Research Article
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Assessment of Alterations in Gait Parameters of Chronic Total Knee Arthroplasty – An Observational Study

Year 2024, Volume: 7 Issue: 2, 351 - 359, 25.03.2024
https://doi.org/10.33438/ijdshs.1397114

Abstract

Purpose of the Study: This research investigates postoperative gait alterations in individuals aged 50 and above who underwent total knee arthroplasty (TKA) at least one year ago. The study aims to fill existing gaps in literature by comprehensively assessing various gait parameters and understanding the persistent changes in mobility following TKA. Materials and Methods: Conducted as an observational study, 30 TKA subjects were assessed using Kinovea software for gait parameters, including cadence, speed, step length, step width, stride length, and knee flexion angle. Statistical analysis with MS Excel compared obtained values with established norms. Results: Significant gait parameter alterations were observed in post-TKA subjects. These changes include decreased cadence, walking speed, step length, and stride length, along with variations in knee flexion angle. Approximately 36.67% of participants exhibited alterations in these parameters, highlighting the need for further understanding of mobility challenges post-TKA. Conclusion: This study contributes vital insights into the persistent impact of TKA on gait parameters, emphasizing the complexity of postoperative mobility changes. The observed alterations highlight the importance of tailored rehabilitation programs to enhance functional independence and address long-term gait concerns in this patient population.

