Portable Gait Analysis of Patients With Rotating Hinge Knee Megaprosthesis Compared With Total Knee Arthroplasty

ABSTRACT Objective The gait analysis of patients after surgery for tumors around the knee joint relies on the use of a three‐dimensional motion capture system. However, obtaining long‐term, free‐standing, real‐world gait data with three‐dimensional gait analysis is challenging. In this study, we uti...

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Main Authors: Ming‐Yong Gu, Jing‐Yu Zhang, Meng‐Yu Chen, Wei Wang, Ji‐Bin Ma, Xuefei Fu, Yan‐Cheng Liu, Jun Miao
Format: Article
Language:English
Published: Wiley 2024-12-01
Series:Orthopaedic Surgery
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Online Access:https://doi.org/10.1111/os.14270
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author Ming‐Yong Gu
Jing‐Yu Zhang
Meng‐Yu Chen
Wei Wang
Ji‐Bin Ma
Xuefei Fu
Yan‐Cheng Liu
Jun Miao
author_facet Ming‐Yong Gu
Jing‐Yu Zhang
Meng‐Yu Chen
Wei Wang
Ji‐Bin Ma
Xuefei Fu
Yan‐Cheng Liu
Jun Miao
author_sort Ming‐Yong Gu
collection DOAJ
description ABSTRACT Objective The gait analysis of patients after surgery for tumors around the knee joint relies on the use of a three‐dimensional motion capture system. However, obtaining long‐term, free‐standing, real‐world gait data with three‐dimensional gait analysis is challenging. In this study, we utilized a portable gait analyzer to collect gait data from patients who underwent rotating hinge knee megaprosthesis (RHK) and total knee arthroplasty (TKA), this study aims to compare via gait analysis patients who underwent megaprosthesis with patients with TKA. Methods A retrospective study was conducted on eight patients with knee bone tumors (RHK group) and ten patients with knee osteoarthritis who underwent standard TKA (TKA group) from January 2018 to January 2022. Gait analysis, was conducted using the Intelligent Device for Energy Expenditure and Activity (IDEEA), and the results were compared with those of a healthy control group. The lower limb alignment of the RHK and TKA groups was evaluated, and the KSS scores of the two groups were collected and compared. Energy consumption during a 20‐m walk was measured and compared among the RHK, TKA, and healthy control groups using one‐way ANOVA. Paired t‐tests were used to compare the operated and nonoperated limbs within groups. Results All patients exhibited slower walking speeds and cadence than the healthy control participants (p < 0.01), While no significant differences were found between the RHK and TKA groups. The single support time (521.15 ± 94.56 ms) of the RHK‐operated limb was significantly shorter than that of the nonoperated limb (576.53 ± 77.40 ms, p = 0.004). The pulling acceleration of the RHK group (0.71 ± 0.27 G) was lower than that of the TKA group (1.04 ± 0.31 G, p = 0.029). The push‐off angle in the RHK group (24.91° ± 10.91°) was significantly greater than that in the TKA group (10.64° ± 5.41°, p = 0.007). The RHK group showed significant differences between the operated and nonoperated limbs in terms of swing power, ground impact, footfall, and push‐off. The RHK (0.03 ± 0.01 kcal/min/kg) and TKA (0.029 ± 0.01 kcal/min/kg) groups had significantly greater energy expenditures than did the healthy control group (0.02 ± 0.00 kcal/min/kg, p < 0.05). The comparison of HKA angles and KSS scores between the TKA and RHK groups showed statistically significant differences. Conclusion A portable gait analyzer appears to be suitable for evaluating the effects of RHK. RHK patients demonstrate more pronounced gait abnormalities than TKA patients, reflected in greater energy expenditure, implying reduced walking efficiency. This suggests the need for increased energy expenditure in RHK patients to compensate for abnormal knee joint conditions during walking and maintain body balance.
