Robotic-arm assisted versus manual total knee arthroplasty: Functional gait analysis from a randomised controlled trial
The primary aim of this study was to assess whether measures of functional gait assessment were improved with robotic total knee arthroplasty (rTKA) when compared to manual TKA (mTKA). Gait analysis was performed as part of a randomised controlled trial. Walking and relaxed standing assessments were...
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| Veröffentlicht in: | Journal of biomechanics 2024-05, Vol.169, p.112112-112112, Article 112112 |
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| creator | Ajekigbe, Bola Ramaskandhan, Jayasree Clement, Nick Galloway, Steven Gabrov, Natasha Smith, Karen Weir, David Deehan, David |
| description | The primary aim of this study was to assess whether measures of functional gait assessment were improved with robotic total knee arthroplasty (rTKA) when compared to manual TKA (mTKA). Gait analysis was performed as part of a randomised controlled trial. Walking and relaxed standing assessments were performed using an instrumented mat system. Spatiotemporal variables included gait cycle parameters, anteroposterior and lateral sway, and plantar pressure ratios. Measurements were recorded at pre-operative baseline and 12 months post-operatively. 100 patients were randomised, 50 to each group. Complete gait cycle data were available for 26 rTKA and 23 mTKA patients. Cadence and walking velocity showed overall improvements following surgery, with no difference between the two groups. In the operated limb, overall step and stride times decreased, while step and stride lengths increased. Subgroup analysis showed reduced propulsion time with rTKA, and decreased foot flat and mid stance times with mTKA. Lateral sway was decreased in the rTKA group. Plantar pressure ratios showed an overall increase in hindfoot loading on the operated limb, with no difference between the two groups. No other significant differences were identified between rTKA and mTKA at 12 months, and limitations may include statistical error. A small sample of the study cohort was followed up; analysis may represent the results of satisfied patients with well-functioning TKA. Further study could incorporate proprioceptive and 3D gait analysis techniques to analyse knee kinetics and kinematics with robotic surgery. Pressure mapping could further subdivide the plantar surfaces to explore any nuances in differential loading. |
| doi_str_mv | 10.1016/j.jbiomech.2024.112112 |
| format | Article |
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Gait analysis was performed as part of a randomised controlled trial. Walking and relaxed standing assessments were performed using an instrumented mat system. Spatiotemporal variables included gait cycle parameters, anteroposterior and lateral sway, and plantar pressure ratios. Measurements were recorded at pre-operative baseline and 12 months post-operatively. 100 patients were randomised, 50 to each group. Complete gait cycle data were available for 26 rTKA and 23 mTKA patients. Cadence and walking velocity showed overall improvements following surgery, with no difference between the two groups. In the operated limb, overall step and stride times decreased, while step and stride lengths increased. Subgroup analysis showed reduced propulsion time with rTKA, and decreased foot flat and mid stance times with mTKA. Lateral sway was decreased in the rTKA group. Plantar pressure ratios showed an overall increase in hindfoot loading on the operated limb, with no difference between the two groups. No other significant differences were identified between rTKA and mTKA at 12 months, and limitations may include statistical error. A small sample of the study cohort was followed up; analysis may represent the results of satisfied patients with well-functioning TKA. Further study could incorporate proprioceptive and 3D gait analysis techniques to analyse knee kinetics and kinematics with robotic surgery. Pressure mapping could further subdivide the plantar surfaces to explore any nuances in differential loading.