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BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2013

Open Access 01-12-2013 | Research article

Differences in gait characteristics between total hip, knee, and ankle arthroplasty patients: a six-month postoperative comparison

Authors: Nicola C Casartelli, Julia F Item-Glatthorn, Mario Bizzini, Michael Leunig, Nicola A Maffiuletti

Published in: BMC Musculoskeletal Disorders | Issue 1/2013

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Abstract

Background

The recovery of gait ability is one of the primary goals for patients following total arthroplasty of lower-limb joints. The aim of this study was to objectively compare gait differences of patients after unilateral total hip arthroplasty (THA), total knee arthroplasty (TKA) and total ankle arthroplasty (TAA) with a group of healthy controls.

Methods

A total of 26 TAA, 26 TKA and 26 THA patients with a mean (± SD) age of 64 (± 9) years were evaluated six months after surgery and compared with 26 matched healthy controls. Subjects were asked to walk at self-selected normal and fast speeds on a validated pressure mat. The following spatiotemporal gait parameters were measured: walking velocity, cadence, single-limb support (SLS) time, double-limb support (DLS) time, stance time, step length and step width.

Results

TAA and TKA patients walked slower than controls at normal (p<0.05) and fast speeds (p<0.01). The involved side of TAA and TKA patients showed shorter SLS compared to controls at both normal and fast speeds (p<0.01). Regardless of walking speed, the uninvolved side of TAA and TKA patients demonstrated longer stance time and shorter step length than controls (p<0.01). TAA patients showed shorter SLS of the involved side, longer stance time and shorter step length of the uninvolved side compared to the contralateral side at both normal and fast speeds (p<0.001).

