Biomechanics of Gait Pattern Adaptation in Patients After Total Knee Arthroplasty

• Change from Baseline in Gait Patterns at 6-8 weeks, 5 months and 11 months [ Time Frame: An average of 2 weeks prior to surgery and an average of 6-8 weeks, 5 months and 11 months after surgery ] [ Designated as safety issue: No ]

  Three-dimensional gait analysis of spatiotemporal, kinetic and kinematic parameters.

  Surface electromyographic analysis of muscle activation patterns. Center of pressure measurements and function tests.

  
  

• Change from Baseline in Pain, Function and Quality of Life Assessments at 6-8 weeks, 5 months and 11 months [ Time Frame: An average of 2 weeks prior to surgery and an average of 6-8 weeks, 5 months and 11 months after surgery ] [ Designated as safety issue: No ]
  Includes self-evaluation questionnaires
  
  

This study is a randomized prospective controlled study of patients after total knee arthroplasty. A total of 60 patients will be recruited to the study and divided randomly into an experimental and control group. Both groups will match in terms of gender, age, pathology and clinical assessment. In addition to the intervention of the present study, all patients, whether in the experimental or control group, will carry out the usual physical therapy exercises for total knee arthroplasty as directed by their physician.

The experimental group will be made up of 30 patients. The patients will be recruited and evaluated prior to surgery and for a follow-up period after surgery. After surgery, patients in this group will be fitted with a customized biomechanical device worn on the feet (Apos System, Apos - Sports and Medical Technologies Ltd. Hertzlia, Israel). The device is calibrated personally to each patient. By calibrating the device, the center-of-pressure of the foot can be manipulated during all phases of the gait cycle. The device is capable of inducing controlled perturbation during gait. The immediate effects of the device will be evaluated using center-of-pressure measurements, three-dimensional gait analyses and surface electromyography. The patients are instructed to walk with the device according to a therapy protocol (AposTherapy). Patients will be evaluated for changes in gait via three-dimensional gait analyses, muscle activation pattern changes via surface electromyography, pain, quality of life and energy consumption.

The control group will include 30 patients. The patients will be recruited and evaluated prior to surgery and for a follow-up period after surgery. The patients will carry out the same walking exercises as the experimental group, but without the biomechanical intervention device (placebo walking shoe). The patients will be evaluated with the same tools over time as with the experimental group.