Open AccessDeficits in functional performance and gait one year after total knee arthroplasty despite improved self‐reported function
Author(s) -
Naili Josefine E.,
Iversen Maura D.,
Esbjörnsson AnnaClara,
Hedström Margareta,
Schwartz Michael H.,
Häger Charlotte K.,
Broström Eva W.
Publication year - 2017
Publication title -
knee surgery, sports traumatology, arthroscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.806
H-Index - 125
eISSN - 1433-7347
pISSN - 0942-2056
DOI - 10.1007/s00167-016-4234-7
Subject(s) - osteoarthritis , gait , medicine , physical therapy , physical medicine and rehabilitation , gait analysis , total knee arthroplasty , arthroplasty , prospective cohort study , cohort , surgery , alternative medicine , pathology
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.