Abstract
BackgroundThe recovery of gait ability is one of the primary goals for patients following total arthroplasty of lower-limb joints. The aim of this study was to objectively compare gait differences of patients after unilateral total hip arthroplasty (THA), total knee arthroplasty (TKA) and total ankle arthroplasty (TAA) with a group of healthy controls.MethodsA total of 26 TAA, 26 TKA and 26 THA patients with a mean (± SD) age of 64 (± 9) years were evaluated six months after surgery and compared with 26 matched healthy controls. Subjects were asked to walk at self-selected normal and fast speeds on a validated pressure mat. The following spatiotemporal gait parameters were measured: walking velocity, cadence, single-limb support (SLS) time, double-limb support (DLS) time, stance time, step length and step width.ResultsTAA and TKA patients walked slower than controls at normal (p<0.05) and fast speeds (p<0.01). The involved side of TAA and TKA patients showed shorter SLS compared to controls at both normal and fast speeds (p<0.01). Regardless of walking speed, the uninvolved side of TAA and TKA patients demonstrated longer stance time and shorter step length than controls (p<0.01). TAA patients showed shorter SLS of the involved side, longer stance time and shorter step length of the uninvolved side compared to the contralateral side at both normal and fast speeds (p<0.001).ConclusionsGait disability after unilateral lower-limb joint arthroplasty was more marked for distal than for proximal joints at six months after surgery, with a proximal-to-distal progression in the impairment (TAA>TKA>THA). THA patients demonstrated no gait differences compared with controls. In contrast, TAA and TKA patients still demonstrated gait differences compared to controls, with slower walking velocity and reduced SLS in the involved limb. In addition, TAA patients presented marked side-to-side asymmetries in gait characteristics.
Highlights
The recovery of gait ability is one of the primary goals for patients following total arthroplasty of lower-limb joints
total ankle arthroplasty (TAA) and total knee arthroplasty (TKA) patients walked slower than controls at both normal (p
The main findings of this comparison of gait characteristics among lower-limb joint arthroplasty patients were the following: (a) TKA and TAA patients walked at a slower velocity compared to matched healthy controls; (b) TKA and TAA patients had shorter single-limb support (SLS) in the involved limb, and longer stance time and shorter step length in the uninvolved limb compared with controls; (c) TAA patients presented considerable side-to-side asymmetries for temporal (SLS, stance time) and spatial parameters; (d) total hip arthroplasty (THA) patients did not present any impairment in gait characteristics; (e) between-group differences in walking variables were comparable at normal and fast speeds
Summary
The recovery of gait ability is one of the primary goals for patients following total arthroplasty of lower-limb joints. Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are currently the most effective surgical interventions for the treatment of end-stage hip and knee arthritis [1] They have been proven to be successful in reducing joint pain and stiffness as well as in improving physical function, with THA patients usually demonstrating earlier and more pronounced improvements in comparison to TKA patients [2]. The recovery of gait function is one of the primary goals for patients, surgeons and physical therapists following lower-limb total joint arthroplasty. The gait characteristics of these three groups of patients have never been compared in a systematic fashion This would provide valuable information about differences in objective functional recovery between patients who have had a primary total arthroplasty of a main weight-bearing joint. It was hypothesized that patients following THA, TKA and TAA would demonstrate gait disturbances compared to healthy controls, with THA and TAA patients presenting the least and greatest gait impairment, respectively
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
