Gait analysis in short-term follow-up of medial opening wedge high tibial osteotomy

Eur J Orthop Surg Traumatol. 2018 Jul;28(5):939-946. doi: 10.1007/s00590-017-2099-1. Epub 2017 Dec 12.

Abstract

Background: Biomechanical gait changes are proposed as adaptations to medial knee osteoarthritis (OA), and little is known about which parameters can be modified early by high tibial osteotomy (HTO) surgery. The aim of this study was to identify early gait changes in a postoperative period of 6 months as compared to a control group, in three different spatial planes.

Methods: Twenty-one patients with OA were submitted to three-dimensional gait analysis preoperatively and 6 months after HTO surgery. Sixteen healthy individuals were selected for the control group.

Results: Compared to the control group, OA patients walked more slowly, with a shorter stride length, and with a higher knee varus and flexion angles. The gait changes detected in the postoperative of 6 months were a significant reduction in knee varus angle and adductor moment in coronal plane; an important reduction in knee extension and an increased extensor moment in sagittal plane; also an increased foot external rotation angle in axial plane was observed. Flexion angle peak in swing phase, adductor and flexor moments were the gait parameters with postoperatively results that were closer to those of the control group.

Conclusions: Even in a short follow-up of 6 months, HTO determines positive results in biomechanical gait, not only in the coronal plane but also in the sagittal and axial planes and should be taken into account during the rehabilitation process.

Keywords: Gait; Knee; Osteoarthritis; Osteotomy; Postoperative period; Range of motion.

MeSH terms

  • Adult
  • Biomechanical Phenomena
  • Follow-Up Studies
  • Gait
  • Gait Analysis*
  • Humans
  • Knee Joint / physiology
  • Knee Joint / physiopathology
  • Knee Joint / surgery
  • Middle Aged
  • Osteoarthritis, Knee / physiopathology*
  • Osteoarthritis, Knee / surgery
  • Osteotomy*
  • Tibia / physiopathology*
  • Tibia / surgery