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Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy 3/2014

01.03.2014 | Knee

Preoperative asymmetry in load distribution during quite stance persist following total knee arthroplasty

verfasst von: Dominic Thewlis, Susan Hillier, Sarah Jane Hobbs, Jim Richards

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 3/2014

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Abstract

Purpose

Preoperative function has been shown to persist posttotal knee arthroplasty. However, it remains unclear whether asymmetries are task specific. Therefore, we investigated postoperative asymmetries in loading during quiet stance and walking gait.

Methods

Ten patients with end-stage knee osteoarthritis scheduled for total knee arthroplasty were studied at baseline (preoperative), 6-week, 3- and 6-month postoperative. Load distribution and balance were quantified during quiet stance. Furthermore, dynamic loading was quantified during walking gait. Patient satisfaction was assessed using the Knee Osteoarthritis and injury Outcome Score.

Results

Preoperatively, load distribution was significantly different between limbs, with approximately 70 % of the load through the contralateral or ‘good’ side. Asymmetries persisted and up to 6-month postoperative during quiet stance. No significant change was found in balance. During walking, preoperative loading asymmetry was present; however, no significant postoperative loading asymmetries were identified.

Conclusions

Total knee arthroplasty does not appear to significantly change load distribution or balance 6-month postoperative during quiet stance; however, during walking gait, symmetry appears to be restored. This could be potentially improved through enhanced rehabilitation.

