Quantitative evaluation of gait features after total knee arthroplasty: Comparison with age and sex-matched controls

Du Hyun Ro, Taehoon Kang, Do hwan Han, Dong Yeon Lee, Hyuk Soo Han, Myung Chul Lee

Research output: Contribution to journalArticle

Abstract

Background: Gait function after total knee arthroplasty (TKA) is suboptimal. However, quantified analysis with comparing a control group is lacking. Research question: The aims of this study were 1) to compare the gait before and after TKA and 2) to compare postoperative gait to that of an age-sex matched control group. Methods: This study consisted of 46 female and 38 male patients with end-stage knee osteoarthritis who underwent bilateral TKA, and 84 age- and sex-matched controls without knee pain and osteoarthritis. Seven gait parameters, including lower extremity alignment, knee adduction moment (KAM), knee flexion angle, external knee flexion moment, hip adduction angle, external hip adduction moment, and the varus-valgus arc during the stance phase, were collected using a commercial opto-electric gait analysis system. Principal component analysis was used for data processing and the standardized mean differences (SMDs) of the principal component scores were compared. Results: The most significant gait change after TKA was the alignment (SMD 1.62, p < 0.001). The average stance phase alignment changed from varus 7.3° to valgus 0.5°. The second significant change was a decrease of the KAM (SMD 1.08, p < 0.001). These two features were closely correlated (r = 0.644, p < 0.001). The gait feature that differed most from the controls was the varus-valgus arc during the stance phase (SMD 1.68, p < 0.001), which was constrained by 31% after TKA (p < 0.001) and was only 37% compared to the controls (p < 0.001). Significance: Improvement in gait after TKA was obtained through alignment correction. However, TKA significantly constrained coronal knee motion. TKA improved gait suboptimally; the gait was significantly different from that of controls.

Original languageEnglish
Pages (from-to)78-84
Number of pages7
JournalGait and Posture
Volume75
DOIs
StatePublished - 1 Jan 2020

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Knee Replacement Arthroplasties
Gait
Knee
Knee Osteoarthritis
Hip
Control Groups
Principal Component Analysis
Lower Extremity
Research Design
Pain

Keywords

  • Biomechanics
  • Function
  • Gait analysis
  • Motion capture system
  • Total knee arthroplasty

Cite this

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title = "Quantitative evaluation of gait features after total knee arthroplasty: Comparison with age and sex-matched controls",
abstract = "Background: Gait function after total knee arthroplasty (TKA) is suboptimal. However, quantified analysis with comparing a control group is lacking. Research question: The aims of this study were 1) to compare the gait before and after TKA and 2) to compare postoperative gait to that of an age-sex matched control group. Methods: This study consisted of 46 female and 38 male patients with end-stage knee osteoarthritis who underwent bilateral TKA, and 84 age- and sex-matched controls without knee pain and osteoarthritis. Seven gait parameters, including lower extremity alignment, knee adduction moment (KAM), knee flexion angle, external knee flexion moment, hip adduction angle, external hip adduction moment, and the varus-valgus arc during the stance phase, were collected using a commercial opto-electric gait analysis system. Principal component analysis was used for data processing and the standardized mean differences (SMDs) of the principal component scores were compared. Results: The most significant gait change after TKA was the alignment (SMD 1.62, p < 0.001). The average stance phase alignment changed from varus 7.3° to valgus 0.5°. The second significant change was a decrease of the KAM (SMD 1.08, p < 0.001). These two features were closely correlated (r = 0.644, p < 0.001). The gait feature that differed most from the controls was the varus-valgus arc during the stance phase (SMD 1.68, p < 0.001), which was constrained by 31{\%} after TKA (p < 0.001) and was only 37{\%} compared to the controls (p < 0.001). Significance: Improvement in gait after TKA was obtained through alignment correction. However, TKA significantly constrained coronal knee motion. TKA improved gait suboptimally; the gait was significantly different from that of controls.",
keywords = "Biomechanics, Function, Gait analysis, Motion capture system, Total knee arthroplasty",
author = "Ro, {Du Hyun} and Taehoon Kang and Han, {Do hwan} and Lee, {Dong Yeon} and Han, {Hyuk Soo} and Lee, {Myung Chul}",
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language = "English",
volume = "75",
pages = "78--84",
journal = "Gait and Posture",
issn = "0966-6362",
publisher = "Elsevier",