</description><identifier>ISSN: 0021-9290</identifier><identifier>EISSN: 1873-2380</identifier><identifier>DOI: 10.1016/j.jbiomech.2024.112112</identifier><identifier>PMID: 38723413</identifier><language>eng</language><publisher>United States: Elsevier Ltd</publisher><subject>Aged ; Arthritis ; Arthroplasty ; Arthroplasty (knee) ; Arthroplasty, Replacement, Knee - methods ; Biomechanical Phenomena ; Contingency tables ; Data analysis ; Error analysis ; Female ; Gait ; Gait - physiology ; Gait analysis ; Gait Analysis - methods ; Humans ; Joint replacement surgery ; Kinematics ; Knee ; Knee Joint - physiopathology ; Knee Joint - surgery ; Male ; Medical imaging ; Middle Aged ; Orthopaedic implants ; Osteoarthritis ; Pandemics ; Patients ; Plantar pressure ; Proprioception ; Robotic ; Robotic surgery ; Robotic Surgical Procedures - methods ; Robotics ; Subgroups ; Surgeons ; Velocity ; Walking</subject><ispartof>Journal of biomechanics, 2024-05, Vol.169, p.112112-112112, Article 112112</ispartof><rights>2024</rights><rights>Crown Copyright © 2024. Published by Elsevier Ltd. All rights reserved.</rights><rights>Copyright Elsevier Limited May 2024</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c343t-5f17c8ea6e744b12e1fb5f27e2a5b504510a276b7db2fe478f3bdbcb13c2e1553</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0021929024001908$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38723413$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ajekigbe, Bola</creatorcontrib><creatorcontrib>Ramaskandhan, Jayasree</creatorcontrib><creatorcontrib>Clement, Nick</creatorcontrib><creatorcontrib>Galloway, Steven</creatorcontrib><creatorcontrib>Gabrov, Natasha</creatorcontrib><creatorcontrib>Smith, Karen</creatorcontrib><creatorcontrib>Weir, David</creatorcontrib><creatorcontrib>Deehan, David</creatorcontrib><title>Robotic-arm assisted versus manual total knee arthroplasty: Functional gait analysis from a randomised controlled trial</title><title>Journal of biomechanics</title><addtitle>J Biomech</addtitle><description>The primary aim of this study was to assess whether measures of functional gait assessment were improved with robotic total knee arthroplasty (rTKA) when compared to manual TKA (mTKA). Gait analysis was performed as part of a randomised controlled trial. Walking and relaxed standing assessments were performed using an instrumented mat system. Spatiotemporal variables included gait cycle parameters, anteroposterior and lateral sway, and plantar pressure ratios. Measurements were recorded at pre-operative baseline and 12 months post-operatively. 100 patients were randomised, 50 to each group. Complete gait cycle data were available for 26 rTKA and 23 mTKA patients. Cadence and walking velocity showed overall improvements following surgery, with no difference between the two groups. In the operated limb, overall step and stride times decreased, while step and stride lengths increased. Subgroup analysis showed reduced propulsion time with rTKA, and decreased foot flat and mid stance times with mTKA. Lateral sway was decreased in the rTKA group. Plantar pressure ratios showed an overall increase in hindfoot loading on the operated limb, with no difference between the two groups. No other significant differences were identified between rTKA and mTKA at 12 months, and limitations may include statistical error. A small sample of the study cohort was followed up; analysis may represent the results of satisfied patients with well-functioning TKA. Further study could incorporate proprioceptive and 3D gait analysis techniques to analyse knee kinetics and kinematics with robotic surgery. Pressure mapping could further subdivide the plantar surfaces to explore any nuances in differential loading.</description><subject>Aged</subject><subject>Arthritis</subject><subject>Arthroplasty</subject><subject>Arthroplasty (knee)</subject><subject>Arthroplasty, Replacement, Knee - methods</subject><subject>Biomechanical Phenomena</subject><subject>Contingency tables</subject><subject>Data analysis</subject><subject>Error analysis</subject><subject>Female</subject><subject>Gait</subject><subject>Gait - physiology</subject><subject>Gait analysis</subject><subject>Gait Analysis - methods</subject><subject>Humans</subject><subject>Joint replacement surgery</subject><subject>Kinematics</subject><subject>Knee</subject><subject>Knee Joint - physiopathology</subject><subject>Knee Joint - surgery</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Middle Aged</subject><subject>Orthopaedic implants</subject><subject>Osteoarthritis</subject><subject>Pandemics</subject><subject>Patients</subject><subject>Plantar pressure</subject><subject>Proprioception</subject><subject>Robotic</subject><subject>Robotic surgery</subject><subject>Robotic Surgical Procedures - 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methods</topic><topic>Biomechanical Phenomena</topic><topic>Contingency tables</topic><topic>Data analysis</topic><topic>Error analysis</topic><topic>Female</topic><topic>Gait</topic><topic>Gait - physiology</topic><topic>Gait analysis</topic><topic>Gait Analysis - methods</topic><topic>Humans</topic><topic>Joint replacement