Arthrodesis of the knee.

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Abstract

[Indexed for MEDLINE] 4. Medicina (Kaunas). 2022 May 24;58(6):696. doi: 10.3390/medicina58060696. Knee Arthrodesis Affects Gait Kinematics More in the Ankle Than in the Hip Joint. Wagener N(1)(2), Böhle S(2), Kirschberg J(2), Rohe S(2), Heinecke M(2), Di Fazio P(3), Matziolis G(2), Röhner E(2)(4). Author information: (1)Department of Trauma Surgery, Orthopedics and Plastic Surgery, University Medical Center Goettingen, Robert-Koch-Str. 40, 37099 Göttingen, Germany. (2)Orthopaedic Professorship of the University Hospital Jena, Orthopaedic Department Waldkliniken Eisenberg, 07607 Eisenberg, Germany. (3)Department of Visceral Thoracic and Vascular Surgery, Philipps University Marburg, Baldingerstraße, 35043 Marburg, Germany. (4)Klinik für Orthopädie, Heinrich-Braun-Klinikum Zwickau, Karl-Keil-Straße 35, 08060 Zwickau, Germany. Background and Objectives: No gold standard exists for treating persistent periprosthetic knee infections. Knee arthrodesis represents one treatment concept for extensive bone defects and extensor system insufficiencies. It has already been shown that knee arthrodesis leads to a significant reduction in one's quality of life. The aim of this survey was to assess the influence of knee arthrodesis on the neighboring joints on the basis of gait analysis data. Our hypothesis is that the hip and ankle joints are negatively influenced by knee arthrodesis in the process of walking. Materials and methods: We performed six pedobarographic and four gait analytical measurements in six patients 2.4 ± 1.6 years after receiving knee arthrodesis at the operating ages of 69.1 ± 9.2 years. Gait analysis consisted of time-distance parameters/minute (number of steps, double support, cycle time, standing phase, step length, gait speed). A healthy group of test subjects (n = 52) was included as the control cohort. Gait analysis was conducted using a three-dimensional movement system and three force-measuring platforms to determine the ground reaction force. Foot pressure was measured using a pedography platform. Results: Five of six patients presented an incomplete rolling movement over the toes on the side that was operated on, presenting with a gait line ending in the forefoot area. All of the patients bore less weight on the side that was operated on. Three of six patients demonstrated a pathological gait line with a healthy opposite side ending in the forefoot area. All of the patients exhibited a reduction in gait speed and step length and a lower number of steps. All of the patients had a prolonged double support/cycle time. Conclusions: Isolated knee arthrodesis is associated with reduced forefoot repulsion, restricted movement on the side receiving the operation, and reduced movement in the ankle/knee joint. The hip showed norm deviations in the hip moment/angle. Knee arthrodesis causes reduced gait kinetics/kinematics. Our survey shows that the relative joint moments of the ankle joint and hip are often reduced. The ankle joint is more affected compared to the hip. DOI: 10.3390/medicina58060696 PMCID: PMC9230178