Normalized gait analysis parameters are closely related to patient-reported outcome measures after total knee arthroplasty

Abstract

Up till now, only a weak connection could be shown between patient-related outcome measures (PROMs) and measurements obtained by gait analysis (e.g. speed, step length, cadence, ground reaction force, joint moments and ranges of motion) after total knee arthroplasty (TKA). This may result from the methodical problem that regression analyses are performed using data that are not normalized against a healthy population. It does appear reasonable to assume that patients presenting a physiological gait pattern are content with their joint. The more the gait parameters differ from a normal gait pattern the worse the clinical outcome measured by PROMs should be expected to be. In this retrospective study, 40 patients were enrolled who had received a gait analysis after TKA, and whose PROMs had been evaluated. A gender- and age-matched control group was formed out of a group of test persons who had already undergone gait analysis. Gait analysis was undertaken using the motion analysis system 3D Vicon with ten infrared cameras and three strength measuring force plates. The physiological gait analysis parameters were deduced from arithmetic mean values taken from all control patients. The deviances of the operated patients' gait analysis parameters from the arithmetic mean values were squared. From these values, the Pearson correlation coefficients for different PROMs were then calculated, and regression analyses were performed to elucidate the correlation between the different PROMs and gait parameters. In the regression analysis, the normalized cadence, relative gait speed of the non-operated side, and range of the relative knee moment of the operated side could be identified as factors which influence the Forgotten Joint Score (FJS-12). The explanation model showed an increase of the FJS-12 with minimisation of these normalized values corresponding to an approximation of the gait pattern seen in the healthy control group. The connection was strong, having a correlation coefficient of 0.708. A physiological gait pattern after TKA results in better PROMs, especially the FJS-12, than a non-physiological gait pattern does.

Unicompartmental knee arthroplasty results in a better gait pattern than total knee arthroplasty: Gait analysis with a smartphone application

“…[3] The gait pattern of patients changes dramatically after knee arthroplasty, and a physiological gait pattern after TKA has been shown to lead to better patient-related outcome measures (PROMs), than a non-physiological gait pattern. [4,5] Gait pattern is an important predictor of functional abilities and PROMs after knee arthroplasty and smartphone-based gait analysis Objectives: The aim of this study was to compare the smartphonebased gait analysis data of patients who underwent total knee arthroplasty (TKA) and unicompartmental knee arthroplasty (UKA).Patients and methods: Between January 2016 and April 2019, a total of 51 patients (3 males, 48 females; mean age: 60.92 years; range, 51 to 70 years) who were operated with UKA or TKA in our clinic were retrospectively analyzed. The patients were divided into two groups according to the type of procedure as the UKA group (n=17) and unilateral TKA group (n=34).…”

“…[3] The gait pattern of patients changes dramatically after knee arthroplasty, and a physiological gait pattern after TKA has been shown to lead to better patient-related outcome measures (PROMs), than a non-physiological gait pattern. [4,5] Gait pattern is an important predictor of functional abilities and PROMs after knee arthroplasty and smartphone-based gait analysis Objectives: The aim of this study was to compare the smartphonebased gait analysis data of patients who underwent total knee arthroplasty (TKA) and unicompartmental knee arthroplasty (UKA).…”

Análisis biomecánico de la marcha en paciente con secuelas de poliomielitis y artroplastia de rodilla

“…Dada la importancia de la deambulación en el ser humano y debido a las alteraciones de los patrones de marcha que se producen en los pacientes con secuelas de poliomielitis, los autores del estudio consideran oportuno realizar una caracterización de la cinemática de la marcha en un paciente de estas características. A través del análisis de la información que facilitan estos estudios, es posible generar estrategias en el campo de la rehabilitación de estos pacientes y mejorar la recuperación de la máxima funcionalidad en las actividades de la vida cotidiana (12)(13).…”

Standard Cruciate-Retaining Total Knee Arthroplasy Implants Can Reproduce Native Kinematics

“…The presented work takes into account tibiofemoral and patellofemoral kinematics together with soft-tissues to position the implant, with the aim to reproduce native kinematics post-TKA. Restoring native kinematics allows for a more normal gait pattern post-TKA (Blakeney et al, 2019), which may result in improved patient-reported outcome measures (Kirschberg et al, 2018;Biggs et al, 2019). For the specimens studied, the required implant position changes were maximally 2.96 mm and 2.40°.…”

“…Biomechanics and quality of movement similar to healthy were found to improve post-operative patient-reported outcomes (Kirschberg et al, 2018;Biggs et al, 2019). Musculoskeletal modeling (MSM) allows to investigate the interplay between patient-specific biomechanics, implant alignment and soft tissues (Vanheule et al, 2017).…”