Conclusions

Gait disability after unilateral lower-limb joint arthroplasty was more marked for distal than for proximal joints at six months after surgery, with a proximal-to-distal progression in the impairment (TAA>TKA>THA). THA patients demonstrated no gait differences compared with controls. In contrast, TAA and TKA patients still demonstrated gait differences compared to controls, with slower walking velocity and reduced SLS in the involved limb. In addition, TAA patients presented marked side-to-side asymmetries in gait characteristics.
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Literature
1.
Felson DT, Lawrence RC, Hochberg MC, McAlindon T, Dieppe PA, Minor MA: Osteoarthritis: new insights. Part 2: treatment approaches. Ann Intern Med. 2000, 133: 726-737. 10.7326/0003-4819-133-9-200011070-00015.CrossRefPubMed
2.
Bachmeier CJ, March LM, Cross MJ, Lapsley HM, Tribe KL, Courtenay BG: A comparison of outcomes in osteoarthritis patients undergoing total hip and knee replacement surgery. Osteoarthr Cartil. 2001, 9: 137-146. 10.1053/joca.2000.0369.CrossRefPubMed
3.
Rippstein PF, Huber M, Coetzee JC, Naal FD: Total ankle replacement with use of a new three-component implant. J Bone Joint Surg Am. 2011, 93: 1426-1435. 10.2106/JBJS.J.00913.CrossRefPubMed
4.
Newton SE: Total ankle arthroplasty. Clinical study of fifty cases. J Bone Joint Surg Am. 1982, 64: 104-111.PubMed
5.
Haddad SL, Coetzee JC, Estok R, Fahrbach K, Banel D, Nalysnyk L: Intermediate and long-term outcomes of total ankle arthroplasty and ankle arthrodesis. A systematic review of the literature. J Bone Joint Surg Am. 2007, 89: 1899-1905. 10.2106/JBJS.F.01149.CrossRefPubMed
6.
Brodsky JW, Polo FE, Coleman SC, Bruck N: Changes in gait following the Scandinavian Total Ankle Replacement. J Bone Joint Surg Am. 2011, 93: 1890-1896. 10.2106/JBJS.J.00347.CrossRefPubMed
7.
van den Akker-Scheek I, Stevens M, Bulstra SK, Groothoff JW, Van Horn JR, Zijlstra W: Recovery of gait after short-stay total hip arthroplasty. Arch Phys Med Rehabil. 2007, 88: 361-367. 10.1016/j.apmr.2006.11.026.CrossRefPubMed
8.
Miki H, Sugano N, Hagio K, Nishii T, Kawakami H, Kakimoto A: Recovery of walking speed and symmetrical movement of the pelvis and lower extremity joints after unilateral THA. J Biomech. 2004, 37: 443-455. 10.1016/j.jbiomech.2003.09.009.CrossRefPubMed
9.
Hodt-Billington C, Helbostad JL, Vervaat W, Rognsvag T, Moe-Nilssen R: Changes in gait symmetry, gait velocity and self-reported function following total hip replacement. J Rehabil Med. 2011, 43: 787-793. 10.2340/16501977-0849.CrossRefPubMed
10.
Rasch A, Dalen N, Berg HE: Muscle strength, gait, and balance in 20 patients with hip osteoarthritis followed for 2 years after THA. Acta Orthop. 2010, 81: 183-188. 10.3109/17453671003793204.CrossRefPubMedPubMedCentral
11.
Alnahdi AH, Zeni JA, Snyder-Mackler L: Gait after unilateral total knee arthroplasty: frontal plane analysis. J Orthop Res. 2011, 29: 647-652. 10.1002/jor.21323.CrossRefPubMed
12.
McClelland JA, Webster KE, Feller JA, Menz HB: Knee kinematics during walking at different speeds in people who have undergone total knee replacement. Knee. 2011, 18: 151-155. 10.1016/j.knee.2010.04.005.CrossRefPubMed
13.
Milner CE: Is gait normal after total knee arthroplasty? Systematic review of the literature. J Orthop Sci. 2009, 14: 114-120. 10.1007/s00776-008-1285-8.CrossRefPubMed
14.
Detrembleur C, Leemrijse T: The effects of total ankle replacement on gait disability: analysis of energetic and mechanical variables. Gait Posture. 2009, 29: 270-274. 10.1016/j.gaitpost.2008.09.009.CrossRefPubMed
15.
Dyrby C, Chou LB, Andriacchi TP, Mann RA: Functional evaluation of the Scandinavian Total Ankle Replacement. Foot Ankle Int. 2004, 25: 377-381.PubMed
16.
Valderrabano V, Nigg BM, Von Tscharner V, Stefanyshyn DJ, Goepfert B, Hintermann B: Gait analysis in ankle osteoarthritis and total ankle replacement. Clin Biomech (Bristol, Avon). 2007, 22: 894-904. 10.1016/j.clinbiomech.2007.05.003.CrossRef
17.
Fritz S, Lusardi M: White paper: "walking speed: the sixth vital sign". J Geriatr Phys Ther. 2009, 32: 46-49.CrossRefPubMed
18.
Maffiuletti NA, Impellizzeri FM, Widler K, Bizzini M, Kain MS, Munzinger U: Spatiotemporal parameters of gait after total hip replacement: anterior versus posterior approach. Orthop Clin North Am. 2009, 40: 407-415. 10.1016/j.ocl.2009.02.004.CrossRefPubMed
19.
Boerger TO, Aglietti P, Mondanelli N, Sensi L: Mini-subvastus versus medial parapatellar approach in total knee arthroplasty. Clin Orthop Relat Res. 2005, 440: 82-87. 10.1097/01.blo.0000185755.09777.2d.CrossRefPubMed
20.
Jolles BM, Bogoch ER: Posterior versus lateral surgical approach for total hip arthroplasty in adults with osteoarthritis. Cochrane Database Syst Rev. 2006, 19: CD003828
21.
Kennon RE, Keggi JM, Wetmore RS, Zatorski LE, Huo MH, Keggi KJ: Total hip arthroplasty through a minimally invasive anterior surgical approach. J Bone Joint Surg Am. 2003, 85-A (Suppl 4): 39-48.PubMed
22.
Bilney B, Morris M, Webster K: Concurrent related validity of the GAITRite walkway system for quantification of the spatial and temporal parameters of gait. Gait Posture. 2003, 17: 68-74. 10.1016/S0966-6362(02)00053-X.CrossRefPubMed
23.
Menz HB, Latt MD, Tiedemann A, Mun San Kwan M, Lord SR: Reliability of the GAITRite walkway system for the quantification of temporo-spatial parameters of gait in young and older people. Gait Posture. 2004, 20: 20-25. 10.1016/S0966-6362(03)00068-7.CrossRefPubMed
24.
van Uden CJ, Besser MP: Test-retest reliability of temporal and spatial gait characteristics measured with an instrumented walkway system (GAITRite). BMC Musculoskelet Disord. 2004, 17: 13-CrossRef
25.
Van Iersel MB, Olde Rikkert MG, Borm GF: A method to standardize gait and balance variables for gait velocity. Gait Posture. 2007, 26: 226-230. 10.1016/j.gaitpost.2006.09.002.CrossRefPubMed
26.
Debi R, Mor A, Segal G, Segal O, Agar G, Debbi E: Correlation between single limb support phase and self-evaluation questionnaires in knee osteoarthritis populations. Disabil Rehabil. 2011, 33: 1103-1109. 10.3109/09638288.2010.520805.CrossRefPubMedPubMedCentral
27.
Shakoor N, Block JA, Shott S, Case JP: Nonrandom evolution of end-stage osteoarthritis of the lower limbs. Arthritis Rheum. 2002, 46: 3185-3189. 10.1002/art.10649.CrossRefPubMed
28.
Mattsson E, Olsson E, Brostrom LA: Assessment of walking before and after unicompartmental knee arthroplasty. A comparison of different methods. Scand J Rehabil Med. 1990, 22: 45-50.PubMed
29.
Ouellet D, Moffet H: Locomotor deficits before and two months after knee arthroplasty. Arthritis Rheum. 2002, 47: 484-493. 10.1002/art.10652.CrossRefPubMed
30.
Mizner RL, Petterson SC, Snyder-Mackler L: Quadriceps strength and the time course of functional recovery after total knee arthroplasty. J Orthop Sports Phys Ther. 2005, 35: 424-436.CrossRefPubMed
31.
Crosbie J, Green T, Refshauge K: Effects of reduced ankle dorsiflexion following lateral ligament sprain on temporal and spatial gait parameters. Gait Posture. 1999, 9: 167-172. 10.1016/S0966-6362(99)00010-7.CrossRefPubMed
32.
Larmer PJ, Mcnair PJ, Smythe L, Williams M: Ankle sprains: patient perceptions of function and performance of physical tasks. A mixed methods approach. Disabil Rehabil. 2011, 33: 2299-2304. 10.3109/09638288.2011.568668.CrossRefPubMed
Metadata
Title
Differences in gait characteristics between total hip, knee, and ankle arthroplasty patients: a six-month postoperative comparison
Authors
Nicola C Casartelli
Julia F Item-Glatthorn
Mario Bizzini
Michael Leunig
Nicola A Maffiuletti
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2013
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/1471-2474-14-176

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