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Research

PATELLOFEMORAL ARTHROPLASTY IMPROVES GAIT IN ISOLATED PATELLOFEMORAL ARTHRITIS: A PROSPECTIVE COHORT GAIT ANALYSIS STUDY

The British Orthopaedic Research Society (BORS) Annual Meeting, Leeds, England, September 2018.



Abstract

Patellofemoral osteoarthritis (PFOA) affects 32% men and 36% women over the age of 60years and is associated with anterior knee pain, stiffness, and poor mobility. Patellofemoral arthroplasty (PFA) is a bone-sparing treatment for isolated PFOA. This study set out to investigate the relationship between patient-related outcome measures (PROMs) and measurements obtained from gait analysis before and after PFA. There are currently no studies relating to gait analysis and PFA available in the literature

A prospective cohort study was conducted of ten patients known to have isolated PFOA who had undergone PFA compared to a gender and age matched control group. The patients were also asked to complete questionnaires (Oxford knee score (OKS), EQ-5D-5L) before surgery and one year after surgery. Gait analysis was done on an instrumented treadmill comparing Ground reaction force parameters between the control and pre and post-operative PFA patients

The average age 60 (49–69) years with a female to male ratio of 9:1. Patient and healthy subjects were matched for age and gender, with no significant difference in BMI. Post-op PFA improvement in gait seen in ground reaction force at 6.5km/h. Base support difference was statistically significant both on the flat P=0.0001 and uphill P=0.429 (5% inclination) and P=0.0062 (10% inclination). PROMS response rate was 70%(7/10) pre-operative and 60%(6/10) post-operative. EQ-5D-5L scores reflected patient health state was better post-operatively.

This study found that gait analysis provides an objective measure of functional gait and reflected by significant quality-of-life improvement of patients post PFA. Literature lacks studies relating to gait-analysis and PFA. Valuable information provided by this study highlights that PFA has a beneficial outcome reflected by PROMs and improvement in vertical ground reaction force and gait

Further research is needed to assess how care-providers may use gait-analysis as part of patient care plans for PFOA patients.