Three-dimensional gait characteristics of patients after unilateral total knee arthroplasty

Wang, Zonghan; Wang, Jincheng; Zheng, Shuang; Xue, Pan; Han, Fujun

doi:10.1097/md.0000000000026968

Cited by 2 publications

(2 citation statements)

References 26 publications

(84 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…While this offers a patient-specific goal for recovery, it does not account for the effect of pre-operative pain and deformity on gait dysfunction and walking discomfort, nor how these variables may influence a patient’s self-selected intensity and duration or the efficiency of physical activity [ 45 ]. For example, advanced OA patients present with lower limb kinematic and kinetic asymmetries during walking that are not corrected by TKA [ 13 , 14 , 15 ], and gait asymmetries in step length and excursion remain despite pain alleviation with arthroplasty [ 13 , 46 ]. This is possibly due to neuromuscular dysfunctions that have embedded in motor programming over time [ 47 ].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Stepping beyond Counts in Recovery of Total Knee Arthroplasty: A Prospective Study on Passively Collected Gait Metrics

Fary

Cholewa

Abshagen

et al. 2023

Sensors

View full text Add to dashboard Cite

Advances in algorithms developed from sensor-based technology data allow for the passive collection of qualitative gait metrics beyond step counts. The purpose of this study was to evaluate pre- and post-operative gait quality data to assess recovery following primary total knee arthroplasty. This was a multicenter, prospective cohort study. From 6 weeks pre-operative through to 24 weeks post-operative, 686 patients used a digital care management application to collect gait metrics. Average weekly walking speed, step length, timing asymmetry, and double limb support percentage pre- and post-operative values were compared with a paired-samples t-test. Recovery was operationally defined as when the respective weekly average gait metric was no longer statistically different than pre-operative. Walking speed and step length were lowest, and timing asymmetry and double support percentage were greatest at week two post-operative (p < 0.0001). Walking speed recovered at 21 weeks (1.00 m/s, p = 0.063) and double support percentage recovered at week 24 (32%, p = 0.089). Asymmetry percentage was recovered at 13 weeks (14.0%, p = 0.23) and was consistently superior to pre-operative values at week 19 (11.1% vs. 12.5%, p < 0.001). Step length did not recover during the 24-week period (0.60 m vs. 0.59 m, p = 0.004); however, this difference is not likely clinically relevant. The data suggests that gait quality metrics are most negatively affected two weeks post-operatively, recover within the first 24-weeks following TKA, and follow a slower trajectory compared to previously reported step count recoveries. The ability to capture new objective measures of recovery is evident. As more gait quality data is accrued, physicians may be able to use passively collected gait quality data to help direct post-operative recovery using sensor-based care pathways.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Step counts are reported to recover as fast as 6 weeks following TKA [ 11 ]. However, range of motion deficits and gait asymmetries persist for at least 3 months post-operatively [ 13 , 14 , 15 ]. Therefore, measuring step count alone provides only a partial indication of physical function recovery following TKA.…”

Section: Introductionmentioning

confidence: 99%