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Supplemental material, sj-docx-1-cho-10.1177_18632521231154975 for A 10.5-year follow-up of walking with unilateral spastic cerebral palsy by Alice Bonnefoy-Mazure, Geraldo De Coulon, Pierre Lascombes, Aline Bregou and Stéphane Armand in Journal of Children’s Orthopaedics

The aim of this preliminary study was to assess the correlation between passive knee kinematics measured during surgery before and after TKA implantation and active kinematics during gait before and three months after surgery.

Computer-assisted surgery (CAS) can provide real-time feedback of the knee kinematics during surgery. Understanding the link between this passive kinematics and the knee kinematics during gait could help surgeons evaluate the quality of the surgery. This study compared the adductionabduction (AA) angle assessed by the surgeon during surgical navigation to AA during gait after total knee arthroplasty (TKA) for 8 patients. This preliminary study showed fair to moderate correlations between those angles but needs further investigations to increase the number of patients and clarify the results.

15th International Symposium on 3-D Analysis of Human Movement, Manchester, ROYAUME-UNI, 03-/07/2018 - 06/07/2018; Stereophotogrammetry has been widely used for measuring gait. Conventional gait analysis systems tend to be based on the Davis marker-set [1]. This marker-set is dependent on the position of a wand on the thigh to define medial-lateral thigh axis. This wand is supposed to lie in the frontal plane of the thigh and can be difficult to position properly. A poor positioning leads to axis misorientation which can cause errors known as crosstalk. Crosstalk corresponds to an unphysiological knee Abduction Adduction (AA) amplitude correlated with knee Flexion-Extension (FE) [2]. This phenomenon also affects hip Internal External Rotation (IER) which is a parameter of high interest in clinical gait analysis (CGA). Several methods have been proposed previously to better define the medial-lateral axis of the thigh and improve the quality of both hip and knee kinematics. However, the corrections were not always satisfying or difficult to implement [2-3].

In patients with debilitating knee osteoarthritis, total knee replacement is the most common surgical procedure. Numerous studies have demonstrated that knee kinematics one year after total knee replacement are still altered compared to the healthy joint. However, little is known regarding impairments and functional limitations of patients several months after total knee replacement. The aim of this study was to describe the evolution of the knee gait kinematic in patients with knee osteoarthritis before and three months after a total knee replacement. Ninety patients who were to undergo total knee replacement were included in this study. Twenty-three subjects were recruited as the control group. Three-dimensional gait analysis was performed before and three months after surgery. The spatio-temporal parameters and three-dimensional knee kinematics for the operated limb were evaluated during a comfortable gait and compared between groups (the before and after surgery groups and the control group). Three months after surgery, patients always walk with a slower gait velocity and lower knee flexion–extension movements compared to the control group. However, a degree of progress was observed in term of the stride and step length, gait velocity and knee alignment in the coronal plane. Our results suggest that the disability is still significant for most patients three months after total knee replacement. A better understand of the impairments and functional limitations following surgery would help clinicians design rehabilitation programs. Moreover, patients should be informed that rehabilitation after total knee replacement is a long process.

22nd Congress of the European Society of Biomechanics (ESB), LYON, FRANCE, 10-/07/2016 - 13/07/2016; Contracture is a permanent shortening of the muscle - tendon - ligament complex that limits joint mobility. Contracture is involved in many diseases (cerebral palsy (CP), stroke, etc.) and can impair walking. Ankle equinus is one of the most common gait deviations (due to soleus and gastrocnemius muscle contractures) in cerebral palsy compromising the first (heel rocker) and second (ankle rocker) rockers of the foot during walking. Moreover, soleus and gastrocnemius contractures have different effects on gait kinematics and these effects are dependant of the degree of contracture. Thus, a good understanding of gait deviations is important to choose the best therapeutic approach, especially to optimise surgical procedures. This study aimed to evaluate the effect of gastrocnemius and soleus contractures on the first and second rocker during walking.