Supporting Institution

Krishna vishwavidyapeeth Deemed to be University Karad

Project Number

617/2022-23

References

  • Aherwar, A., Singh, A. K., & Patnaik, A. (2016). Cobalt Based Alloy: A Better Choice Biomaterial for Hip Implants. Trends in Biomaterials & Artificial Organs, 30(1).
  • Aherwar, A., Singh, A. K., & Patnaik, A. (2016). Cobalt Based Alloy: A Better Choice Biomaterial for Hip Implants. Trends in Biomaterials & Artificial Organs, 30(1).
  • Andersson, G. B., Andriacchi, T. P., & Galante, J. O. (1981). Correlations between changes in gait and in clinical status after knee arthroplasty. Acta Orthopaedica Scandinavica, 52(5), 569-573.
  • Astephen, J. L., Caldwell, G. E., Deluzio, K. J., & Dunbar, M. J. (2008). Biomechanical changes at the hip, knee, and ankle joints during gait are associated with knee osteoarthritis severity. Journal of orthopaedic research, 26(3), 332-341. [Pubmed]
  • Bączkowicz, D., Skiba, G., Czerner, M., & Majorczyk, E. (2018). Gait and functional status analysis before and after total knee arthroplasty. The Knee, 25(5), 888-896. [Pubmed]
  • Bade, M. J., Kohrt, W. M., & Stevens- Lapsley, J. E. (2010). Outcomes before and after total knee arthroplasty compared to healthy adults. Journal of orthopaedic & sports physical therapy, 40(9), 559-567. [Pubmed]
  • Bade, M. J., & Stevens-Lapsley, J. E. (2011). Early high-intensity rehabilitation following total knee arthroplasty improves outcomes. journal of orthopaedic & sports physical therapy, 41(12), 932-941. [Pubmed]
  • Benedetti, M. G., Catani, F., Bilotta, T. W., Marcacci, M., Mariani, E., & Giannini, S. (2003). Muscle activation pattern and gait biomechanics after total knee replacement. Clinical biomechanics, 18(9), 871-876. [Pubmed]
  • Bonnefoy-Mazure, A., Armand, S., Sagawa Jr, Y., Suvà, D., Miozzari, H., & Turcot, K. (2017). Knee kinematic and clinical outcomes evolution before, 3 months, and 1 year after total knee arthroplasty. The Journal of arthroplasty, 32(3), 793-800. [Pubmed]
  • Brotzman, S. B., & Manske, R. C. (2012). Clinical orthopaedic rehabilitation e-book: An evidence-based approach-expert consult. J Can Chiropr Assoc; 56(3):234. [Pubmed]
  • Carr, B.C., & Goswami, T. (2009). Knee implants–Review of models and biomechanics. Materials & Design, 30(2), 398-413. [Pubmed]
  • Rabarty, G., Leeder, D., & Vashishtha, M. (2015). Polyethylene in knee arthroplasty: a review. Journal of clinical orthopaedics and trauma, 6(2), 108-112. [Pubmed]
  • Hardy, S. E., Perera, S., Roumani, Y. F., Chandler, J. M., & Studenski, S. A. (2007). Improvement in usual gait speed predicts better survival in older adults. Journal of the American Geriatrics Society, 55(11), 1727-1734. [Pubmed]
  • Hilding, M. B. (1996). Knee joint loading and tibial component loosening: RSA and gait analysis in 45 osteoarthritic patients before and after TKA. The Journal of Bone & Joint Surgery British;78(1), 66-73. [Pubmed]
  • Insall, J. N., Binazzi, R., Mestriner, L. A., & Soudry, M. (1985). Total Knee Arthroplasty. Clinical Orthopaedics and Related Research, 192, 13-22. [Pubmed]
  • Karandikar, N., & Vargas, O. O. O. (2011). Kinetic chains: a review of the concept and its clinical applications. Pm&r, 3(8), 739-745. [Pubmed]
  • Kharb, A., Dhiman, S., Jain, Y. K., & Saini, V. (2011). A review of gait cycle and its parameters. IJCEM International Journal of Computational Engineering & Management, 13, 78-83.
  • Kramers-de Quervain, I. A., Kämpfen, S., Munzinger, U., & Mannion, A. F. (2012). Prospective study of gait function before and 2 years after total knee arthroplasty. The Knee, 19(5), 622-627. [Pubmed]
  • Lange, T., Günther, K. P., Kopkow, C., Lützner, J., Rataj, E., & Schmitt, J. (2017). What do patients expect from total knee arthroplasty? A Delphi consensus study on patient treatment goals. The Journal of arthroplasty, 32(7), 2093-2099. [Pubmed]
  • Levangie, P. K., & Norkin, C. C. (2011). Joint structure and function: a comprehensive analysis. FA Davis. Levine, B., Sporer, S., Della Valle, C. J., Jacobs, J. J., & Paprosky, W. (2007). Porous tantalum in reconstructive surgery of the knee–a review. The journal of knee surgery, 20(03), 185-194. [Pubmed]
  • Levinger, P., Menz, H. B., Morrow, A. D., Feller, J. A., Bartlett, J. R., & Bergman, N. R. (2013). Lower limb biomechanics in individuals with knee osteoarthritis before and after total knee arthroplasty surgery. Journal of arthroplasty, 28(6), 994-999. [Pubmed]
