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Does a third condyle TKA restore normal gait kinematics in varus knees? In vivo knee kinematic analysis

  • Knee Arthroplasty
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

Patients with knee osteoarthritis tend to modify spatial and temporal parameters during walking to reduce the pain. Total knee arthroplasty (TKA) is considered the gold standard treatment for end-stage knee osteoarthritis. However, reduced physical function of the knee is partly, but apparently not fully, remedied by surgery. The purpose of this study was to investigate the in vivo, three dimensional knee kinematics during gait at the patients with knee osteoarthritis and the influence of “third condyle” psoterior stabilized (PS) total knee arthroplasty on restoration of normal kinematics.

Materials and Methods

Twenty patients with medial knee osteoarthritis and a control group with age-matched subjects were prospectively collected for this study. The same group of 20 patients were re-assessed 10 months after total knee arthroplasty with “third condyle” PS prosthesis. All subjects were assessed with a 3D, optoelectric knee assessement device, while walking on a treadmill at a self-selected speed. For each participant, knee flexion–extension, abduction–adduction, internal–external rotation and anterior–posterior displacement, were calculated.

Results

The range of flexion/extension was improved significantly (39.9° ± 5.5° vs 44.8° ± 5.1°, p < 0.05) after TKA but it still remained lower than control group (6.9° ± 5.5° vs 2.2° ± 3.9°, p < 0.05). The range of motion in internal-external rotation did not change pre- and post-arthroplasty, but remained lower than the matched control group (6.7° ± 2.4° vs 9.3° ± 2.4, p < 0.05). The maximum posterior displacement during swing phase was significantly higher at post-arthroplasty group comparing with control group (−9.5 ± 2.2 vs −5.7 ± 3 mm, p < 0.05).

Conclusion

Following “third condyle” PS-TKA, patients had better clinical, spatiotemporal and kinematic parameters. Despite improvements, the knee kinematics during gait in TKA group differed from healthy control group. TKA group had a lower extension lower range of axial rotation and an increased tibial posterior displacement.

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Authors and Affiliations

  1. Laboratoire de Biomécanique et Mécanique des Chocs, University Claude Bernard Lyon 1, Lyon, France

    Dafina Bytyqi, Bujar Shabani, Laurence Cheze, Philippe Neyret & Sebastien Lustig

  2. Albert Trillat Center, Lyon, France

    Dafina Bytyqi, Bujar Shabani, Philippe Neyret & Sebastien Lustig

  3. University of Prishtina, Prishtina, Kosovo

    Dafina Bytyqi & Bujar Shabani

Authors
  1. Dafina Bytyqi
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  2. Bujar Shabani
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  3. Laurence Cheze
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  4. Philippe Neyret
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  5. Sebastien Lustig
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Corresponding author

Correspondence to Sebastien Lustig.

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Conflict of interest

Authors Bytyqi Dafina, Shabani Bujar, Cheze Laurence declare that they have no conflict of interest. Sébastien Lustig is consultant for Smith and Nephew and received institutional support from Amplitude and Wright-Tornier. Philippe Neyret received royalties from Wright-Tornier and institutional support from Amplitude and Wright-Tornier.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Bytyqi, D., Shabani, B., Cheze, L. et al. Does a third condyle TKA restore normal gait kinematics in varus knees? In vivo knee kinematic analysis. Arch Orthop Trauma Surg 137, 409–416 (2017). https://doi.org/10.1007/s00402-017-2629-7

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  • DOI: https://doi.org/10.1007/s00402-017-2629-7

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