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TY - JOUR

T1 - Quantitative evaluation of gait features after total knee arthroplasty

T2 - Comparison with age and sex-matched controls

AU - Ro, Du Hyun

AU - Kang, Taehoon

AU - Han, Do hwan

AU - Lee, Dong Yeon

AU - Han, Hyuk Soo

AU - Lee, Myung Chul

PY - 2020/1/1

Y1 - 2020/1/1

N2 - Background: Gait function after total knee arthroplasty (TKA) is suboptimal. However, quantified analysis with comparing a control group is lacking. Research question: The aims of this study were 1) to compare the gait before and after TKA and 2) to compare postoperative gait to that of an age-sex matched control group. Methods: This study consisted of 46 female and 38 male patients with end-stage knee osteoarthritis who underwent bilateral TKA, and 84 age- and sex-matched controls without knee pain and osteoarthritis. Seven gait parameters, including lower extremity alignment, knee adduction moment (KAM), knee flexion angle, external knee flexion moment, hip adduction angle, external hip adduction moment, and the varus-valgus arc during the stance phase, were collected using a commercial opto-electric gait analysis system. Principal component analysis was used for data processing and the standardized mean differences (SMDs) of the principal component scores were compared. Results: The most significant gait change after TKA was the alignment (SMD 1.62, p < 0.001). The average stance phase alignment changed from varus 7.3° to valgus 0.5°. The second significant change was a decrease of the KAM (SMD 1.08, p < 0.001). These two features were closely correlated (r = 0.644, p < 0.001). The gait feature that differed most from the controls was the varus-valgus arc during the stance phase (SMD 1.68, p < 0.001), which was constrained by 31% after TKA (p < 0.001) and was only 37% compared to the controls (p < 0.001). Significance: Improvement in gait after TKA was obtained through alignment correction. However, TKA significantly constrained coronal knee motion. TKA improved gait suboptimally; the gait was significantly different from that of controls.

AB - Background: Gait function after total knee arthroplasty (TKA) is suboptimal. However, quantified analysis with comparing a control group is lacking. Research question: The aims of this study were 1) to compare the gait before and after TKA and 2) to compare postoperative gait to that of an age-sex matched control group. Methods: This study consisted of 46 female and 38 male patients with end-stage knee osteoarthritis who underwent bilateral TKA, and 84 age- and sex-matched controls without knee pain and osteoarthritis. Seven gait parameters, including lower extremity alignment, knee adduction moment (KAM), knee flexion angle, external knee flexion moment, hip adduction angle, external hip adduction moment, and the varus-valgus arc during the stance phase, were collected using a commercial opto-electric gait analysis system. Principal component analysis was used for data processing and the standardized mean differences (SMDs) of the principal component scores were compared. Results: The most significant gait change after TKA was the alignment (SMD 1.62, p < 0.001). The average stance phase alignment changed from varus 7.3° to valgus 0.5°. The second significant change was a decrease of the KAM (SMD 1.08, p < 0.001). These two features were closely correlated (r = 0.644, p < 0.001). The gait feature that differed most from the controls was the varus-valgus arc during the stance phase (SMD 1.68, p < 0.001), which was constrained by 31% after TKA (p < 0.001) and was only 37% compared to the controls (p < 0.001). Significance: Improvement in gait after TKA was obtained through alignment correction. However, TKA significantly constrained coronal knee motion. TKA improved gait suboptimally; the gait was significantly different from that of controls.

KW - Biomechanics

KW - Function

KW - Gait analysis

KW - Motion capture system

KW - Total knee arthroplasty

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U2 - 10.1016/j.gaitpost.2019.09.026

DO - 10.1016/j.gaitpost.2019.09.026

M3 - Article

C2 - 31627118

AN - SCOPUS:85073142806

VL - 75

SP - 78

EP - 84

JO - Gait and Posture

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SN - 0966-6362

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