  • McClelland, J. A., Feller, J. A., & Webster, K. E. (2007). Gait analysis of patients following total knee replacement: a systematic review. The Knee, 14(4), 253-263.[Pubmed]
  • Mancuso, C. A., Charlson, M. E., Esdaile, J. M., Johanson, N. A., & Ranawat, C. S. (1996). Indications for total hip and total knee arthroplasties: results of orthopaedic surveys. Journal of arthroplasty, 11(1), 34-46. [Pubmed]
  • Mehjabeen, A., Qian, M., Song, T., Tang, H. P., & Xu, W. (2018). Zirconium alloys for orthopaedic and dental applications. Advanced Engineering Materials, 20(9), 1800207. [CrossRef]
  • Naili, J. E., Wretenberg, P., Lindgren, V., Iversen, M. D., Hedström, M., & Broström, E. W. (2017). Improved knee biomechanics among patients reporting a good outcome in knee-related quality of life one year after total knee arthroplasty. BMC musculoskeletal disorders, 18, 1-11. [Pubmed]
  • Orishimo, K. F., Kremenic, I. J., Deshmukh, A. J., Nicholas, S. J., & Rodriguez, J. A. (2012). Does total knee arthroplasty change frontal plane knee biomechanics during gait?. Clinical Orthopaedics and Related Research, 470, 1171-1176. [Pubmed]
  • Otsuki, T., Nawata, K., & Okuno, M. (1999). Quantitative evaluation of gait pattern in patients with osteoarthrosis of the knee before and after total knee arthroplasty. Gait analysis using a pressure measuring system. Journal of Orthopaedic Science, 4(2), 99-105. [Pubmed]
  • Pachore, J. A., Bhalodia, H. K. P., Thakkar, C. J., Vaidya, S. V., & Wakankar, H. M. (2013). ISHKS joint registry: A preliminary report. Indian Journal of Orthopaedics, 47(5), 505. [Pubmed]
  • Planckaert, C., Larose, G., Ranger, P., Lacelle, M., Fuentes, A., & Hagemeister, N. (2018). Total knee arthroplasty with unexplained pain: new insights from kinematics. Archives of Orthopaedic and Trauma Surgery, 138, 553-561. [Pubmed]
  • Pua, Y. H., Seah, F. J. T., Clark, R. A., Poon, C. L. L., Tan, J. W. M., & Chong, H. C. (2017). Factors associated with gait speed recovery after total knee arthroplasty: a longitudinal study. In Seminars in arthritis and rheumatism; 46(5):544-551. WB Saunders. [Pubmed]
  • Puig-Diví, A., Busquets, A., Escalona-Marfil, C., Marcos-Ruiz, D., Padullés-Chando, X., & Padullés-Riu, J. M. (2019). Validity and reliability of the Kinovea program in obtaining angles and distances using coordinates in 4 perspectives. PlosOne, 14(6), e0216448. [Pubmed]
  • Rahman, J., Tang, Q., Monda, M., Miles, J., & McCarthy, I. (2015). Gait assessment as a functional outcome measure in total knee arthroplasty: a cross-sectional study. BMC musculoskeletal disorders;16(1), 1-9. [Pubmed]
  • Rana, P., Bodwal, M., & Joshi, S. (2016). Quantitative gait analysis in patients with knee osteoarthritis. Int J Physiother Research, 4(5), 1684-88. [CrossRef]
  • Ritter, M. A., Carr, K. D., Keating, E. M., & Faris, P. M. (1994). Long-term outcomes of contralateral knees after unilateral total knee arthroplasty for osteoarthritis. Journal of arthroplasty, 9(4), 347-349. [Pubmed]
  • Ro, D. H., Han, H. S., Lee, D. Y., Kim, S. H., Kwak, Y. H., & Lee, M. C. (2018). Slow gait speed after bilateral total knee arthroplasty is associated with suboptimal improvement of knee biomechanics. Knee Surgery, Sports Traumatology, Arthroscopy, 26, 1671-1680. [Pubmed]
  • Schache, M. B., McClelland, J. A., & Webster, K. E. (2014). Lower limb strength following total knee arthroplasty: a systematic review. The Knee, 21(1), 12-20. [Pubmed]
  • Taniguchi, M., Sawano, S., Kugo, M., Maegawa, S., Kawasaki, T., & Ichihashi, N. (2016). Physical activity promotes gait improvement in patients with total knee arthroplasty. Journal of arthroplasty, 31(5), 984-988. [Pubmed]
  • Varacallo, M., Johanson, N. A., & Luo, T. D. (2018). Total knee arthroplasty techniques.
  • Yoshida, Y., Zeni Jr, J., & Snyder-Mackler, L. (2012). Do patients achieve normal gait patterns 3 years after total knee arthroplasty? Journal of orthopaedic & sports physical therapy, 42(12), 1039-1049. [Pubmed]
  • Zeni Jr, J. A., & Snyder-Mackler, L. (2010). Most patients gain weight in the 2 years after total knee arthroplasty: comparison to ahealthy control group. Osteoarthritis and Cartilage, 18 (4), 510-514. [Pubmed]
Year 2024, Volume: 7 Issue: 2, 351 - 359, 25.03.2024
https://doi.org/10.33438/ijdshs.1397114

