Global Spatiotemporal Gait Performance and Ambulation Capacity After Total Knee Arthroplasty: A Longitudinal Comparison of Fixed-Bearing and Mobile-Bearing Prostheses.
9 affiliations
- 1Faculty of Medicine, University Evangelica of Goiás, Anápolis 75083-515, Brazil.
- 2Department of Orthopedics Surgery, Municipal Hospital of Aparecida de Goiânia (HMAP), Aparecida de Goiânia 74936-600, Brazil.
- 3School of Medical Sciences, Santa Casa de São Paulo, São Paulo 01221-020, Brazil.
- 4Graduate Program in Health Sciences, Federal University of Goiás (UFG), Goiânia 74605-050, Brazil.
- 5Hospital Israelita Albert Einstein, São Paulo 01221-020, Brazil.
- 6State Center for Rehabilitation and Readaptation Dr. Henrique Santillo (CRER), Goiânia 74653-230, Brazil.
- 7Human Movement and Rehabilitation Post Graduation Program, Evangelical University of Goiás (UniEVANGELICA), Anápolis 75083-515, Brazil.
- 8Department of Electronics, Information and Bioengineering, Politecnico di Milano, 20133 Milan, Italy.
- 9IRCCS Istituto Auxologico Italiano, San Giuseppe Hospital, Piancavallo, 28823 Verbania, Italy.
Abstract
Background: The choice between fixed-bearing (FB) and mobile-bearing (MB) prostheses in total knee arthroplasty (TKA) remains controversial, and longitudinal evidence based on objective instrumented assessment is limited. Objectives: To compare global spatiotemporal gait performance and ambulation capacity across three postoperative assessments in patients receiving FB versus MB/rotating-platform implants. Methods: In this retrospective, longitudinal, observational cohort study, patients who had undergone primary unilateral TKA were assessed at up to three postoperative visits approximately 12 months apart, the first at a median of 12 months after surgery. Gait speed, cadence, stride length, a step-time symmetry index and a gait quality index were obtained from a single lumbar-mounted inertial measurement unit during steady-state level walking, and ambulation capacity was measured with the 2-Minute Walk Test (2MWT). Linear mixed-effects models with a random intercept per patient, adjusted for age and sex, were fitted for all six outcomes, with time specified both as a linear term and, in a sensitivity analysis, as a categorical factor yielding estimated marginal means and between-group contrasts at each visit. Results: A total of 105 observations from 54 patients were analysed (29 FB, 25 MB/PS-RP). Groups were comparable at the first assessment on age, sex, body mass index, WOMAC score and all gait outcomes. No between-group difference reached statistical significance for any outcome, in either the linear or the categorical specification; all 18 visit-specific contrasts included the null value. Within the FB group, gait speed, stride length, the symmetry index, the gait quality index and 2MWT distance decreased significantly between the second and third assessments, a change based on six patients. Conclusions: Under the conditions of this study, no significant differences in global spatiotemporal gait performance or ambulation capacity were detected between FB and MB/rotating-platform prostheses. Because the study was not designed or powered as an equivalence trial, lacks preoperative and joint-level kinematic data, and cannot separate bearing design from the surgical approach with which it was collinear, these findings do not establish that the two designs perform equivalently.
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BibTeX
@article{trindade2026global,
title = {{Global Spatiotemporal Gait Performance and Ambulation Capacity After Total Knee Arthroplasty: A Longitudinal Comparison of Fixed-Bearing and Mobile-Bearing Prostheses.}},
author = {Andrei Machado Viegas da Trindade and Leonardo Pinheiro Rezende and Helder Rocha da Silva Araújo and Junichiro Sado Junior and Halley Paranhos Júnior and Karla Cristina Naves de Carvalho and Marcos Henrique Alves Resende and Heren Nepomuceno Costa Paixão and Juliana Oliveira Hassel Mendes and Veronica Cimolin and Rodolfo Borges Parreira and Claudia Santos Oliveira},
journal = {Journal of functional morphology and kinesiology},
year = {2026},
month = sep,
doi = {10.3390/jfmk11040384},
url = {https://europepmc.org/article/MED/42924663},
note = {CC BY},
}
RIS
TY - JOUR
TI - Global Spatiotemporal Gait Performance and Ambulation Capacity After Total Knee Arthroplasty: A Longitudinal Comparison of Fixed-Bearing and Mobile-Bearing Prostheses.
AU - Andrei Machado Viegas da Trindade
AU - Leonardo Pinheiro Rezende
AU - Helder Rocha da Silva Araújo
AU - Junichiro Sado Junior
AU - Halley Paranhos Júnior
AU - Karla Cristina Naves de Carvalho
AU - Marcos Henrique Alves Resende
AU - Heren Nepomuceno Costa Paixão
AU - Juliana Oliveira Hassel Mendes
AU - Veronica Cimolin
AU - Rodolfo Borges Parreira
AU - Claudia Santos Oliveira
PY - 2026
DA - 2026/09/25
JO - Journal of functional morphology and kinesiology
DO - 10.3390/jfmk11040384
UR - https://europepmc.org/article/MED/42924663
AB - Background: The choice between fixed-bearing (FB) and mobile-bearing (MB) prostheses in total knee arthroplasty (TKA) remains controversial, and longitudinal evidence based on objective instrumented assessment is limited. Objectives: To compare global spatiotemporal gait performance and ambulation capacity across three postoperative assessments in patients receiving FB versus MB/rotating-platform implants. Methods: In this retrospective, longitudinal, observational cohort study, patients who had undergone primary unilateral TKA were assessed at up to three postoperative visits approximately 12 months apart, the first at a median of 12 months after surgery. Gait speed, cadence, stride length, a step-time symmetry index and a gait quality index were obtained from a single lumbar-mounted inertial measurement unit during steady-state level walking, and ambulation capacity was measured with the 2-Minute Walk Test (2MWT). Linear mixed-effects models with a random intercept per patient, adjusted for age and sex, were fitted for all six outcomes, with time specified both as a linear term and, in a sensitivity analysis, as a categorical factor yielding estimated marginal means and between-group contrasts at each visit. Results: A total of 105 observations from 54 patients were analysed (29 FB, 25 MB/PS-RP). Groups were comparable at the first assessment on age, sex, body mass index, WOMAC score and all gait outcomes. No between-group difference reached statistical significance for any outcome, in either the linear or the categorical specification; all 18 visit-specific contrasts included the null value. Within the FB group, gait speed, stride length, the symmetry index, the gait quality index and 2MWT distance decreased significantly between the second and third assessments, a change based on six patients. Conclusions: Under the conditions of this study, no significant differences in global spatiotemporal gait performance or ambulation capacity were detected between FB and MB/rotating-platform prostheses. Because the study was not designed or powered as an equivalence trial, lacks preoperative and joint-level kinematic data, and cannot separate bearing design from the surgical approach with which it was collinear, these findings do not establish that the two designs perform equivalently.
SN - 2411-5142
ER -