Gait Analysis and Total Knee Replacement

Andriacchi, Thomas P.; Dyrby, Chris O.

doi:10.1007/3-540-27658-0_6

Cited by 28 publications

(37 citation statements)

References 14 publications

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“…Given the reported limitations in patient function and the proposed relationship between excessive knee moments and loosening of the prosthesis [13,14] it is important to know whether the differences in knee moments between patients and controls are maintained during walking at faster speeds. To date there has been no study that compares the knee kinetics between these groups at faster walking speeds.…”

Section: Introductionmentioning

confidence: 99%

“…Joint moments are considered particularly relevant in the assessment of outcome from TKR because they closely represent the forces acting across the knee and the subsequent demand for muscle activity to stabilise the knee against these forces [12]. Since excessive knee moments have been associated with prosthesis loosening in TKR patients [13,14], motion analysis may provide unique information about the predicted long-term outcome from surgery.…”

Section: Introductionmentioning

confidence: 99%

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Knee kinetics during walking at different speeds in people who have undergone total knee replacement

et al. 2010

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Previous research suggests that most people who have undergone total knee replacement (TKR) walk with a sagittal knee moment profile and peak knee moments that are different from normal. However, most previous research has consisted of small samples of patients with prostheses that are no longer in use. The aim of this study was to compare the peak knee moments and patterns of the moment waveforms of walking at different speeds between a large cohort of TKR patients with the Genesis-II PS prosthesis (Smith and Nephew, Memphis, USA) and matched control participants. Forty patients 12months following TKR and 40 control participants were assessed during walking at self-selected comfortable and fast speeds using motion analysis. Individual sagittal plane knee moment graphs were assessed for the presence of a biphasic pattern. Peak sagittal and coronal plane knee moments were compared between groups using a univariate ANOVA with walking speed as a covariate. A biphasic moment pattern was present in 87% and 92% of TKR patients when walking at comfortable and fast speeds, respectively. The knee flexor (p<0.001 at both speeds), extensor (p=0.004 at comfortable speed and p<0.001 at fast speed) and adductor (p<0.001 at both speeds) moments were reduced in the TKR patients. The high proportion of TKR patients with biphasic moment patterns was unexpected, but suggests that modern prostheses can result in more normal outcomes. Nonetheless, the peak knee moments of patients were reduced compared to controls. Although these reductions may be beneficial to the survival of the prosthesis, these abnormalities may also indicate suboptimal functional outcome from TKR.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Knee kinetics during walking at different speeds in people who have undergone total knee replacement

et al. 2010

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“…In addition, the general gait parameters (stride length, cadence, etc.) and daily activities, such as labour tasks and sport practice, can also influence the knee joint dynamic response [70].…”

Section: Discussionmentioning

confidence: 99%

“…The results showed that the cartilage reduces the contact force experienced by the models without cartilage, and extends the period of contact. This cartilage role is of paramount importance during walking, since the ground reaction force typically rises to a peak after heel strikes and during this phase, loads across the knee joint have been calculated to be about three times the body weight [70]. Moreover, the computational simulations showed that the presence of OP does not change the level of contact forces at the OA knee model, meaning that this disease does not contribute to the OA progression.…”

Section: Discussionmentioning

confidence: 99%

Influence of the contact model on the dynamic response of the human knee joint

Machado

Flores

Ambrósio

et al. 2011

Proceedings of the Institution of Mechanical Engineers, Part K:

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The goal of this work is to study the influence of the contact force model, contact geometry, and contact material properties on the dynamic response of a human knee joint model. For this purpose, a multibody knee model composed by two rigid bodies, the femur and the tibia, and four non-linear spring elements that represent the main knee ligaments, is considered. The contact force models used were the Hertz, the Hunt-Crossley, and the Lankarani-Nikravesh approaches. Results obtained from computational simulations show that Hertz law is less suitable to describe the dynamic response of the cartilage contact, because this pure elastic model does not account for the viscoelastic nature of the human articulations. Since knee can exhibit conformal and non-conformal contact scenarios, three different geometrical configurations for femur-tibia contact are considered, that is convex-convex sphere contact, convex-concave sphere contact, and convex sphere-plane contact. The highest level of contact forces is obtained for the case of convex-convex sphere contact. As far as the influence of the material contact properties is concerned, the dynamic response of a healthy and natural knee is analysed and compared with three pathological and two artificial knee models. The obtained results demonstrate that the presence of the cartilage reduces significantly the knee contact forces.

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“…Three-dimensional motion analysis has been used by researchers to assess the gait of patients who have undergone total knee replacement (TKR) [1][2][3]. Motion analysis has been advocated as a useful assessment tool in this patient group because it provides objective and biomechanical information about patients' walking and functional outcome that is not available from subjective questionnaires or standard clinical assessment.…”

Section: Introductionmentioning

confidence: 99%