scholarly journals Comparison of the Kinematics Following Gait Perturbation in Individuals Who Did or Did Not Undergo Total Knee Replacement

2021 ◽  
Vol 11 (16) ◽  
pp. 7453
Author(s):  
Vicktoria Elkarif ◽  
Leonid Kandel ◽  
Debbie Rand ◽  
Isabella Schwartz ◽  
Alexander Greenberg ◽  
...  
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Plantar Flexion ◽  
Joint Kinematics ◽  
Gait Velocity ◽  
Timed Up And Go ◽  
Flexion Extension ◽  
Risk Of Falls ◽  
Total Knee ◽  
One Year

We aimed to compare the spatiotemporal parameters and joint kinematics during unperturbed and perturbed gait between individuals with osteoarthritis (OA) who did or did not undergo total knee replacement (TKR) one year post a baseline evaluation. OA subjects scheduled for TKR (TKR group; n = 14) and not scheduled for TKR (NTKR group; n = 17) were age-matched. Outcome measures included: joint range of motion, timed up and go, joint pain levels, Oxford score, and the Activities-specific Balance Confidence Scale. In addition, spatiotemporal gait parameters and joint kinematics were recorded during perturbed and unperturbed gait. After one year, most of the TKR group (71%), but only 41% of the NTKR group, increased their gait velocity by more than 0.1m/sec, which is the meaningful clinical important difference for gait velocity. After perturbation of the contralateral limb, the TKR group showed a greater decrease in the maximal extension of the OA hip compared to the NTKR group (p = 0.031). After perturbation of the OA limb, more subjects decreased their OA knee flexion–extension range in the NTKR group compared to the TKR group (p = 0.011) and more subjects decreased their maximal ankle plantar flexion in the TKR group (p = 0.049). Although the surgery was successful in terms of pain reduction and increased functionality, individuals following TKR exhibited unique compensatory strategies in response to the perturbation of both limbs. These findings might suggest that balance deficits remain in individuals following TKR and therefore are associated with a risk of falls.

Total Knee Replacement Polyethylene Stresses During Loading in a Knee Simulator

2000 ◽  
Vol 123 (4) ◽  
pp. 842-847 ◽  
Author(s):  
Virginia L. Giddings ◽  
Steven M. Kurtz ◽  
Avram A. Edidin
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Tibial Component ◽  
Joint Kinematics ◽  
Knee Simulator ◽  
Flexion Extension ◽  
Total Knee ◽  
Von Mises ◽  
Anterior Posterior ◽  
Bumper System

We investigated the stresses and kinematics of a total knee replacement during the duty cycle of a knee simulator. Finite element models were constructed of the tibial and the femoral component of a commercially available cruciate retaining total knee replacement. Time dependent flexion/extension, axial loading, and anterior/posterior loading were applied to the components of the arthroplasty to match those generated by the knee simulator. We evaluated the effect of varying the stiffness of a spring-loaded bumper system for anterior-posterior constraint on the joint kinematics as well as on the stresses within the polyethylene tibial component. Both the joint kinematics and the stresses and strains subjected to the polyethylene tibial component, were found to be comparatively insensitive to the stiffness of the spring bumper system for this design. When the stiffness of the bumper system was increased by two orders of magnitude, the maximum contact stresses, von Mises stresses, and von Mises strains in the polyethylene tibial component varied by only 15 to 59 percent. In general, increasing the stiffness of the bumper system decreased the displacements of the base plate, but the relationships were nonlinear, possibly due to the added constraints imposed by the tibiofemoral contact interaction. The long-term goal of this research is to develop a validated structural model to predict the stresses, kinematics, and ultimately, the wear, of total joint replacement components in a contemporary knee joint simulator.

