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Gait Analysis 1 Year after Primary TKA: No Difference between Gap Balancing and Measured Resection Technique
Hermes H Miozzari1, Stéphane Armand2, Katia Turcot3,4
1Division of Orthopaedic Surgery and Traumatology, Geneva University Hospitals, Geneva, Switzerland.
The Journal of Knee Surgery
|January 1, 2020
Summary
Dependent bone cuts in total knee arthroplasty (TKA) did not improve gait, patient outcomes, or satisfaction compared to independent cuts. Both techniques showed overall improvement but did not reach healthy control levels.
Area of Science:
- Orthopedic Surgery
- Biomechanics
- Rehabilitation Medicine
Background:
- Mechanical alignment is crucial in total knee arthroplasty (TKA) for optimal function.
- Dependent bone cuts are hypothesized to create a better-balanced TKA compared to independent cuts.
Purpose of the Study:
- To compare the efficacy of dependent versus independent bone cuts in TKA.
- To evaluate the impact on gait parameters, patient-reported outcome measures (PROMs), and satisfaction.
Main Methods:
- A prospective study of 58 TKA patients (Press Fit Condylar Sigma PS design).
- Patients were divided into independent (n=39) and dependent (n=19) bone cut groups.
- Gait analysis (3D motion system), WOMAC, SF-12, and Likert scale satisfaction were assessed pre-operatively and at 1-year follow-up.
Main Results:
- No significant baseline differences in age, BMI, pain, or function between groups.
- At 1-year follow-up, both groups showed overall improvements in gait, WOMAC, SF-12 physical score, and pain.
- No significant differences were observed between the dependent and independent bone cut techniques regarding gait, clinical outcomes, or satisfaction.
Conclusions:
- Neither dependent nor independent bone cut techniques in TKA yielded superior gait parameters, clinical outcomes, or patient satisfaction at 1-year follow-up.
- While TKA generally improves patient function, neither technique restored gait to healthy control levels.
- The choice between dependent and independent bone cuts may not significantly impact TKA outcomes.
