Franziska Schmitter (Basel / CH; Freiburg i. Br.), Dr. Corina Nüesch (Basel / CH), David Koch (Basel / CH), Prof. Karl Stoffel (Basel / CH), Dr. Petros Ismailidis (Basel / CH), Prof. Annegret Mündermann (Basel / CH)
Abstract-Text (inkl. Referenzen und Bildunterschriften)
Introduction: Patients undergoing unilateral total knee arthroplasty (TKA) or total hip arthroplasty (THA) often develop osteoarthritis of the contralateral knee or hip joint1. However, gait research in patients after TKA or THA has mainly focused on the affected but not on the adjacent joints or the contralateral side.
Purpose: To evaluate whether there are differences in gait kinematics and kinetics of the contralateral and ipsilateral side of TKA and THA patients compared to asymptomatic controls.
Methods: 103 participants (45 patients 1 year after THA; 30 patients 1 year after TKA; 28 controls) performed a three-dimensional instrumented gait analysis on an overground walkway with two embedded force plates using the PlugInGait model. Differences in lower extremity kinematic and kinetic waveform data between each patient group and controls were analyzed using statistical parametric mapping with independent samples t-tests (p<0.05).
Results: Compared to controls, patients after TKA had greater hip flexion (p=0.012) and ankle dorsiflexion (p=0.024) angles and greater knee adduction (p<0.001) and lower ankle dorsiflexion (p=0.001) moments on the contralateral side (Fig.1). On the ipsilateral side, TKA had greater sagittal ankle (p=0.018) and hip (p=0.024) angles and lower ankle moments (p<0.01) than controls. THA patients had only smaller hip adduction (p=0.039) and greater knee flexion (p=0.027) angles on the ipsilateral side compared to controls (Fig.2).
Discussion: Differences in kinematic and kinetic patterns in TKA compared to controls were observed not only on the operated joint, but also in adjacent and contralateral joints. In contrast, THA differed from controls only in ipsilateral joint kinematics. The results suggest that 1 year after surgery, THA patients may have had faster rehabilitation in contralateral joints than patients who underwent TKA.
1Alnahdi et al. 2011 J Orthop Res