Analysis Of Plantar Pressure Before And After Total Knee Arthroplasty

BACKGROUND: K nee osteoarthritis is a kind of common chronic joint disease in the elderly, also known as the degenerative knee joint disease, osseous arthritis, degenerative arthritis, etc. Knee osteoarthritis is pathologically characterized by the degeneration and loss of articular cartilage, and accompanied with hyperplasia of the subchondral bone or osteoporosis. The main clinical manifestation of knee osteoarthritis is pain, which is even progressively worse when the patients are exhausted or walking. With the development of the illness, patients are suffering from knee flexion contracture deformity including varus or valgus, which causes limping gait. With the extension of life expectancy, the incidence of knee osteoarthritis is significantly increased over the world recently. Knee osteoarthritis has been one of the common diseases which affects the health and quality of life of the elderly. Currently, total knee arthroplasty(TKA) has become an effective means for the clinical treatment of the moderate to severe end-stage knee osteoarthritis. The severe knee osteoarthritis can cause compensatory lumbar scoliosis and hip diseases which seriously affect the plantar pressure. Hence, the plantar pressure may reflect the severity of knee osteoarthritis.As an important part of gait analysis, plantar pressure analysis is an effective method for the diagnosis of KOA. Besides this, plantar pressure analysis can also further quantitatively evaluate the rehabilitation, guide the patients with rehabilitation training, and assess the gait and limb function postoperatively. In this study, we wish to identify the max force and its distribution through the analysis of normal plantar pressure in the elderly. In contrast with normal population, knee osteoarthritis patients often suffered from flexion contracture, varus deformity and lower limb mechanics line changes. Through the analysis of the plantar pressure between normal elderly and knee osteoarthritis patients, the regularity and characteristic of plantar pressure distribution will be demonstrated. With the gradual improvement of patients' gait and the correction of mechanics line and deformity caused by TKA, the changes of the plantar pressure will be measured through the analysis of plantar pressure preoperatively and postoperatively.Analysis of plantar pressure between normal elderly and elder Knee OA patients Objective: Through the analysis of plantar pressure between normal elderly and Knee OA patients(unilateral and bilateral), the plantar pressure and distribution was objectively described in normal elderly and elder K nee O A patients in order to reveal the differences and characteristics between normal elderly and elder Knee OA patients. Methods: 25 randomly selected healthy elderly, 50 and 25 patients who underwent primary unilateral or bilateral total knee arthroplasty(TK A) respectively between 2014 and 2016 in Xijing Hospital were analyzed as the research object. Plantar pressure data was collected in acquisitioned 10 areas before TKA in use of the footscan plate system measurement system(Belgium RSscan company). Max Force(Max-F), Max Time(Max-T), Pressure Time Integral(PTI), Force Time Integral(FTI) and Max Pressure(Max-P) were chosen as the main parameters for statistical analysis.Results:1. There was no significant difference on the Max-F, Max-T, PTI, FTI and Max-P of the plantar pressure between two feet in normal elder people(P > 0.05). 2. The unilateral knee osteoarthritis patients' plantar pressure. Max-F:the affected foot(side) a foot partition Toe1, Toe2-5, M1, M2, M3, M4, Midfoot, HL decreased(P<0.05); the uninjured foot(i.e., the contralateral) plantar partition of Toe1, Toe2-5, M1, M2, and M3 increase(P<0.05). Max- T: affected foot(side) a foot partition Toe2-5, M1, Midfoot, HM, the HL decreased(P<0.05); the contralateral foot Toe2-5 foot partition, M2, M3, Midfoot increase(P<0.05); HM, HL decreased(P<0.05). FTI: the affected foot(side) a foot partition Toe2-5, M1, M2, M3, M4, Midfoot, HM, HL decreased(P<0.05); The M5 increases(P<0.05); the contralateral foot a foot partition M2, M3, M5, Midfoot, HM, HL increase(P<0.05). Max- P: the uninjured oot(side) a foot partition Toe1, Toe2-5, M1, M2 decreased(P<0.05); The M3, M4, M5, increase HL. the contralateral foot M4, M5, reduce plantar partition; M2, HM increased. PTI: the affected foot(side) a foot partition Toe1, Toe2-5, M1, M2, HM decreased; The M3, M4, M5; the contralateral foot Toe1 plantar partition, M4, M5 decreased; M2, HM increased. 