Knee Arthrodesis Affects Gait Kinematics More in the Ankle Than in the Hip Joint

Abstract

Background and Objectives: No gold standard exists for treating persistent periprosthetic knee infections. Knee arthrodesis represents one treatment concept for extensive bone defects and extensor system insufficiencies. It has already been shown that knee arthrodesis leads to a significant reduction in one’s quality of life. The aim of this survey was to assess the influence of knee arthrodesis on the neighboring joints on the basis of gait analysis data. Our hypothesis is that the hip and ankle joints are negatively influenced by knee arthrodesis in the process of walking. Materials and methods: We performed six pedobarographic and four gait analytical measurements in six patients 2.4 ± 1.6 years after receiving knee arthrodesis at the operating ages of 69.1 ± 9.2 years. Gait analysis consisted of time–distance parameters/minute (number of steps, double support, cycle time, standing phase, step length, gait speed). A healthy group of test subjects (n = 52) was included as the control cohort. Gait analysis was conducted using a three-dimensional movement system and three force-measuring platforms to determine the ground reaction force. Foot pressure was measured using a pedography platform. Results: Five of six patients presented an incomplete rolling movement over the toes on the side that was operated on, presenting with a gait line ending in the forefoot area. All of the patients bore less weight on the side that was operated on. Three of six patients demonstrated a pathological gait line with a healthy opposite side ending in the forefoot area. All of the patients exhibited a reduction in gait speed and step length and a lower number of steps. All of the patients had a prolonged double support/cycle time. Conclusions: Isolated knee arthrodesis is associated with reduced forefoot repulsion, restricted movement on the side receiving the operation, and reduced movement in the ankle/knee joint. The hip showed norm deviations in the hip moment/angle. Knee arthrodesis causes reduced gait kinetics/kinematics. Our survey shows that the relative joint moments of the ankle joint and hip are often reduced. The ankle joint is more affected compared to the hip.

Effects of age-related changes in trunk and lower limb range of motion on gait

“…Our results suggested a positive correlation between hip ROM and step length, stride length, and gait speed, but only the correlation with gait speed was statistically significant. One study showed that knee arthrodesis appeared to reduce knee ROM, resulting in decreased gait speed, step length, and stride length [ 27 ], but the findings were not statistically significant. Doyo et al [ 28 ] found that gait speed decreased with age, and that gait speed for females was higher than that for males.…”

Total Hip Arthroplasty through Direct Anterior Approach in a Patient with Ipsilateral Knee Arthrodesis: A Case Report

“…An arthrodesis of the knee alters the gait and the biomechanics of the hip. Walking speed is affected, and range of motion (ROM) reduced (especially the extension moment of the hip) [ 2 ].…”