surgery</topic><topic>Kinematics</topic><topic>Knee</topic><topic>Knee Joint - physiopathology</topic><topic>Knee Joint - surgery</topic><topic>Male</topic><topic>Medical imaging</topic><topic>Middle Aged</topic><topic>Orthopaedic implants</topic><topic>Osteoarthritis</topic><topic>Pandemics</topic><topic>Patients</topic><topic>Plantar pressure</topic><topic>Proprioception</topic><topic>Robotic</topic><topic>Robotic surgery</topic><topic>Robotic Surgical Procedures - methods</topic><topic>Robotics</topic><topic>Subgroups</topic><topic>Surgeons</topic><topic>Velocity</topic><topic>Walking</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ajekigbe, Bola</creatorcontrib><creatorcontrib>Ramaskandhan, Jayasree</creatorcontrib><creatorcontrib>Clement, Nick</creatorcontrib><creatorcontrib>Galloway, Steven</creatorcontrib><creatorcontrib>Gabrov, Natasha</creatorcontrib><creatorcontrib>Smith, Karen</creatorcontrib><creatorcontrib>Weir, David</creatorcontrib><creatorcontrib>Deehan, David</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Mechanical & Transportation Engineering Abstracts</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of biomechanics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ajekigbe, Bola</au><au>Ramaskandhan, Jayasree</au><au>Clement, Nick</au><au>Galloway, Steven</au><au>Gabrov, Natasha</au><au>Smith, Karen</au><au>Weir, David</au><au>Deehan, David</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Robotic-arm assisted versus manual total knee arthroplasty: Functional gait analysis from a randomised controlled trial</atitle><jtitle>Journal of biomechanics</jtitle><addtitle>J Biomech</addtitle><date>2024-05</date><risdate>2024</risdate><volume>169</volume><spage>112112</spage><epage>112112</epage><pages>112112-112112</pages><artnum>112112</artnum><issn>0021-9290</issn><eissn>1873-2380</eissn><abstract>The primary aim of this study was to assess whether measures of functional gait assessment were improved with robotic total knee arthroplasty (rTKA) when compared to manual TKA (mTKA). Gait analysis was performed as part of a randomised controlled trial. Walking and relaxed standing assessments were performed using an instrumented mat system. Spatiotemporal variables included gait cycle parameters, anteroposterior and lateral sway, and plantar pressure ratios. Measurements were recorded at pre-operative baseline and 12 months post-operatively. 100 patients were randomised, 50 to each group. Complete gait cycle data were available for 26 rTKA and 23 mTKA patients. Cadence and walking velocity showed overall improvements following surgery, with no difference between the two groups. In the operated limb, overall step and stride times decreased, while step and stride lengths increased. Subgroup analysis showed reduced propulsion time with rTKA, and decreased foot flat and mid stance times with mTKA. Lateral sway was decreased in the rTKA group. Plantar pressure ratios showed an overall increase in hindfoot loading on the operated limb, with no difference between the two groups. No other significant differences were identified between rTKA and mTKA at 12 months, and limitations may include statistical error. A small sample of the study cohort was followed up; analysis may represent the results of satisfied patients with well-functioning TKA. Further study could incorporate proprioceptive and 3D gait analysis techniques to analyse knee kinetics and kinematics with robotic surgery. Pressure mapping could further subdivide the plantar surfaces to explore any nuances in differential loading.</abstract><cop>United States</cop><pub>Elsevier Ltd</pub><pmid>38723413</pmid><doi>10.1016/j.jbiomech.2024.112112</doi><tpages>1</tpages></addata></record> |
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| ispartof | Journal of biomechanics, 2024-05, Vol.169, p.112112-112112, Article 112112 |
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| subjects | Aged Arthritis Arthroplasty Arthroplasty (knee) Arthroplasty, Replacement, Knee - methods Biomechanical Phenomena Contingency tables Data analysis Error analysis Female Gait Gait - physiology Gait analysis Gait Analysis - methods Humans Joint replacement surgery Kinematics Knee Knee Joint - physiopathology Knee Joint - surgery Male Medical imaging Middle Aged Orthopaedic implants Osteoarthritis Pandemics Patients Plantar pressure Proprioception Robotic Robotic surgery Robotic Surgical Procedures - methods Robotics Subgroups Surgeons Velocity Walking |
| title | Robotic-arm assisted versus manual total knee arthroplasty: Functional gait analysis from a randomised controlled trial |
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