Evaluation of gait performance of knee osteoarthritis patients after total knee arthroplasty with different assistive devices

Abstract

Introduction: Nowadays Knee Osteoarthritis (KOA) affects a large percentage of the elderly, and one solution is to perform a Total Knee Arthroplasty (TKA). In this paper, one intends to study the gait and posture of these patients after the TKA, while walking with three assistive devices (ADs) (crutches, standard walker (SW) and rollator with forearm supports (RFS)). Methods: Eleven patients were evaluated in 2 phases: 5 days and 15 days after surgery. This evaluation was conducted with two inertial sensors, one attached to the operated leg ankle, to measure spatiotemporal parameters, and the other at the sacrum, to measure posture and fall risk-related parameters. Multivariate analysis of variance (MANOVA) with repeated measures was performed to detect group differences. Results: The MANOVA results show that all spatiotemporal parameters are significantly different (p < 0.05) between the two phases of study. So, time has a significant influence on such parameters. In relation to the ADs, one observes that there are statistical significant effects on all spatiotemporal parameters, except for swing duration and step length (p > 0.05). The interaction between time and ADs only affects significantly the velocity (p < 0.05). In terms of fall risk parameters, time only significantly affects the antero-posterior direction (p < 0.05) and ADs affects significantly root mean square in medio-lateral direction (p < 0.05). In terms of interaction between time and ADs, there are no statistical significant differences. Conclusion: This study concludes that depending on the state of recovery of the patient, different ADs should be prescribed. On the overall, standard walker is good to give stability to the patient and RFS allows the patient to present a gait pattern closer to a natural gait.