Abstract

Project Number

617/2022-23

References

  • Aherwar, A., Singh, A. K., & Patnaik, A. (2016). Cobalt Based Alloy: A Better Choice Biomaterial for Hip Implants. Trends in Biomaterials & Artificial Organs, 30(1).
  • Aherwar, A., Singh, A. K., & Patnaik, A. (2016). Cobalt Based Alloy: A Better Choice Biomaterial for Hip Implants. Trends in Biomaterials & Artificial Organs, 30(1).
  • Andersson, G. B., Andriacchi, T. P., & Galante, J. O. (1981). Correlations between changes in gait and in clinical status after knee arthroplasty. Acta Orthopaedica Scandinavica, 52(5), 569-573.
  • Astephen, J. L., Caldwell, G. E., Deluzio, K. J., & Dunbar, M. J. (2008). Biomechanical changes at the hip, knee, and ankle joints during gait are associated with knee osteoarthritis severity. Journal of orthopaedic research, 26(3), 332-341. [Pubmed]
  • Bączkowicz, D., Skiba, G., Czerner, M., & Majorczyk, E. (2018). Gait and functional status analysis before and after total knee arthroplasty. The Knee, 25(5), 888-896. [Pubmed]
  • Bade, M. J., Kohrt, W. M., & Stevens- Lapsley, J. E. (2010). Outcomes before and after total knee arthroplasty compared to healthy adults. Journal of orthopaedic & sports physical therapy, 40(9), 559-567. [Pubmed]
  • Bade, M. J., & Stevens-Lapsley, J. E. (2011). Early high-intensity rehabilitation following total knee arthroplasty improves outcomes. journal of orthopaedic & sports physical therapy, 41(12), 932-941. [Pubmed]
  • Benedetti, M. G., Catani, F., Bilotta, T. W., Marcacci, M., Mariani, E., & Giannini, S. (2003). Muscle activation pattern and gait biomechanics after total knee replacement. Clinical biomechanics, 18(9), 871-876. [Pubmed]
  • Bonnefoy-Mazure, A., Armand, S., Sagawa Jr, Y., Suvà, D., Miozzari, H., & Turcot, K. (2017). Knee kinematic and clinical outcomes evolution before, 3 months, and 1 year after total knee arthroplasty. The Journal of arthroplasty, 32(3), 793-800. [Pubmed]
  • Brotzman, S. B., & Manske, R. C. (2012). Clinical orthopaedic rehabilitation e-book: An evidence-based approach-expert consult. J Can Chiropr Assoc; 56(3):234. [Pubmed]
  • Carr, B.C., & Goswami, T. (2009). Knee implants–Review of models and biomechanics. Materials & Design, 30(2), 398-413. [Pubmed]
  • Rabarty, G., Leeder, D., & Vashishtha, M. (2015). Polyethylene in knee arthroplasty: a review. Journal of clinical orthopaedics and trauma, 6(2), 108-112. [Pubmed]
  • Hardy, S. E., Perera, S., Roumani, Y. F., Chandler, J. M., & Studenski, S. A. (2007). Improvement in usual gait speed predicts better survival in older adults. Journal of the American Geriatrics Society, 55(11), 1727-1734. [Pubmed]
  • Hilding, M. B. (1996). Knee joint loading and tibial component loosening: RSA and gait analysis in 45 osteoarthritic patients before and after TKA. The Journal of Bone & Joint Surgery British;78(1), 66-73. [Pubmed]
  • Insall, J. N., Binazzi, R., Mestriner, L. A., & Soudry, M. (1985). Total Knee Arthroplasty. Clinical Orthopaedics and Related Research, 192, 13-22. [Pubmed]
  • Karandikar, N., & Vargas, O. O. O. (2011). Kinetic chains: a review of the concept and its clinical applications. Pm&r, 3(8), 739-745. [Pubmed]
  • Kharb, A., Dhiman, S., Jain, Y. K., & Saini, V. (2011). A review of gait cycle and its parameters. IJCEM International Journal of Computational Engineering & Management, 13, 78-83.
  • Kramers-de Quervain, I. A., Kämpfen, S., Munzinger, U., & Mannion, A. F. (2012). Prospective study of gait function before and 2 years after total knee arthroplasty. The Knee, 19(5), 622-627. [Pubmed]
  • Lange, T., Günther, K. P., Kopkow, C., Lützner, J., Rataj, E., & Schmitt, J. (2017). What do patients expect from total knee arthroplasty? A Delphi consensus study on patient treatment goals. The Journal of arthroplasty, 32(7), 2093-2099. [Pubmed]
  • Levangie, P. K., & Norkin, C. C. (2011). Joint structure and function: a comprehensive analysis. FA Davis. Levine, B., Sporer, S., Della Valle, C. J., Jacobs, J. J., & Paprosky, W. (2007). Porous tantalum in reconstructive surgery of the knee–a review. The journal of knee surgery, 20(03), 185-194. [Pubmed]
  • Levinger, P., Menz, H. B., Morrow, A. D., Feller, J. A., Bartlett, J. R., & Bergman, N. R. (2013). Lower limb biomechanics in individuals with knee osteoarthritis before and after total knee arthroplasty surgery. Journal of arthroplasty, 28(6), 994-999. [Pubmed]
