Tanpure Sanket, Phadnis Ashish, Nagda Taral, Rathod Chasanal, Kothurkar Rohan, Chavan Ajay, Lekurwale Ramesh
Department of Orthopaedics, Jupiter Lifeline Hospital, Thane, India.
Department of Mechanical Engineering, K. J. Somaiya College of Engineering, Mumbai, India.
J Clin Orthop Trauma. 2024 Aug 29;55:102524. doi: 10.1016/j.jcot.2024.102524. eCollection 2024 Aug.
Osteoarthritis (OA) stands as the most prevalent disability among the elderly population. Assessing functional outcomes after Total Knee Replacement (TKR) typically involves Gait analysis along with other evaluation methods. The objective of this study was to compare Gait results, including temporospatial parameters, joint angles, gait profile score (GPS), and movement analysis profiles (MAP), between conventional and iASSIST TKR techniques.
The study involved 21 participants (mean age 68.4 ± 4.2 years), with 16 females and 5 males. Among them, 11 patients had traditional surgery (15 TKR), and 10 patients had iASSIST surgery (13 TKR), totaling 28 knees (7 bilateral). The pre-operative Gait analysis was conducted one day before the surgical procedure, whereas the postoperative Gait analysis was performed, on average, 210 ± 20 days after surgery. Gait analysis was conducted using the Qualisys Motion capture system, operating at a rate of 120 Hz. The data were thoroughly analyzed using Visual 3D C-Motion Software.
An analysis of gait biomechanics metrics, encompassing temporospatial parameters, joint angles, GPS, and MAP, was undertaken. Significant differences were observed in sagittal plane joint angles of the pelvis and hip, transverse plane joint angles of the knee, cadence, and MAP of foot internal/external rotation. However, there were no statistically significant differences between the two TKR techniques in the remaining temporospatial variables, joint angles, GPS, or MAP.
This study revealed a significant difference between iASSIST-guided TKR and conventional TKR, demonstrating that the iASSIST procedure led to improvements in walking biomechanics. Findings hold potential utility for orthopedic surgeons in their decision-making processes, ultimately contributing to the improvement of functional outcomes following TKR.
骨关节炎(OA)是老年人群中最常见的致残原因。评估全膝关节置换术(TKR)后的功能结果通常涉及步态分析以及其他评估方法。本研究的目的是比较传统TKR技术和iASSIST TKR技术之间的步态结果,包括时空参数、关节角度、步态轮廓评分(GPS)和运动分析轮廓(MAP)。
该研究纳入了21名参与者(平均年龄68.4±4.2岁),其中16名女性和5名男性。其中,11例患者接受了传统手术(15次TKR),10例患者接受了iASSIST手术(13次TKR),共计28个膝关节(7例双侧)。术前步态分析在手术前一天进行,而术后步态分析平均在术后210±20天进行。使用Qualisys运动捕捉系统进行步态分析,采样频率为120Hz。使用Visual 3D C-Motion软件对数据进行全面分析。
对包括时空参数、关节角度、GPS和MAP在内的步态生物力学指标进行了分析。在骨盆和髋关节的矢状面关节角度、膝关节的横断面关节角度、步频以及足部内/外旋转的MAP方面观察到显著差异。然而,在其余时空变量、关节角度、GPS或MAP方面,两种TKR技术之间没有统计学上的显著差异。
本研究揭示了iASSIST引导的TKR与传统TKR之间存在显著差异,表明iASSIST手术改善了步行生物力学。这些发现对骨科医生的决策过程具有潜在的实用价值,最终有助于改善TKR后的功能结果。