Neuromuscular Research Laboratory, Schulthess Clinic, Zurich, Switzerland.
BMC Musculoskelet Disord. 2013 Jun 3;14:176. doi: 10.1186/1471-2474-14-176.
The 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.
A 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.
TAA 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).
Gait 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.
下肢关节全关节置换术后患者的主要目标之一是恢复步态能力。本研究旨在客观比较单侧全髋关节置换术（THA）、全膝关节置换术（TKA）和全踝关节置换术（TAA）患者与健康对照组之间的步态差异。
共评估了 26 例 TAA、26 例 TKA 和 26 例 THA 患者，平均年龄（±标准差）为 64（±9）岁，术后 6 个月进行评估，并与 26 例匹配的健康对照组进行比较。要求患者在经过验证的压力垫上以自我选择的正常和快速速度行走。测量以下时空步态参数：行走速度、步频、单腿支撑（SLS）时间、双腿支撑（DLS）时间、站立时间、步长和步宽。
TAA 和 TKA 患者在正常（p<0.05）和快速（p<0.01）速度下行走速度均慢于对照组。TAA 和 TKA 患者的患侧 SLS 在正常和快速速度下均短于对照组（p<0.01）。无论行走速度如何，TAA 和 TKA 患者的非患侧站立时间较长，步长较短于对照组（p<0.01）。TAA 患者在正常和快速速度下，患侧 SLS 较短，非患侧站立时间和步长较短，与对侧相比（p<0.001）。
术后 6 个月，单侧下肢关节置换术后的步态障碍在远端关节比近端关节更为明显，从近端到远端逐渐加重（TAA>TKA>THA）。THA 患者与对照组相比无步态差异。相比之下，TAA 和 TKA 患者与对照组相比仍存在步态差异，行走速度较慢，受累侧 SLS 降低。此外，TAA 患者的步态特征存在明显的侧间不对称。