  • McClelland, J. A., Feller, J. A., & Webster, K. E. (2007). Gait analysis of patients following total knee replacement: a systematic review. The Knee, 14(4), 253-263.[Pubmed]
  • Mancuso, C. A., Charlson, M. E., Esdaile, J. M., Johanson, N. A., & Ranawat, C. S. (1996). Indications for total hip and total knee arthroplasties: results of orthopaedic surveys. Journal of arthroplasty, 11(1), 34-46. [Pubmed]
  • Mehjabeen, A., Qian, M., Song, T., Tang, H. P., & Xu, W. (2018). Zirconium alloys for orthopaedic and dental applications. Advanced Engineering Materials, 20(9), 1800207. [CrossRef]
  • Naili, J. E., Wretenberg, P., Lindgren, V., Iversen, M. D., Hedström, M., & Broström, E. W. (2017). Improved knee biomechanics among patients reporting a good outcome in knee-related quality of life one year after total knee arthroplasty. BMC musculoskeletal disorders, 18, 1-11. [Pubmed]
  • Orishimo, K. F., Kremenic, I. J., Deshmukh, A. J., Nicholas, S. J., & Rodriguez, J. A. (2012). Does total knee arthroplasty change frontal plane knee biomechanics during gait?. Clinical Orthopaedics and Related Research, 470, 1171-1176. [Pubmed]
  • Otsuki, T., Nawata, K., & Okuno, M. (1999). Quantitative evaluation of gait pattern in patients with osteoarthrosis of the knee before and after total knee arthroplasty. Gait analysis using a pressure measuring system. Journal of Orthopaedic Science, 4(2), 99-105. [Pubmed]
  • Pachore, J. A., Bhalodia, H. K. P., Thakkar, C. J., Vaidya, S. V., & Wakankar, H. M. (2013). ISHKS joint registry: A preliminary report. Indian Journal of Orthopaedics, 47(5), 505. [Pubmed]
  • Planckaert, C., Larose, G., Ranger, P., Lacelle, M., Fuentes, A., & Hagemeister, N. (2018). Total knee arthroplasty with unexplained pain: new insights from kinematics. Archives of Orthopaedic and Trauma Surgery, 138, 553-561. [Pubmed]
  • Pua, Y. H., Seah, F. J. T., Clark, R. A., Poon, C. L. L., Tan, J. W. M., & Chong, H. C. (2017). Factors associated with gait speed recovery after total knee arthroplasty: a longitudinal study. In Seminars in arthritis and rheumatism; 46(5):544-551. WB Saunders. [Pubmed]
  • Puig-Diví, A., Busquets, A., Escalona-Marfil, C., Marcos-Ruiz, D., Padullés-Chando, X., & Padullés-Riu, J. M. (2019). Validity and reliability of the Kinovea program in obtaining angles and distances using coordinates in 4 perspectives. PlosOne, 14(6), e0216448. [Pubmed]
  • Rahman, J., Tang, Q., Monda, M., Miles, J., & McCarthy, I. (2015). Gait assessment as a functional outcome measure in total knee arthroplasty: a cross-sectional study. BMC musculoskeletal disorders;16(1), 1-9. [Pubmed]
  • Rana, P., Bodwal, M., & Joshi, S. (2016). Quantitative gait analysis in patients with knee osteoarthritis. Int J Physiother Research, 4(5), 1684-88. [CrossRef]
  • Ritter, M. A., Carr, K. D., Keating, E. M., & Faris, P. M. (1994). Long-term outcomes of contralateral knees after unilateral total knee arthroplasty for osteoarthritis. Journal of arthroplasty, 9(4), 347-349. [Pubmed]
  • Ro, D. H., Han, H. S., Lee, D. Y., Kim, S. H., Kwak, Y. H., & Lee, M. C. (2018). Slow gait speed after bilateral total knee arthroplasty is associated with suboptimal improvement of knee biomechanics. Knee Surgery, Sports Traumatology, Arthroscopy, 26, 1671-1680. [Pubmed]
  • Schache, M. B., McClelland, J. A., & Webster, K. E. (2014). Lower limb strength following total knee arthroplasty: a systematic review. The Knee, 21(1), 12-20. [Pubmed]
  • Taniguchi, M., Sawano, S., Kugo, M., Maegawa, S., Kawasaki, T., & Ichihashi, N. (2016). Physical activity promotes gait improvement in patients with total knee arthroplasty. Journal of arthroplasty, 31(5), 984-988. [Pubmed]
  • Varacallo, M., Johanson, N. A., & Luo, T. D. (2018). Total knee arthroplasty techniques.
  • Yoshida, Y., Zeni Jr, J., & Snyder-Mackler, L. (2012). Do patients achieve normal gait patterns 3 years after total knee arthroplasty? Journal of orthopaedic & sports physical therapy, 42(12), 1039-1049. [Pubmed]
  • Zeni Jr, J. A., & Snyder-Mackler, L. (2010). Most patients gain weight in the 2 years after total knee arthroplasty: comparison to ahealthy control group. Osteoarthritis and Cartilage, 18 (4), 510-514. [Pubmed]
There are 40 citations in total.

