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Comprehensive gait analysis in posterior-stabilized knee arthroplasty
S A Wilson1, P D McCann, R S Gotlin
1Insall Scott Kelly Institute for Orthopaedics and Sports Medicine, New York, NY 10128, USA.
The Journal of Arthroplasty
|June 1, 1996
Summary
Posterior-stabilized knee replacements show normal gait and strength at nearly 4 years. However, some patients exhibit prolonged vastus medialis firing and reduced knee motion during walking and stair descent.
Area of Science:
- Orthopedic Surgery
- Biomechanics
- Gait Analysis
Background:
- Total knee arthroplasty (TKA) aims to restore function.
- Posterior-stabilized (PS) prostheses are common, but long-term gait outcomes require further investigation.
Purpose of the Study:
- To evaluate gait parameters and muscle strength in patients with posterior-stabilized TKA compared to healthy controls.
- To identify potential gait abnormalities not explained by muscle weakness or limited range of motion.
Main Methods:
- Isokinetic muscle testing and comprehensive gait analysis were performed on 16 patients with PS-TKA (Insall-Burstein PS II) and 32 age-matched controls.
- Evaluations were conducted at a mean of 46 months post-surgery.
Main Results:
- No significant differences in spatiotemporal gait parameters or isokinetic strength were found between PS-TKA patients and controls.
- Reduced knee range of motion was observed during level walking and stair descent in the PS-TKA group.
- Prolonged vastus medialis firing was noted in some patients, indicating altered muscle activation patterns.
Conclusions:
- While PS-TKA provides comparable spatiotemporal gait parameters to controls at nearly 4 years, subtle gait abnormalities persist.
- These abnormalities are not fully explained by muscle weakness, altered muscle activity, or limited range of motion.
- Gait outcomes with PS prostheses are comparable to cruciate-retaining and superior to cruciate-sacrificing designs.