Highlights
- •Higher differences were found in stance phase for coordination and knee motion
- •Frequency of in-phase coordination was lower in patient groups compared to controls
- •Knee range of motion was greater after arthroplasty, but lower than controls
- •During swing phase, variability was higher after surgery compared to controls
- •Knee osteoarthritis affects the coordination with limited improvement after surgery
Abstract
Background
Total knee arthroplasty is the most common treatment for severe knee osteoarthritis.
Coordination and variability analyses are effective measures of the injury stage or
rehabilitation process. This study compared the inter-joint coordination before and
after arthroplasty, compared to controls.
Methods
Twenty-seven patients were evaluated before and 12 months after surgery, compared
to 27 controls. Coordination and variability in the sagittal plane between the hip-knee
and knee-ankle were calculated using vector coding and circular statistics. Coordination
was categorized as in-phase, anti-phase, or distal or proximal joint-phase. The gait
cycle was divided into sub-phases for the coordination, variability, and range of
motion results.
Findings
Coordination and range of motion differed significantly between the patient groups
and controls, while small differences between pre- and post-operative groups were
also detected. The hip-knee showed a reduced in-phase frequency in the patient group
compared to control during stance, particularly mid-stance: pre-operative 24.3% ± 33.9,
post-operative 29.5 ± 29.7, and controls 70.7 ± 17.0. This difference was compensated
for by increasing proximal-phase (hip) frequency in the patient groups. For knee-ankle
coordination, the patient groups showed higher distal-phase (ankle) frequency during
the early and mid-stance. Coordination variability was higher post-operatively during
swing and terminal swing phases, compared to controls.
Interpretation
The results indicated reduced degrees of freedom for the knee during stance phase
with a reduced capacity to move the knee and hip in opposing directions before and
one year after surgery. The patient group after the surgery increased knee range of
motion and coordination compared to pre-operative during swing phase.
Keywords
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Article info
Publication history
Published online: October 20, 2022
Accepted:
October 17,
2022
Received:
May 20,
2022
Identification
Copyright
© 2022 Elsevier Ltd. All rights reserved.
