The Journal of Bone and Joint Surgery, Vol 69, Issue 9 1340-1345, Copyright © 1987 by Journal of Bone and Joint Surgery, Inc
Quantitative gait analysis after unilateral or bilateral total knee replacement
AT Berman, VJ Zarro, SJ Bosacco and C Israelite
Department of Orthopedic Surgery and Rehabilitation, Hahnemann University, Philadelphia, Pennsylvania 19102.
Using a gait mat, we characterized the functional results for thirty-five
patients before and after a total knee replacement for the treatment of
degenerative arthritis. Preoperatively, we studied three distinct
populations of patients. Group I consisted of sixteen patients who were
scheduled to have a unilateral total knee replacement and who had no signs
or symptoms of arthritis in the contralateral knee. Group II consisted of
twelve patients who were scheduled to have a unilateral total knee
replacement but who had asymptomatic degenerative arthritis in the
contralateral knee. Group III consisted of seven patients who had bilateral
arthritis that was to be managed by total knee replacement. The gait mat
allowed us to measure stance time, step length, double-support time, swing
time, swing-to-stance ratio, and velocity. A knee-rating scale was used to
measure pain. The data were compared with those obtained from an
age-matched control group of ninety-one subjects. Postoperatively, the gait
evaluation revealed marked improvement in all of the patients. However, the
patients in Group II did not improve as much as those in Groups I and III
did. We concluded that even asymptomatic arthritis can impair gait, that
bilateral total knee replacement can yield excellent results, and that
patients tend to use the lower limbs in as symmetrical a way as possible.
Gait analysis can be an important source of objective information, and it
is easily performed by using a gait mat.