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spelling doaj-art-e72196708f4d4eb7a3cf86aabe10036e2025-08-20T02:08:27ZengWileyOrthopaedic Surgery1757-78531757-78612024-12-0116123141315010.1111/os.14270Portable Gait Analysis of Patients With Rotating Hinge Knee Megaprosthesis Compared With Total Knee ArthroplastyMing‐Yong Gu0Jing‐Yu Zhang1Meng‐Yu Chen2Wei Wang3Ji‐Bin Ma4Xuefei Fu5Yan‐Cheng Liu6Jun Miao7Clinical School/Colledge of Orthopedics Tianjin Medical University Tianjin ChinaDepartment of Bone and Soft Tissue Oncology Tianjin Hospital Tianjin ChinaDepartment of Bone and Joint Surgery Beijing Luhe Hospital, Capital Medical University Beijing ChinaDepartment of Bone and Soft Tissue Oncology Tianjin Hospital Tianjin ChinaDepartment of Orthopedics The Second People's Hospital of Changzhi Changzhi ChinaDepartment of Orthopedics Anhui No. 2 Provincial People's Hospital Hefei ChinaDepartment of Bone and Soft Tissue Oncology Tianjin Hospital Tianjin ChinaDepartment of Bone and Soft Tissue Oncology Tianjin Hospital Tianjin ChinaABSTRACT Objective The gait analysis of patients after surgery for tumors around the knee joint relies on the use of a three‐dimensional motion capture system. However, obtaining long‐term, free‐standing, real‐world gait data with three‐dimensional gait analysis is challenging. In this study, we utilized a portable gait analyzer to collect gait data from patients who underwent rotating hinge knee megaprosthesis (RHK) and total knee arthroplasty (TKA), this study aims to compare via gait analysis patients who underwent megaprosthesis with patients with TKA. Methods A retrospective study was conducted on eight patients with knee bone tumors (RHK group) and ten patients with knee osteoarthritis who underwent standard TKA (TKA group) from January 2018 to January 2022. Gait analysis, was conducted using the Intelligent Device for Energy Expenditure and Activity (IDEEA), and the results were compared with those of a healthy control group. The lower limb alignment of the RHK and TKA groups was evaluated, and the KSS scores of the two groups were collected and compared. Energy consumption during a 20‐m walk was measured and compared among the RHK, TKA, and healthy control groups using one‐way ANOVA. Paired t‐tests were used to compare the operated and nonoperated limbs within groups. Results All patients exhibited slower walking speeds and cadence than the healthy control participants (p < 0.01), While no significant differences were found between the RHK and TKA groups. The single support time (521.15 ± 94.56 ms) of the RHK‐operated limb was significantly shorter than that of the nonoperated limb (576.53 ± 77.40 ms, p = 0.004). The pulling acceleration of the RHK group (0.71 ± 0.27 G) was lower than that of the TKA group (1.04 ± 0.31 G, p = 0.029). The push‐off angle in the RHK group (24.91° ± 10.91°) was significantly greater than that in the TKA group (10.64° ± 5.41°, p = 0.007). The RHK group showed significant differences between the operated and nonoperated limbs in terms of swing power, ground impact, footfall, and push‐off. The RHK (0.03 ± 0.01 kcal/min/kg) and TKA (0.029 ± 0.01 kcal/min/kg) groups had significantly greater energy expenditures than did the healthy control group (0.02 ± 0.00 kcal/min/kg, p < 0.05). The comparison of HKA angles and KSS scores between the TKA and RHK groups showed statistically significant differences. Conclusion A portable gait analyzer appears to be suitable for evaluating the effects of RHK. RHK patients demonstrate more pronounced gait abnormalities than TKA patients, reflected in greater energy expenditure, implying reduced walking efficiency. This suggests the need for increased energy expenditure in RHK patients to compensate for abnormal knee joint conditions during walking and maintain body balance.https://doi.org/10.1111/os.14270gait analysismegaprosthesisportable gait analyzerTKA
spellingShingle Ming‐Yong Gu
Jing‐Yu Zhang
Meng‐Yu Chen
Wei Wang
Ji‐Bin Ma
Xuefei Fu
Yan‐Cheng Liu
Jun Miao
Portable Gait Analysis of Patients With Rotating Hinge Knee Megaprosthesis Compared With Total Knee Arthroplasty
Orthopaedic Surgery
gait analysis
megaprosthesis
portable gait analyzer
TKA
title Portable Gait Analysis of Patients With Rotating Hinge Knee Megaprosthesis Compared With Total Knee Arthroplasty
title_full Portable Gait Analysis of Patients With Rotating Hinge Knee Megaprosthesis Compared With Total Knee Arthroplasty
title_fullStr Portable Gait Analysis of Patients With Rotating Hinge Knee Megaprosthesis Compared With Total Knee Arthroplasty
title_full_unstemmed Portable Gait Analysis of Patients With Rotating Hinge Knee Megaprosthesis Compared With Total Knee Arthroplasty
title_short Portable Gait Analysis of Patients With Rotating Hinge Knee Megaprosthesis Compared With Total Knee Arthroplasty
title_sort portable gait analysis of patients with rotating hinge knee megaprosthesis compared with total knee arthroplasty
topic gait analysis
megaprosthesis
portable gait analyzer
TKA
url https://doi.org/10.1111/os.14270
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