Pain, balance, and mobility in people 1 year after total knee arthroplasty: a non-randomized cross-sectional pilot study contrasting posterior-stabilized and medial-pivot designs
Abstract Background Total knee arthroplasty (TKA) is a common treatment for severe knee osteoarthritis. Medial-pivot TKA systems (MP-TKA) are theoretically better than posterior-stabilized TKA systems (PS-TKA) in improving static and dynamic balance of patients although it is difficult to objectivel...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-06-01
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| Series: | Pilot and Feasibility Studies |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40814-022-01094-0 |
| _version_ | 1818488531900694528 |
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| author | Cathy W. T. Lo Matthew A. Brodie William W. N. Tsang Stephen R. Lord Chun-Hoi Yan Arnold Y. L. Wong |
| author_facet | Cathy W. T. Lo Matthew A. Brodie William W. N. Tsang Stephen R. Lord Chun-Hoi Yan Arnold Y. L. Wong |
| author_sort | Cathy W. T. Lo |
| collection | DOAJ |
| description | Abstract Background Total knee arthroplasty (TKA) is a common treatment for severe knee osteoarthritis. Medial-pivot TKA systems (MP-TKA) are theoretically better than posterior-stabilized TKA systems (PS-TKA) in improving static and dynamic balance of patients although it is difficult to objectively quantify these balance parameters in a clinical setting. Therefore, this pilot study aimed to evaluate the feasibility of using wearable devices in a clinical setting to examine whether people with MP-TKA have better postoperative outcomes than PS-TKA, and their balance control is more akin to age-matched asymptomatic controls. Methods The current cross-sectional pilot study recruited 57 participants with 2 different prosthesis designs (20 PS-TKA, 18 MP-TKA) and 19 asymptomatic controls. At 1-year post-TKA, pain, knee stiffness, and physical function were assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Static balance, mobility, and gait stability of the participants were evaluated based on data collected from wearable motion sensors during the near tandem stance, timed-up-and-go, and 6-min walk tests. Results Compared to asymptomatic controls, both TKA groups reported significantly more pain and stiffness and demonstrated reduced functional mobility, increased stride-time-variability, and impaired balance. After Bonferroni adjustment, no significant differences in pain, balance, and mobility performance were observed between PS-TKA and MP-TKA participants 1 year after surgery. However, there was a trend for increased anteroposterior sway of the lumbar and head regions in the MP-TKA participants when undertaking the near tandem stance test. The wearable motion sensors were easy to use without any adverse effects. Conclusions It is feasible to use wearable motion sensors in a clinical setting to compare balance and mobility performance of patients with different TKA prothesis designs. Since this was a pilot study and no definite conclusions could be drawn, future clinical trials should determine the impacts of different TKA prosthesis designs on post-operative outcomes over a longer follow-up period. |
| first_indexed | 2024-12-10T16:52:15Z |
| format | Article |
| id | doaj.art-54eb186e1fe34dbab97ccf46ddaaf540 |
| institution | Directory Open Access Journal |
| issn | 2055-5784 |
| language | English |
| last_indexed | 2024-12-10T16:52:15Z |
| publishDate | 2022-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Pilot and Feasibility Studies |
| spelling | doaj.art-54eb186e1fe34dbab97ccf46ddaaf5402022-12-22T01:40:52ZengBMCPilot and Feasibility Studies2055-57842022-06-018111310.1186/s40814-022-01094-0Pain, balance, and mobility in people 1 year after total knee arthroplasty: a non-randomized cross-sectional pilot study contrasting posterior-stabilized and medial-pivot designsCathy W. T. Lo0Matthew A. Brodie1William W. N. Tsang2Stephen R. Lord3Chun-Hoi Yan4Arnold Y. L. Wong5Department of Rehabilitation Sciences, The Hong Kong Polytechnic UniversityNeuroscience Research Australia, University of New South WalesDepartment of Physiotherapy, School of Nursing and Health Studies, Hong Kong Metropolitan