A Performance Test to Assess Strategies to Transfer Weight During Knee Flexion and Extension With Rotation for Individuals With a Total Knee Replacement

2012 ◽  
Author(s):  
Lauren Ferris ◽  
Linda Denney ◽  
Lorin Maletsky
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Performance Test ◽  
Knee Stability ◽  
Vertical Projection ◽  
Single Plane ◽  
Flexion Extension ◽  
Weight Shift ◽  
Total Knee ◽  
Supporting Base

Stability has been defined as the ability to transfer the vertical projection of the center of gravity to the supporting base and keep the knee as still as possible1. The transfer of weight (load) to a single limb while still in double-stance is functional and simulates every day activities such as loading the dishwasher, transferring laundry, or reaching to pick up an item. Adding rotation in a transverse plane to this weight shift challenges knee stability, especially those with a total knee replacement (TKR). A clinical sign of laxity in mid-flexion indicates a risk for developing symptomatic instability; a common reason for TKR revision2. Laxity is usually measured clinically in a single plane (anterior-posterior) and functionally with added turning maneuvers. Single-leg weight acceptance has been analyzed during athletic activities such as hopping, landing with cutting as well as in the older population with stair ascent and descent3–5. Although single-leg performance tests are a good indicator of knee stability, weight shift during double-stance may be more functional for individuals with a TKR. A functional double-stance test should include both flexion/extension with rotation and loading. Our study utilizes a novel approach (Target Touch Task) in order to facilitate transfer of load to one extremity during squatting or extending while still in double-stance. The objective of this study was to identify strategies utilized by individuals with a TKR while in double-stance transferring load during rotational activities.

scholarly journals Knee Flexion and Daily Activities in Patients following Total Knee Replacement: A Comparison with ISO Standard 14243

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Markus A. Wimmer ◽  
William Nechtow ◽  
Thorsten Schwenke ◽  
Kirsten C. Moisio
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Knee Flexion ◽  
Daily Activities ◽  
Wear Testing ◽  
Significant Difference ◽  
Flexion Extension ◽  
Total Knee ◽  
Stair Walking ◽  
The Many

Walking is only one of many daily activities performed by patients following total knee replacement (TKR). The purpose of this study was to examine the hypotheses (a) that subject activity characteristics are correlated with knee flexion range of motion (ROM) and (b) that there is a significant difference between the subject’s flexion/extension excursion throughout the day and the ISO specified input for knee wear testing. In order to characterize activity, the number of walking and stair stepping cycles, the time spent with dynamic and stationary activities, the number of activity sequences, and the knee flexion/extension excursion of 32 TKR subjects were collected during daily activity. Flexion/extension profiles were compared with the ISO 14243 simulator input profile using a level crossing classification algorithm. Subjects took an average of 3102 (range: 343–5857) walking cycles including 65 (range: 0–319) stair stepping cycles. Active and passive ROMs were positively correlated with stair walking time, stair step counts, and stair walking sequences. Simulated knee motion according to ISO showed significantly fewer level crossings at the flexion angles 20–40° and beyond 50° than those measured with the monitor. This suggests that implant wear testing protocols should contain more cycles and a variety of activities requiring higher knee flexion angles with incorporated resting/transition periods to account for the many activity sequences.

Evaluation of the relationship of tibiofemoral kinematics before and after total knee replacement in an in vitro model of cranial cruciate deficiency in the dog

2016 ◽  
Vol 29 (06) ◽  
pp. 484-490 ◽  
Author(s):  
Rebecca Howie ◽  
Timothy Foutz ◽  
Curtis Cathcart ◽  
Jeff Burmeister ◽  
Steve Budsberg
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
External Rotation ◽  
Cruciate Ligament ◽  
Flexion Extension ◽  
Before And After ◽  
Total Knee ◽  
Tibiofemoral Kinematics ◽  
The Relationship

SummaryObjective: To investigate the relationship between tibiofemoral kinematics before and after total knee replacement (TKR) in vitro.Animals: Eight canine hemipelves.Methods: A modified Oxford Knee Rig was used to place cadaveric limbs through a range of passive motion allowing the kinematics of the stifle to be evaluated. Four measurements were performed: a control stage, followed by a cranial cruciate transection stage, then following TKR with the musculature intact stage, and finally TKR with removal of limb musculature stage. Joint angles and translations of the femur relative to the tibia, including flexion-extension versus adduction-abduction, flexion-extension versus internal-external rotation, as well as flexion-extension versus each translation (cranial-caudal and lateral-medial) were calculated.Results: Significant differences were identified in kinematic data from limbs following TKR implantation as compared to the unaltered stifle. The TKR resulted in significant decreases in external rotation of the stifle during flexion-extension compared to the limb prior to any intervention, as well as increasing the abduction. The TKR significantly increased the caudal translation of the femur relative to the tibia compared to the unaltered limb. When compared with the cranial cruciate ligament-transection stage, TKR significantly decreased the ratio of the external rotation to flexion.Discussion: All three test periods showed significant differences from the unaltered stifle. The TKR did not completely restore the normal kinematics of the stifle.

