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Abnormal loading and functional deficits are present in both limbs before and after unilateral knee arthroplasty

Metcalfe, A. J., Stewart, C. J., Postans, N. J., Biggs, P. R. ORCID:, Whatling, G. M. ORCID:, Holt, C. A. ORCID: and Roberts, A. P. 2017. Abnormal loading and functional deficits are present in both limbs before and after unilateral knee arthroplasty. Gait and Posture 55 , pp. 109-115. 10.1016/j.gaitpost.2017.04.008

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Unilateral knee replacement is often followed by a contralateral replacement in time and the biomechanics of the other knee before and after knee replacement remains poorly understood. The aim of this paper is to distinguish the features of arthritic gait in the affected and unaffected legs relative to a normal population and to assess the objective recovery of gait function post-operatively, with the aim of defining patients at risk of poor post-operative function. Twenty patients with severe knee OA but no pain or deformity in any other lower limb joint were compared to twenty healthy subjects of the same age. Gait analysis was performed and quadriceps and hamstrings co-contraction was measured. Fifteen subjects returned 1 year following knee arthroplasty. Moments and impulses were calculated, principal component analysis was used to analyse the waveforms and a classification technique (the Cardiff Classifier) was used to select the most discriminant data and define functional performance. Comparing pre-operative function to healthy function, classification accuracies for the affected and unaffected knees were 95% and 92.5% respectively. Post-operatively, the affected limb returned to the normal half of the classifier in 8 patients, and 7 of those patients returned to normal function in the unaffected limb. Recovery of normal gait could be correctly predicted 13 out of 15 times at the affected knee, and 12 out of 15 times at the unaffected knee based on pre-operative gait function. Focused rehabilitation prior to surgery may be beneficial to optimise outcomes and protect the other joints following knee arthroplasty.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Engineering
Additional Information: This is an open access article under the CC BY license.
Publisher: Elsevier
ISSN: 0966-6362
Funders: Betsi Cadwaladr University Health Board, Arthritis Research UK
Date of First Compliant Deposit: 6 July 2017
Date of Acceptance: 3 April 2017
Last Modified: 09 May 2023 01:03

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