Article

Unilateral knee replacement is often followed by a contralateral replacement in
time and the biomechanics of the other knee before and after knee replacement
remains poorly understood.
The aim of this paper is to distinguish the features
of arthritic gait in the affected and unaffected legs relative to a normal
population and to assess the objective recovery of gait function
post-operatively, with the aim of defining patients at risk of poor
post-operative function.
Twenty patients with severe knee OA but no pain or
deformity in any other lower limb joint were compared to twenty healthy subjects
of the same age. Gait analysis was performed and quadriceps and hamstrings
co-contraction was measured. Fifteen subjects returned 1year following knee
arthroplasty. Moments and impulses were calculated, principal component analysis
was used to analyse the waveforms and a classification technique (the Cardiff
Classifier) was used to select the most discriminant data and define functional
performance. Comparing pre-operative function to healthy function, classification
accuracies for the affected and unaffected knees were 95% and 92.5% respectively.
Post-operatively, the affected limb returned to the normal half of the classifier
in 8 patients, and 7 of those patients returned to normal function in the
unaffected limb. Recovery of normal gait could be correctly predicted 13 out of
15 times at the affected knee, and 12 out of 15 times at the unaffected knee
based on pre-operative gait function. Focused rehabilitation prior to surgery may
be beneficial to optimise outcomes and protect the other joints following knee arthroplasty.
CI - Copyright (c) 2017. Published by Elsevier B.V.

Langue : ANGLAIS