Details

Primary Language English
Subjects Physiotherapy
Journal Section Original Article
Authors

Harshada Joshi 0009-0004-1587-5958

Suraj Kanase 0000-0002-1776-3843

Project Number 617/2022-23
Early Pub Date March 18, 2024
Publication Date March 25, 2024
Submission Date November 28, 2023
Acceptance Date March 8, 2024
Published in Issue Year 2024 Volume: 7 Issue: 2

Cite

APA Joshi, H., & Kanase, S. (2024). Assessment of Alterations in Gait Parameters of Chronic Total Knee Arthroplasty – An Observational Study. International Journal of Disabilities Sports and Health Sciences, 7(2), 351-359. https://doi.org/10.33438/ijdshs.1397114
AMA Joshi H, Kanase S. Assessment of Alterations in Gait Parameters of Chronic Total Knee Arthroplasty – An Observational Study. International Journal of Disabilities Sports &Health Sciences. March 2024;7(2):351-359. doi:10.33438/ijdshs.1397114
Chicago Joshi, Harshada, and Suraj Kanase. “Assessment of Alterations in Gait Parameters of Chronic Total Knee Arthroplasty – An Observational Study”. International Journal of Disabilities Sports and Health Sciences 7, no. 2 (March 2024): 351-59. https://doi.org/10.33438/ijdshs.1397114.
EndNote Joshi H, Kanase S (March 1, 2024) Assessment of Alterations in Gait Parameters of Chronic Total Knee Arthroplasty – An Observational Study. International Journal of Disabilities Sports and Health Sciences 7 2 351–359.
IEEE H. Joshi and S. Kanase, “Assessment of Alterations in Gait Parameters of Chronic Total Knee Arthroplasty – An Observational Study”, International Journal of Disabilities Sports &Health Sciences, vol. 7, no. 2, pp. 351–359, 2024, doi: 10.33438/ijdshs.1397114.
ISNAD Joshi, Harshada - Kanase, Suraj. “Assessment of Alterations in Gait Parameters of Chronic Total Knee Arthroplasty – An Observational Study”. International Journal of Disabilities Sports and Health Sciences 7/2 (March 2024), 351-359. https://doi.org/10.33438/ijdshs.1397114.
JAMA Joshi H, Kanase S. Assessment of Alterations in Gait Parameters of Chronic Total Knee Arthroplasty – An Observational Study. International Journal of Disabilities Sports &Health Sciences. 2024;7:351–359.
MLA Joshi, Harshada and Suraj Kanase. “Assessment of Alterations in Gait Parameters of Chronic Total Knee Arthroplasty – An Observational Study”. International Journal of Disabilities Sports and Health Sciences, vol. 7, no. 2, 2024, pp. 351-9, doi:10.33438/ijdshs.1397114.
Vancouver Joshi H, Kanase S. Assessment of Alterations in Gait Parameters of Chronic Total Knee Arthroplasty – An Observational Study. International Journal of Disabilities Sports &Health Sciences. 2024;7(2):351-9.


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