Contralateral and ipsilateral cane usage by patients with total knee or hip replacement.

Four men were studied to determine the effect of ipsilateral (IP) and contralateral (C) cane use on gait. One subject had had total hip replacement, two had had total knee replacements and one was preoperative for total knee replacement. Force transducers were installed in an adjustable aluminum cane to measure the axial forces exerted during free speed walking. A portable force shoe system, which measured each step of the affected extremity, was used to record fore, aft, medial, lateral, and vertical floor reaction forces. Foot-floor placement data (affected extremity) were obtained from photo-cells, a conductive walkway, and metal tape on the bottom of the subjects' shoes that triggered a computerized system. Motion pictures (16mm, 50 frames/s) were taken in the sagittal plane to record cadence, stride length, velocity, and joint motion of the affected limb as well as cane angles. With C cane use, three subjects had greater mean stride length; cadence was greater in all subjects; and the combined effect of stride length and cadence was faster mean velocity. Mean knee joint motion of the affected extremity was greater with IP cane use in all subjects. Conversely, mean hip joint motion was less with IP cane use. Mean peak vertical floor reaction forces were greater with IP cane use. Temporal and kinetic components of fore and aft forces had the greatest interaction between cane and extremity forces. Increased IP fore cane forces correlated with reduced fore extremity forces in the subject with THR and in two with TKR.(ABSTRACT TRUNCATED AT 250 WORDS)