title: Kinematic gait parameters changes in patients after total knee arthroplasty. Comparison between cruciate-retaining and posterior-substituting design.
abstract: OBJECTIVE
  The patients expect optimal knee function after Total Knee Arthroplasty. It is necessary to apply appropriate surgical technique and supervised physical therapy. The optimal management of posterior cruciate ligament remains controversial. Both implant designs, i.e., cruciate retaining and posterior substituting, allow the orthopedic surgeon to achieve excellent clinical outcomes, as measured by commonly used questionnaires. Such methods of assessment may poorly reflect the functional status of patients. Therefore, three-dimensional gait analysis is recommended to evaluate the outcomes of surgical intervention. This study sought to determine differences in kinematic gait parameters and Knee Society Score between cruciate-retaining and posterior-substituting patients.
  
  
  METHODS
  23 individuals after cruciate-retaining total knee arthroplasty and 19 individuals after posterior-substituting total knee arthroplasty were subjected to gait analysis using three-dimensional motion capture system BTS Smart DX 7000. In addition, gait was assessed in 21 patients with knee osteoarthritis and in 30 healthy individuals.
  
  
  RESULTS
  The study did not reveal differences between cruciate-retaining and posterior-substituting groups, both in terms of Knee Society Score and kinematic gait parameters. There were also no differences in kinematic gait parameters between patients from the knee osteoarthritis group and total knee arthroplasty groups. The analyzed parameters in all of the groups differed significantly from those found in healthy individuals.
  
  
  CONCLUSIONS
  Surgical technique and implant design do not affect values of kinematic gait parameters evaluated under natural walking speed. Several months after surgery the patients still demonstrated alterations in gait pattern, similar to those recorded in patients with knee osteoarthritis.
authors.affiliation: Department of Orthopaedics and Traumatology, Medical University of Silesia, Katowice, Poland.
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Hajduk
authors.affiliation: Department of Theory and Practice of Sport, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland.
authors.forename: Karina
authors.initials: K
authors.lastname: Nowak
authors.affiliation: Department of Human Motor Behavior, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland.
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Sobota
authors.affiliation: Department of Orthopaedics and Traumatology, Medical University of Silesia, Katowice, Poland.
authors.forename: Damian
authors.initials: D
authors.lastname: Kusz
authors.affiliation: Department of Orthopaedics and Traumatology, Medical University of Silesia, Katowice, Poland.
authors.forename: Konrad
authors.initials: K
authors.lastname: Kopeć
authors.affiliation: Department of Biophysics, Medical University of Silesia, Katowice, Poland.
authors.forename: Edward
authors.initials: E
authors.lastname: Błaszczak
authors.affiliation: Department of Orthopaedics and Traumatology, Medical University of Silesia, Katowice, Poland.
authors.forename: Łukasz
authors.initials: Ł
authors.lastname: Cieliński
authors.affiliation: Department of Human Motor Behavior, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland.
authors.forename: Bogdan
authors.initials: B
authors.lastname: Bacik
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee; D001696:Biomechanical Phenomena; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology; D008297:Male; D016119:Posterior Cruciate Ligament / Q000503:physiopathology*; D011474:Prosthesis Design; D016059:Range of Motion, Articular