Knee Arthrodesis After Failure of Knee Arthroplasty: A Nationwide Register-Based Study.

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Abstract

[Indexed for MEDLINE] 13. Knee. 2023 Jun;42:273-280. doi: 10.1016/j.knee.2023.04.006. Epub 2023 Apr 27. The impact of knee arthrodesis on gait kinematics, muscle activity and patient-reported outcome. Cibura C(1), Rosteius T(2), Brinkemper A(2), Ull C(2), Hufnagel S(2), Jettkant B(2), Godolias P(2), Rausch V(2), Schildhauer TA(2), Kruppa C(2). Author information: (1)Department of General and Trauma Surgery, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Germany. Electronic address: charlotte.cibura@bergmannsheil.de. (2)Department of General and Trauma Surgery, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Germany. BACKGROUND: The aim of this retrospective study was to analyze gait kinematicsandoutcome parameters after knee arthrodesis. METHODS: Fifteenpatients with a mean follow-up of 5.9 (range0.8-36) years after unilateral knee arthrodesis were included. A 3D gait analysis was performed and compared to a healthy control group of14patients. Comparative electromyography was performed bilaterally at the rectus femoris, vastuslateralis/medialisand tibialis anterior muscles. The assessment further included standardized outcome scores- Lower Extremity Functional Scale (LEFS) andShort Form Health Survey (SF-36). RESULTS: The 3D analysis showed a significantly shortened stance phase (p = 0.000), an extended swing phase (p = 0.000), and an increased time per step (p = 0.009) for the operated side compared with thenonoperatedside. There were statistically significant differences in the extent of movement of the hips, knees and ankles among the operated andnonoperatedsides and the control group. For the mean EMG measurement, no significant difference was found between the healthy control group and the patients with arthrodesis.The average LEFSscorewas 27.5 ± 10.6out of a maximum of 80 points,and the mean physical total scale and mean emotional total scale scores for the SF-36 were 27.9 ± 8.5and 52.9 ± 9.9, respectively. CONCLUSIONS: Arthrodesis of the knee joint causes significant kinematic changes in gait pattern,and patients achieve poor results in subjective and functional outcomes(SF- 36, LEFS).Arthrodesis ensures that the extremities are preserved and can enable walking, but it must be viewed as a severe handicap for the patient. Copyright © 2023 Elsevier B.V. All rights reserved. DOI: 10.1016/j.knee.2023.04.006