Level of evidence

Therapeutic study, Level IV.
Literatur
1.
Zurück zum Zitat Badley E (1995) The impact of disabling arthritis. Arthritis Rheum 8:221–228CrossRef Badley E (1995) The impact of disabling arthritis. Arthritis Rheum 8:221–228CrossRef
3.
Zurück zum Zitat Gage W, Frank J, Prentice S (2008) Postural responses following a rotational support surface perturbation, following knee joint replacement: frontal plane rotations. Gait Posture 27:286–293PubMedCrossRef Gage W, Frank J, Prentice S (2008) Postural responses following a rotational support surface perturbation, following knee joint replacement: frontal plane rotations. Gait Posture 27:286–293PubMedCrossRef
4.
Zurück zum Zitat Gauchard GC, Vançon G, Meyer P, Mainard D, Perrin PP (2010) On the role of knee joint in balance control and postural strategies: effects of total knee replacement in elderly subjects with knee osteoarthritis. Gait Posture 32:155–160PubMedCrossRef Gauchard GC, Vançon G, Meyer P, Mainard D, Perrin PP (2010) On the role of knee joint in balance control and postural strategies: effects of total knee replacement in elderly subjects with knee osteoarthritis. Gait Posture 32:155–160PubMedCrossRef
5.
Zurück zum Zitat Gerber H, Stuessi E (1987) A measuring system to assess and to compute the double stride. Biomech X-B Int Ser Biomech 24:1055–1085 Gerber H, Stuessi E (1987) A measuring system to assess and to compute the double stride. Biomech X-B Int Ser Biomech 24:1055–1085
6.
Zurück zum Zitat Kee CC (2000) Osteoarthritis: manageable scourge of aging. Nurs Clin North Am 35:199–208PubMed Kee CC (2000) Osteoarthritis: manageable scourge of aging. Nurs Clin North Am 35:199–208PubMed
7.
Zurück zum Zitat Kellgren JH, Lawrence JS (1957) Radiological assessment of osteo-arthrosis. Ann Rheum Dis 16:494–502PubMedCrossRef Kellgren JH, Lawrence JS (1957) Radiological assessment of osteo-arthrosis. Ann Rheum Dis 16:494–502PubMedCrossRef
8.
Zurück zum Zitat Kurtz SM, Lau E, Ong K, Zhao K, Kelly M, Bozic KJ (2009) Future young patient demand for primary and revision joint replacement: national projections from 2010 to 2030. Clin Orthop Relat R 467:2606–2612CrossRef Kurtz SM, Lau E, Ong K, Zhao K, Kelly M, Bozic KJ (2009) Future young patient demand for primary and revision joint replacement: national projections from 2010 to 2030. Clin Orthop Relat R 467:2606–2612CrossRef
9.
Zurück zum Zitat Levinger P, Menz HB, Morrow AD, Perrott MA, Bartlett JR, Feller JA, Bergman N (2011) Knee biomechanics early after knee replacement surgery predict abnormal gait patterns 12 months postoperatively. J Orthop Res 30:371–376PubMedCrossRef Levinger P, Menz HB, Morrow AD, Perrott MA, Bartlett JR, Feller JA, Bergman N (2011) Knee biomechanics early after knee replacement surgery predict abnormal gait patterns 12 months postoperatively. J Orthop Res 30:371–376PubMedCrossRef
10.
Zurück zum Zitat Levinger P, Menz HB, Morrow AD, Wee E, Feller JA, Bartlett JR, Bergman N (2011) Lower limb proprioception deficits persist following knee replacement surgery despite improvements in knee extension strength. Knee Surg Sports Traumatol Arthrosc 8:1097–1103 Levinger P, Menz HB, Morrow AD, Wee E, Feller JA, Bartlett JR, Bergman N (2011) Lower limb proprioception deficits persist following knee replacement surgery despite improvements in knee extension strength. Knee Surg Sports Traumatol Arthrosc 8:1097–1103
11.
Zurück zum Zitat Maki B, Holliday P (1994) A prospective study of postural balance and risk of falling in an ambulatory and independent elderly population. J Gerontol 49:M72–M84PubMedCrossRef Maki B, Holliday P (1994) A prospective study of postural balance and risk of falling in an ambulatory and independent elderly population. J Gerontol 49:M72–M84PubMedCrossRef
12.
Zurück zum Zitat McClelland J, Webster K, Feller J (2007) Gait analysis of patients following total knee replacement: a systematic review. Knee 14:253–263PubMedCrossRef McClelland J, Webster K, Feller J (2007) Gait analysis of patients following total knee replacement: a systematic review. Knee 14:253–263PubMedCrossRef
13.
Zurück zum Zitat Rasch A, Dalén N (2010) Muscle strength, gait, and balance in 20 patients with hip osteoarthritis followed for 2 years after THA. Acta Orthop 81:183–188PubMedCrossRef Rasch A, Dalén N (2010) Muscle strength, gait, and balance in 20 patients with hip osteoarthritis followed for 2 years after THA. Acta Orthop 81:183–188PubMedCrossRef
14.
Zurück zum Zitat Roos EM, Toksvig-Larsen S (2003) Knee injury and Osteoarthritis Outcome Score (KOOS)—validation and comparison to the WOMAC in total knee replacement. Health Qual Life Outcomes 1:17PubMedCentralPubMedCrossRef Roos EM, Toksvig-Larsen S (2003) Knee injury and Osteoarthritis Outcome Score (KOOS)—validation and comparison to the WOMAC in total knee replacement. Health Qual Life Outcomes 1:17PubMedCentralPubMedCrossRef
15.
Zurück zum Zitat Shakoor N, Block J, Shott S (2002) Nonrandom evolution of end-stage osteoarthritis of the lower limbs. Arthritis Rheum 46:3185–3189PubMedCrossRef Shakoor N, Block J, Shott S (2002) Nonrandom evolution of end-stage osteoarthritis of the lower limbs. Arthritis Rheum 46:3185–3189PubMedCrossRef
16.
Zurück zum Zitat Terwee CB, van der Slikke RMA, van Lummel RC, Benink RJ, Meijers WGH, de Vet HCW (2006) Self-reported physical functioning was more influenced by pain than performance-based physical functioning in knee-osteoarthritis patients. J Clin Epidemiol 59:724–731PubMedCrossRef Terwee CB, van der Slikke RMA, van Lummel RC, Benink RJ, Meijers WGH, de Vet HCW (2006) Self-reported physical functioning was more influenced by pain than performance-based physical functioning in knee-osteoarthritis patients. J Clin Epidemiol 59:724–731PubMedCrossRef
17.
Zurück zum Zitat Winter D, Prince F, Frank J, Powell C, Zabjek K (1996) Unified theory regarding A/P and M/L balance in quiet standing. J Neurophysiol 23:2334–2343 Winter D, Prince F, Frank J, Powell C, Zabjek K (1996) Unified theory regarding A/P and M/L balance in quiet standing. J Neurophysiol 23:2334–2343
18.
Zurück zum Zitat (2011) MATLAB 2011b, The MathWorks Inc., MA (2011) MATLAB 2011b, The MathWorks Inc., MA
Metadaten
Titel
Preoperative asymmetry in load distribution during quite stance persist following total knee arthroplasty
verfasst von
Dominic Thewlis
Susan Hillier
Sarah Jane Hobbs
Jim Richards
Publikationsdatum
01.03.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 3/2014
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-013-2616-7

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