UniversityNeuroscience Research Australia, University of New South WalesDepartment of Orthopaedics and Traumatology, The University of Hong KongDepartment of Rehabilitation Sciences, The Hong Kong Polytechnic UniversityAbstract Background Total knee arthroplasty (TKA) is a common treatment for severe knee osteoarthritis. Medial-pivot TKA systems (MP-TKA) are theoretically better than posterior-stabilized TKA systems (PS-TKA) in improving static and dynamic balance of patients although it is difficult to objectively quantify these balance parameters in a clinical setting. Therefore, this pilot study aimed to evaluate the feasibility of using wearable devices in a clinical setting to examine whether people with MP-TKA have better postoperative outcomes than PS-TKA, and their balance control is more akin to age-matched asymptomatic controls. Methods The current cross-sectional pilot study recruited 57 participants with 2 different prosthesis designs (20 PS-TKA, 18 MP-TKA) and 19 asymptomatic controls. At 1-year post-TKA, pain, knee stiffness, and physical function were assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Static balance, mobility, and gait stability of the participants were evaluated based on data collected from wearable motion sensors during the near tandem stance, timed-up-and-go, and 6-min walk tests. Results Compared to asymptomatic controls, both TKA groups reported significantly more pain and stiffness and demonstrated reduced functional mobility, increased stride-time-variability, and impaired balance. After Bonferroni adjustment, no significant differences in pain, balance, and mobility performance were observed between PS-TKA and MP-TKA participants 1 year after surgery. However, there was a trend for increased anteroposterior sway of the lumbar and head regions in the MP-TKA participants when undertaking the near tandem stance test. The wearable motion sensors were easy to use without any adverse effects. Conclusions It is feasible to use wearable motion sensors in a clinical setting to compare balance and mobility performance of patients with different TKA prothesis designs. Since this was a pilot study and no definite conclusions could be drawn, future clinical trials should determine the impacts of different TKA prosthesis designs on post-operative outcomes over a longer follow-up period.https://doi.org/10.1186/s40814-022-01094-0ProsthesisPostural swayGaitWearable sensorsPost-operationBalance performance |
| spellingShingle | Cathy W. T. Lo Matthew A. Brodie William W. N. Tsang Stephen R. Lord Chun-Hoi Yan Arnold Y. L. Wong Pain, balance, and mobility in people 1 year after total knee arthroplasty: a non-randomized cross-sectional pilot study contrasting posterior-stabilized and medial-pivot designs Pilot and Feasibility Studies Prosthesis Postural sway Gait Wearable sensors Post-operation Balance performance |
| title | Pain, balance, and mobility in people 1 year after total knee arthroplasty: a non-randomized cross-sectional pilot study contrasting posterior-stabilized and medial-pivot designs |
| title_full | Pain, balance, and mobility in people 1 year after total knee arthroplasty: a non-randomized cross-sectional pilot study contrasting posterior-stabilized and medial-pivot designs |
| title_fullStr | Pain, balance, and mobility in people 1 year after total knee arthroplasty: a non-randomized cross-sectional pilot study contrasting posterior-stabilized and medial-pivot designs |
| title_full_unstemmed | Pain, balance, and mobility in people 1 year after total knee arthroplasty: a non-randomized cross-sectional pilot study contrasting posterior-stabilized and medial-pivot designs |
| title_short | Pain, balance, and mobility in people 1 year after total knee arthroplasty: a non-randomized cross-sectional pilot study contrasting posterior-stabilized and medial-pivot designs |
| title_sort | pain balance and mobility in people 1 year after total knee arthroplasty a non randomized cross sectional pilot study contrasting posterior stabilized and medial pivot designs |
| topic | Prosthesis Postural sway Gait Wearable sensors Post-operation Balance performance |
| url | https://doi.org/10.1186/s40814-022-01094-0 |
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