Intersegmental Coordination in Patients With Total Knee Arthroplasty During Walking

Area of Science:

• Biomechanics
• Orthopedic Surgery
• Rehabilitation Science

Background:

• Accurate assessment of intersegmental coordination is crucial for evaluating total knee arthroplasty (TKA) outcomes and personalizing rehabilitation.
• Limited understanding exists regarding the temporal changes in intersegmental coordination and functional limitations in TKA patients during walking.

Purpose of the Study:

• To investigate lower limb intersegmental coordination patterns in knee osteoarthritis patients before and after TKA.
• To identify alterations in intersegmental coordination during walking pre- and post-TKA.

Main Methods:

• Gait analysis was conducted on 36 patients pre- and 6-month post-TKA, and 34 healthy controls.
• Continuous relative phase (CRP) measured segment coordination throughout the gait cycle.
• Statistical parametric mapping (SPM) analyzed gait cycle curve differences.

Main Results:

• Six months post-TKA, thigh-shank CRP showed partial improvement compared to pre-operation but remained different from healthy subjects.
• Shank-foot CRP showed no significant improvement post-TKA compared to pre-operation, with persistent alterations compared to healthy subjects.
• Altered intersegmental coordination was observed during loading response and swing phases both pre- and post-TKA.

Conclusions:

• TKA partially restores thigh-shank coordination, but full recovery to healthy levels is not achieved by 6 months.
• Shank-foot coordination patterns do not improve post-TKA and remain significantly altered.
• CRP and SPM are valuable tools for assessing TKA surgical outcomes and guiding rehabilitation strategies.