by 61 publications

References 28 publications

Hip and knee joint rotations differ between patients with medial and lateral knee osteoarthritis: Gait analysis of 30 patients and 15 controls

Hip and knee joint rotations differ between patients with medial and lateral knee osteoarthritis: Gait analysis of 30 patients and 15 controls

Functional Performance with a Single-radius Femoral Design Total Knee Arthroplasty

Examining Gait Patterns after Total Knee Arthroplasty Using Parameterization and Principal Component Analysis

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