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J Knee Surg 2021; 34(08): 898-905
DOI: 10.1055/s-0039-3402079
Original Article

Gait Analysis 1 Year after Primary TKA: No Difference between Gap Balancing and Measured Resection Technique

Hermes H. Miozzari
1   Division of Orthopaedic Surgery and Traumatology, Geneva University Hospitals, Geneva, Switzerland
,
Stéphane Armand
2   Willy Taillard Laboratory of Kinesiology, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
,
Katia Turcot
3   Department of Kinesiology, Laval University, Quebec, Canada
4   Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Quebec, Canada
,
Anne Lübbeke
1   Division of Orthopaedic Surgery and Traumatology, Geneva University Hospitals, Geneva, Switzerland
,
Alice Bonnefoy-Mazure
2   Willy Taillard Laboratory of Kinesiology, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
› Author Affiliations Funding This work was supported by the Division of Orthopaedic Surgery and Traumatology of the Geneva University Hospitals and the Clinical Research Center, University Hospitals and Faculty of Medicine, Geneva, and the Louis-Jeantet Foundation.
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Abstract

Mechanical alignment in total knee arthroplasty (TKA) can be achieved using dependent bone cuts. The hypothesis is that patients have a better balanced TKA, as a result. The aim of this study was to determine if this technique is superior to an independent bone cut technique in terms of gait parameters, patient-reported outcome measures (PROMs), and satisfaction assessed before surgery and at 1-year follow-up. A total of 58 patients were evaluated before and 1 year following TKA, using the Press Fit Condylar (PFC) Sigma posterior stabilizer (PS) design; 39 (70 ± 8 years; 27 women) with independent bone cuts and 19 (71 ± 7 years; 12 women) with dependent bone cuts using the Specialist TRAM. Gait was evaluated with a three-dimensional motion analysis system for spatiotemporal and kinematics parameters. Pain and functional levels were assessed using the Western Ontario and McMaster Universities arthritis index (WOMAC); general health was assessed by the short form (SF)-12. Global satisfaction, as well as patient satisfaction, related to pain and functional levels were assessed using a five-point Likert's scale. No significant difference was found between both groups in terms of age, body mass index, pain, and functional levels at baseline. At 1-year follow-up, despite an overall improvement in gait, WOMAC, SF-12 physical score and pain, none of the patients showed gait parameters comparable to a healthy control group. No surgical technique effect was observed on gait, clinical outcomes, and satisfaction level. While observing an overall improvement at 1-year follow-up, we did not find any significant difference between the two surgical techniques in terms of gait parameters, patients' outcomes, and satisfaction.

Keywords

osteoarthritis - total knee arthroplasty - knee kinematics - gait analysis - PROMs - gap balancing - resection technique


Publication History

Received: 29 August 2019

Accepted: 10 November 2019

Article published online:
31 December 2019

© 2019. Thieme. All rights reserved.

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