Deficits in Functional Performance and Gait One Year After Total Knee Arthroplasty Despite Improved Self-reported Function

Overview

Journal Knee Surg Sports Traumatol Arthrosc

Publisher Wiley

Specialties Emergency Medicine
General Surgery
Orthopedics

Date 2016 Jul 21

PMID 27436196

Citations 21

Authors

Josefine E Naili

Maura D Iversen

Anna-Clara Esbjornsson

Margareta Hedstrom

Michael H Schwartz

Charlotte K Hager

Eva W Brostrom

Affiliations

Soon will be listed here.

Abstract

Purpose: The current literature lacks sufficient information about improvements in gait patterns and function after total knee arthroplasty (TKA) and whether patients return to full function. This study evaluated change in gait, performance-based function, and self-reported function 1 year after TKA in patients with symptomatic knee osteoarthritis and how these aspects interrelate.

Methods: A total of 28 patients (64 % female) with knee osteoarthritis, with a mean age of 66 (±7) years, and 25 age- and gender-matched controls participated in this prospective cohort study. Three-dimensional gait analysis generated comprehensive measures of kinematic and kinetic gait deviations, respectively. Participants completed the Five Times Sit-to-Stand (5STS) test, and the self-reported questionnaire Knee Injury and Osteoarthritis Outcome Score (KOOS), at baseline prior to surgery and 1 year after TKA.

Results: Kinetic gait deviations of both the operated and non-operated limb persisted in patients with knee osteoarthritis at 1 year after surgery, while kinematic gait patterns were comparable to controls. Performance on the 5STS and KOOS scores in patients with knee osteoarthritis improved significantly 1 year after surgery (effect size 0.5-1.5), but did not reach the level of controls. Ten patients with knee osteoarthritis (36 %) exceeded the minimally detectable change on the 5STS.

Conclusion: Measures of overall gait patterns and the 5STS revealed improvements in function 1 year after TKA, but were not restored to the level of healthy controls. Based on change in 5STS performance, we identified patients with substantial improvements in gait patterns. Self-reported measures of function could not detect differences between patients improving in 5STS performance and those who did not. These findings highlight the use of the 5STS in clinical practice since improvement on this test seems to follow the reduction in gait pattern deviations.

Level Of Evidence: II.

Citing Articles

The Effects of Biomechanical Loading on the Tibial Insert After Primary Total Knee Arthroplasty: A Systematic Review.

Diconi A, Roman M, Cristian A, Boicean A, Mohor C, Ion N J Clin Med. 2025; 14(4).

PMID: 40004574 PMC: 11855950. DOI: 10.3390/jcm14041043.

Self-assessed performance-based function test versus patient-reported outcome measures for knee and hip osteoarthritis.

Kiadaliri A, Sirard P, Dahlberg L, Lohmander L BMC Sports Sci Med Rehabil. 2024; 16(1):232.

PMID: 39574141 PMC: 11580485. DOI: 10.1186/s13102-024-01020-2.

Gait, Quality of Life, and Knee Function in Advanced Knee Osteoarthritis: A Single-Center, Prospective, Observational Study.

Freijo V, Navarro C, Villalba J J Clin Med. 2024; 13(18).

PMID: 39336879 PMC: 11432757. DOI: 10.3390/jcm13185392.

Number of conditioning trials, but not stimulus intensity, influences operant conditioning of brain responses after total knee arthroplasty.

Rodriguez K, Krishnan C, Palmieri-Smith R Knee Surg Sports Traumatol Arthrosc. 2024; 33(3):967-976.

PMID: 39324365 PMC: 11848966. DOI: 10.1002/ksa.12480.

Deficient gait function despite effect index of the Western Ontario and McMaster university osteoarthritis index score considered cured one year after bilateral total knee arthroplasty.

Zhao R, Wei X, Hu S, Zhang Y, Wu H, Li P BMC Musculoskelet Disord. 2024; 25(1):230.

PMID: 38521939 PMC: 10960387. DOI: 10.1186/s12891-024-07348-7.

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