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DOS Kongressen 2016 ·
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Gait Function Before and After Total Knee
Arthroplasty A Randomized Study of Fixed Bearing
versus Mobile Bearing Articulation
Michael Tjørnild, Uwe Kersting, Kjeld Søballe, Poul Mogensen, Maiken Stilling
Ortopædkirurgisk Afdeling E, Aarhus Universitetshospital; Center for Sensory-
Motor Interaction, Aalborg University; Ortopædkirurgisk afdeling E, Aarhus
Universitetshospital; Neurologisk afdeling, Aalborg Universitetshospital;
Ortopædkirurgisk afdeling, Regionshospitalet Holstebro, Hospitalsenheden Vest
Background:
Total knee arthroplasty (TKA) is the standard treatment at the
terminal stadium of knee arthritis. Good results are achieved based on assess-
ment of pain relief, misalignment correction and improved function.
Purpose / Aim of Study:
The purpose of this study was to compare two TKA
articulation designs frequently used in the Nordic countries (P.F.C. Sigma fixed
bearing (FB) and mobile bearing (MB) design) in an RCT investigating new as-
pects of gait function and restored function following TKA. The focus points
were 1) to compare the FB to MB patients regarding level walking and surface
electromyography (EMG) pre-operatively, at 6, and 12 months post-surgical
follow-up; and 2) to compare the patients’ level walking to a healthy and BMI,
gender and age-matched group. Finally we aimed at complementing the objec-
tive gait analysis with 3) patient reported outcome measurements.
Materials andMethods:
In a prospective, randomized clinical trial we compared
51 osteoarthritis patients operated either with a FB or a MB TKA. Assessments
were made using three-dimensional gait analysis, EMG and knee-scores prior to
surgery, and at 6 and 12- months follow-up. A reference data set of body mass
index, gender and age-matched controls was included in this study.
Findings / Results:
Both intervention groups increased their walking speed
at 12-months follow-up and decreased asymmetry in single support times.
Regarding kinematics and kinetics both intervention groups reached the con-
trol group conficence interval. EMG results indicate less co-contraction after 12
months in both groups and knee scores improved with both articulation designs
(p<0.01).
Conclusions:
Both articulation designs demonstrated improved knee scores
and favourable changes towards a more normal gait pattern, but neither of the
two significantly outperformed the other.
No conflicts of interest reported
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