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Quantitative gait analysis after bilateral total knee arthroplasty with two different systems within each subject
I A Kramers-de Quervain1, E Stüssi, R Müller
1Laboratory for Biomechanics, ETH, Zurich, Switzerland.
The Journal of Arthroplasty
|February 1, 1997
Summary
Gait analysis after knee replacement reveals reduced walking speed and altered movement patterns. Asymmetry in knee motion persists, often unrelated to implant type, suggesting other factors influence patient function.
Area of Science:
- Biomechanics
- Orthopedic Surgery
- Gait Analysis
Background:
- Knee arthroplasty aims to restore function, but gait deviations can persist post-surgery.
- Understanding functional outcomes requires detailed analysis of patient movement.
Purpose of the Study:
- To compare the functional behavior of two different knee arthroplasty systems within the same patient.
- To identify factors contributing to gait asymmetry after bilateral knee replacement.
Main Methods:
- Gait analysis including 3D kinematics, kinetics, and dynamic electromyography.
- Study involved five elderly patients 2-5 years post-bilateral knee arthroplasty.
Main Results:
- Reduced gait velocity, shortened stride length, and decreased single-limb stance duration observed in all patients.
- Undynamic gait characterized by slow loading, reduced vertical force modulation, and poor shear forces.
- Reduced sagittal knee motion with compensatory trunk/pelvic movements and prolonged muscle activity.
- Significant side-to-side asymmetry in knee motion patterns, not clearly linked to prosthesis type.
Conclusions:
- Knee arthroplasty patients exhibit functional deficits despite good clinical outcomes.
- Persistent gait asymmetry may stem from factors beyond implant kinematics, including biomechanical and neuromuscular influences.
- Individual patient factors significantly impact functional recovery and movement symmetry post-surgery.