The impact of knee arthrodesis on gait kinematics, muscle activity and patient-reported outcome.


Journal

The Knee
ISSN: 1873-5800
Titre abrégé: Knee
Pays: Netherlands
ID NLM: 9430798

Informations de publication

Date de publication:
Jun 2023
Historique:
received: 29 12 2022
revised: 17 02 2023
accepted: 03 04 2023
medline: 27 6 2023
pubmed: 30 4 2023
entrez: 29 4 2023
Statut: ppublish

Résumé

The aim of this retrospective study was to analyze gait kinematicsandoutcome parameters after knee arthrodesis. Fifteenpatients with a mean follow-up of 5.9 (range0.8-36) years after unilateral knee arthrodesis were included. A 3D gait analysis was performed and compared to a healthy control group of14patients. Comparative electromyography was performed bilaterally at the rectus femoris, vastuslateralis/medialisand tibialis anterior muscles. The assessment further included standardized outcome scores- Lower Extremity Functional Scale (LEFS) andShort Form Health Survey (SF-36). The 3D analysis showed a significantly shortened stance phase (p = 0.000), an extended swing phase (p = 0.000), and an increased time per step (p = 0.009) for the operated side compared with thenonoperatedside. There were statistically significant differences in the extent of movement of the hips, knees and ankles among the operated andnonoperatedsides and the control group. For the mean EMG measurement, no significant difference was found between the healthy control group and the patients with arthrodesis.The average LEFSscorewas 27.5 ± 10.6out of a maximum of 80 points,and the mean physical total scale and mean emotional total scale scores for the SF-36 were 27.9 ± 8.5and 52.9 ± 9.9, respectively. Arthrodesis of the knee joint causes significant kinematic changes in gait pattern,and patients achieve poor results in subjective and functional outcomes(SF- 36, LEFS).Arthrodesis ensures that the extremities are preserved and can enable walking, but it must be viewed as a severe handicap for the patient.

Sections du résumé

BACKGROUND BACKGROUND
The aim of this retrospective study was to analyze gait kinematicsandoutcome parameters after knee arthrodesis.
METHODS METHODS
Fifteenpatients with a mean follow-up of 5.9 (range0.8-36) years after unilateral knee arthrodesis were included. A 3D gait analysis was performed and compared to a healthy control group of14patients. Comparative electromyography was performed bilaterally at the rectus femoris, vastuslateralis/medialisand tibialis anterior muscles. The assessment further included standardized outcome scores- Lower Extremity Functional Scale (LEFS) andShort Form Health Survey (SF-36).
RESULTS RESULTS
The 3D analysis showed a significantly shortened stance phase (p = 0.000), an extended swing phase (p = 0.000), and an increased time per step (p = 0.009) for the operated side compared with thenonoperatedside. There were statistically significant differences in the extent of movement of the hips, knees and ankles among the operated andnonoperatedsides and the control group. For the mean EMG measurement, no significant difference was found between the healthy control group and the patients with arthrodesis.The average LEFSscorewas 27.5 ± 10.6out of a maximum of 80 points,and the mean physical total scale and mean emotional total scale scores for the SF-36 were 27.9 ± 8.5and 52.9 ± 9.9, respectively.
CONCLUSIONS CONCLUSIONS
Arthrodesis of the knee joint causes significant kinematic changes in gait pattern,and patients achieve poor results in subjective and functional outcomes(SF- 36, LEFS).Arthrodesis ensures that the extremities are preserved and can enable walking, but it must be viewed as a severe handicap for the patient.

Identifiants

pubmed: 37119600
pii: S0968-0160(23)00093-5
doi: 10.1016/j.knee.2023.04.006
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

273-280

Informations de copyright

Copyright © 2023 Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Auteurs

Charlotte Cibura (C)

Department of General and Trauma Surgery, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Germany. Electronic address: charlotte.cibura@bergmannsheil.de.

Thomas Rosteius (T)

Department of General and Trauma Surgery, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Germany.

Alexis Brinkemper (A)

Department of General and Trauma Surgery, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Germany.

Christopher Ull (C)

Department of General and Trauma Surgery, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Germany.

Silvia Hufnagel (S)

Department of General and Trauma Surgery, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Germany.

Birger Jettkant (B)

Department of General and Trauma Surgery, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Germany.

Periklis Godolias (P)

Department of General and Trauma Surgery, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Germany.

Valentin Rausch (V)

Department of General and Trauma Surgery, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Germany.

Thomas A Schildhauer (TA)

Department of General and Trauma Surgery, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Germany.

Christiane Kruppa (C)

Department of General and Trauma Surgery, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Germany.

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