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. 2022 Jun;142(6):1189-1196.
doi: 10.1007/s00402-021-03915-y. Epub 2021 May 6.

Patients' perceived walking abilities, daily-life gait behavior and gait quality before and 3 months after total knee arthroplasty

Bas L Fransen  1   2 , Mirjam Pijnappels  3 , Ise K Butter  4 , B J Burger  4 , J H van Dieën  3 , M J M Hoozemans  3
Affiliations

Patients' perceived walking abilities, daily-life gait behavior and gait quality before and 3 months after total knee arthroplasty

Bas L Fransen et al. Arch Orthop Trauma Surg. 2022 Jun.

Abstract

Introduction: Functional outcome and patients' daily-life activities after total knee arthroplasty are becoming more important with a younger and more active patient population. In addition to patient-reported outcome measures (PROMs), trunk-based accelerometry has shown to be a promising method for evaluating gait function after total knee arthroplasty. The aim of this study was to evaluate daily-life perceived walking abilities, gait behavior and gait quality before and 3 months after total knee arthroplasty, using PROMs and trunk-based accelerometry.

Materials and methods: A cohort of 38 patients completed questionnaires including the Oxford Knee Score and modified Gait Efficacy Scale before and 3 months after primary unilateral total knee arthroplasty. At both time points, they wore a tri-axial accelerometer at the lower back for seven consecutive days and nights. Gait behavior was calculated using gait quantity and walking speed, and multiple gait quality parameters were calculated.

Results: Significant improvements were seen after 3 months in the Oxford Knee Score [median (interquartile range) 29 (10) vs 39 (8), p < 0.001] and modified Gait Efficacy Scale [median (interquartile range) 67 (24) vs 79 (25), p = 0.001]. No significant changes were observed in gait behavior (quantity and speed) or gait quality variables.

Conclusions: In contrast to the significant improvements in patients' perception of their walking abilities and PROMs, patients did not show improvements in gait behavior and gait quality. This implies that after 3 months patients' perceived functional abilities after total knee arthroplasty do not necessarily represent their actual daily-life quantity and quality of gait, and that more focus is needed on postoperative rehabilitation to improve gait and functional behavior.

Keywords: Arthroplasty; Behavior; Functional outcome; Gait analysis; Knee.

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Conflict of interest statement

None of the authors reported any conflict of interest.

Figures

Fig. 1
Fig. 1
This Movemonitor accelerometer was worn by patients 1 week before and after total knee arthroplasty
Fig. 2
Fig. 2
Flow chart of the study population
See this image and copyright information in PMC

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