3, double knee O A in elderly patients with plantar pressure analysis: Max- F: patients with injured foot(that is, the heavy side) a foot partition Toe2-5, M1, M2, M3, M4, HL decreased; patients with injured foot(the light side) a foot partition Toe1 increases, the M4. Max- T: the heavy side a foot partition Midfoot decreased; the light side a foot partition Toe2-5. FTI: the heavy side a foot partition Toe2-5, M2, M3, M4, Midfoot, HM, HL decreased; Toe1 increase; the light side a foot partition Toe1 decreased; Toe2-5, M2, M3, M4 increased; Max- P: the heavy side Toe2-5 foot partition, M1, M2, M3, M4, HM, HL decreased; the light side a foot partition Toe2-5, M2, M3, HM, the HL. PTI: the heavy side a foot partition Toe2-5, M3, M4, M5 decreased; the light side a foot partition Toe1 decreased; The M3, M4, increase HL. Conclusion: Through the plantar pressure gait analysis system test in normal population and knee osteoarthritis patients, to understand both of the double foot plantar pressure distribution, re vealing the causal relationship exists between patients with osteoarthritis of the knee and the axial alignment of the lower extremity and the plantar pressure.Analysis of plantar pressure in unilateral Knee OA patients before and after TKA Objective: To evaluate the clinical effect of unilateral TKA by quantitatively analyzing the plantar pressure and its distribution in unilateral elder Knee OA patients before and after operation. Methods: The experiment one of 50 patients who underwent primary unilateral total knee arthroplasty(TKA) were selected as the research object. Plantar pressure data was collected in acquisitioned 10 areas before TKA in use of the footscan plate system measurement system(Belgium RSscan company). Max-F, Max-T, PTI, FTI and Max-P were chosen as the main parameters for statistical analysis.Results: 1, one knee OA, compared to older patients before and after TKA surgery of lateral plantar pressure parameters of the Max-F, Max-T, PTI, FTI and Max- P in a particular region are obviously different foot, there are significant differences(P<0.05).2,the heavier preoperative genu varus deformity of patients, postoperative plantar pressure distribution more preoperative change, the more obvious.Conclusion: Analysing the plantar pressure data of the unilateral knee OA patients before and after operation, plantar pressure gait system can be a more scientific, objective and quantitative evaluat ion of TKA surgery, also providing a reference for the later clinical rehabilitation exercise.Analysis of plantar pressure in bilateral Knee OA elder patients before and after TKA Objective:Through the assessment of the changes in plantar pressure distribution before and after total knee arthroplasty, the gait changes and the limb alignment were analyzed to evaluate the flexion contracture deformity correction and the reconstruction of knee function postoperatively.Methods:The experiment one of 25 patients who underwent primary bilateral total knee arthroplasty(TKA) were analyzed as the research object. Plantar pressure data was collected in acquisitioned 10 areas before and 6 months after TKA respectively. Max-F, Max-T, PTI, FTI and Max-P were chosen as the main parameters for statistical analysis.Results:1. Max-F. The postoperative Max-F in Toe1-5 and M4-5 regions of the severe symptomatic limb were significantly lower than the preoperative, there were significant differences(P<0.05). Compared with the preoperative Max-F, the postoperative Max-F in HM region was significant increased(P<0.05). O n the mild symptomatic limb, the Max-F in Toe1-5, M1, M3, M5, MF, HL, HM regions were significantly lower than the preoperative ones, and there were significant differences(P<0.05).2. Max-T. The forefoot regions(Toe2-5, M1), midfoot region MF, hind foot area(HM, ML) of the severe symptomatic limb plantar had higher postoperative max-T than preoperative. The differences had significant significance(P< 0.05). The max-T of the mild symptomatic limb plantar forefoot area Toe2-5, M5 regions were shorter compared with the preoperative ones, and there was significant difference(P<0.05).3. FTI. Postoperatively, the FTI of the severe symptomatic limb plantar forefoot area Toe1-5 regions was significantly reduced(P<0.05), while the FTI of heel HM was significantly increased(P<0.05). On the mild symptomatic limb, the FTI in Toe1-5, M3, M5, HL regions were decreased compared with the preoperative FTI. There were significant differences(P<0.05).4. Max-P. 6 months after the surgery, the max-P of the severe symptomatic limb plantar forefoot areas Toe 2-5, M4 were reduced compared with the preoperative ones, and there were significant differences(P<0.05). However, the max-P of heel HM region was significantly increased postoperatively(P<0.05). On the mild symptomatic limb, the max-P of forefoot region(Toe1-5, M3), the midfoot area(MF), and the heel regions(HM, HL) were significantly decreased compared with the preoperative Max-P(P<0.05). 5. PTI. PTI of the severe symptomatic limb foot Toe1-5, M2 regions were reduced compared with that before the surgery, and there were significant differences(P<0.05). After the surgery, the PTI in HM region was increased(P<0.05). There were significant differences between the preoperative PTI and postoperative PTI in Toe1-5, M3, MF, HL areas of the mild symptomatic limb, and postoperative PTI were reduced(P<0.05). Conclusion: Analysing the plantar pressure data of the double knee OA patients before and after operation, plantar pressure gait system can be a more scientific, objective and qua ntitative evaluation of TKA surgery, also providing a reference for the later clinical rehabilitation exercise.