Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Sep 5:34:304-309.
doi: 10.1016/j.jor.2022.08.003. eCollection 2022 Nov-Dec.

Total knee arthroplasty improves gait adaptability in osteoarthritis patients; a pilot study

M J Booij  1 , B J van Royen  2 , P A Nolte  3 , J W R Twisk  4 , J Harlaar  5   6 , J C van den Noort  7
Affiliations

Total knee arthroplasty improves gait adaptability in osteoarthritis patients; a pilot study

M J Booij et al. J Orthop. .

Abstract

Background: Gait adaptability is of utmost importance for keeping balance during gait in patients with knee osteoarthritis, also after total knee arthroplasty (TKA). The aims of this explorative study are: (1) assess the effect of age, knee osteoarthritis and TKA on gait adaptability; (2) assess changes in gait adaptability pre-to post-TKA and (3) their relation to functional outcomes.

Methods: Gait adaptability was measured using a Target Stepping Test (TST) in knee osteoarthritis patients before (preTKA) and 12 months after TKA (postTKA) and compared to asymptomatic old (AsOld) and young adults (AsYng). TST imposed an asymmetrical gait pattern with projected stepping targets at high walking speed. Gait adaptability was determined through stepping accuracy on the targets. The Oxford Knee Score (OKS) and Timed-Up-and-Go test (TUG) measured patients' physical function.

Results: 12 preTKA, 8 postTKA, 18 AsYng, 21 AsOld were tested. Age showed no effect on TST-stepping accuracy. PreTKA showed worse TST-stepping accuracy compared to AsYng and AsOld (7.7; 6.2 cm difference). PostTKA showed an improvement of 52% in TST-stepping accuracy compared to preTKA (3.2 cm).Higher stepping accuracy preTKA predicted higher stepping accuracy post-TKA. In addition, low preTKA stepping accuracy predicted more improvement postTKA. Pre-to post-TKA improvement of stepping accuracy was related to improvement on the TUG (Beta = 0.17, p = 0.024), but not to OKS.

Conclusions: Gait adaptability is improved following TKA in knee osteoarthritis patients and no longer significantly worse than asymptomatic adults. The relation of gait adaptability to function is shown by its relation to the TUG and shows to have predictive value pre-to post-TKA.

Keywords: Aging; Motor control; Stepping stones; Total knee replacement; Walking adaptability.

PubMed Disclaimer

Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
Target Stepping Test Targets were presented up to 6 targets ahead. In this example the left foot targets imposed 20% shorter step length, and right foot targets imposed 20% longer step length.
Fig. 2
Fig. 2
Stepping accuracy per group expressed in stepping error. Higher error means a worse stepping accuracy.
Fig. 3
Fig. 3
Significant relationships between stepping accuracy (stepping error) pre- and post-TKA and with clinical function scores. Shown regression lines are not corrected for speed. The analyses were corrected for speed. Δ = difference between post- and pre-TKA score, a negative Δ is an improvement. Stepping accuracy is expressed as the stepping error, which definitions are expressed inversely.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Manlapaz D.G., Sole G., Jayakaran P., Chapple C.M. Risk factors for falls in adults with knee osteoarthritis : a systematic review. Am Acad Phys Med Rehabil. 2019;11:745–757. doi: 10.1002/pmrj.12066. - DOI - PubMed
    1. Frattura L., Filardo G., Giunchi D., Fusco A., Za S., Candrian C. Risk of falls in patients with knee osteoarthritis undergoing total knee arthroplasty: a systematic review and best evidence synthesis. J Orthop. 2018;15:903–908. doi: 10.1016/j.jor.2018.08.026. - DOI - PMC - PubMed
    1. Levinger P., Menz H.B., Bergman N.R. Physiological risk factors for falls in people with knee osteoarthritis before and early after knee replacement surgery. Knee Surg Sports Traumatol Arthrosc. 2011:1082. doi: 10.1007/s00167-010-1325-8. –9. - DOI - PubMed
    1. Tsonga T., Michalopoulou M., Kapetanakis S., et al. Risk factors for fear of falling in elderly patients with severe knee osteoarthritis before and one year after total knee arthroplasty. J Orthop Surg. 2016;24:302–306. doi: 10.1177/1602400306. - DOI - PubMed
    1. Caetano M.J.D., Menant J.C., Schoene D., Pelicioni P.H.S., Sturnieks D.L., Lord S.R. Sensorimotor and cognitive predictors of impaired gait adaptability in older people. J Gerontol Ser A Biol Sci Med Sci. 2016:glw171. doi: 10.1093/gerona/glw171. 00. - DOI - PubMed

LinkOut - more resources