scholarly journals High-Flexion Total Knee Replacement: Functional Outcome at One Year

2010 ◽  
Vol 6 (2) ◽  
pp. 138-144 ◽  
Author(s):  
Matthew S. Hepinstall ◽  
Amar S. Ranawat ◽  
Chitranjan S. Ranawat
Keyword(s):  
Total Knee Replacement ◽  
Functional Outcome ◽  
Knee Replacement ◽  
High Flexion ◽  
Total Knee ◽  
One Year

EFFECTS OF EARLY REHABILITATION PROTOCOL POST HIGH FLEX CRUCIATE RETAINING TOTAL KNEE REPLACEMENT ON RANGE OF MOTION, PAIN AND FUNCTION: A PROSPECTIVE STUDY

2017 ◽  
Vol 20 (03) ◽  
pp. 1750017
Author(s):  
Karvannan Harikesavan ◽  
Raj Dev Chakravarty ◽  
Arun G. Maiya
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Rating Scale ◽  
Quadriceps Strength ◽  
Early Rehabilitation ◽  
Timed Up And Go ◽  
Cruciate Retaining ◽  
Post Surgery ◽  
Total Knee ◽  
And Function

Purpose: The purpose of the study was to find the effects of early rehabilitation on high flex cruciate retaining total knee replacement (TKR) on pain and function. Methods: We designed a prospective pre-post trial and evaluated 34 participants who underwent unilateral TKR following end stage knee osteoarthritis. Outcome measure of numeric pain rating scale (NPRS), knee ROM, quadriceps strength and functional measure of timed up and go test (TUG) and six-minute walk test (SMWT) was assessed before and three months post surgery by a blinded observer. Results: The knee flexion ROM showed significant improvement of 25.1∘[Formula: see text]±[Formula: see text]11.2∘ at 3-months. The NPRS, TUG and SMWT showed significant change of 6.47[Formula: see text]±[Formula: see text]0.92, 21.7[Formula: see text]±[Formula: see text]2.6, 157.7[Formula: see text]±[Formula: see text]31 from baseline to 1.3[Formula: see text]±[Formula: see text]0.8, 17.5[Formula: see text]±[Formula: see text]1.6, 263[Formula: see text]±[Formula: see text]37.9 at 3 months respectively following TKR (p = 0.001). Conclusion: Early rehabilitation showed improvement in knee ROM, pain reduction, and accelerated recovery in performing TUG and SMWT.

Knee flexion one year after total knee replacement, what improves (and what does not)?

2006 ◽  
Vol 24 ◽  
pp. S170-S171 ◽  
Author(s):  
Marietta van der Linden ◽  
Philip Rowe ◽  
Paul Gaston ◽  
Fraser Wade ◽  
Richard Nutton
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Knee Flexion ◽  
Total Knee ◽  
One Year

Efficacy of Rehabilitation After Total Knee Replacement in Gonarthrosis

2004 ◽  
Vol 11 (2) ◽  
pp. 27-31
Author(s):  
V G Golubev ◽  
N G Goncharov ◽  
D V Rimashevskiy ◽  
T K Khutyz ◽  
S V Pirozhenko ◽  
...  
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Course Completion ◽  
Rehabilitation Program ◽  
Outpatient Rehabilitation ◽  
Final Examination ◽  
Orthopaedic Department ◽  
Significant Difference ◽  
Total Knee ◽  
One Year

The evaluation of the efficacy of rehabilitation program in patients with unilateral gonarthrosis after total knee replacement was performed at the orthopaedic department, Central Clinical Hospital of the Russian Academy of Science. The study included 44 patients who underwent primary total knee replacement with cement implants Osteonics 7000, USA, during the period from 1996 to 2000. After discharge all patients were recommended to take an outpatient rehabilitation course. Due to various reasons 26 patients refused and 18 patients completed the rehabilitation program. The results were assessed after the rehabilitation course completion (3 months after surgery), one year after surgery and at final examination ( 45,2 months average), In the post-rehabilitation group of patients statistically trustworthy improvement of knee joint function and strength of extensors were noted directly after completion of the rehabilitation program and 1 year after surgical intervention. Final examination did not show significant difference between the two groups.

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