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INTRODUCTION
Total Knee Arthroplasty (TKA) is undoubtedly
one of the most successful orthopaedic opera-
tions of the end of the last century [1, 2].
Although it has a high success rate, patient dis-
satisfaction linked to functional impairments
remains substantial. This rate has been reported
up to 20% [3, 4] and even to 37% in the Ayers
and Franklin study who reviewed hundreds of
TKA [5]. Function limitations are usually asso-
ciated with pain, instability, reduced range of
motion and lower quality of life. These limita-
tions become more noticeable on young and
demanding patients. The number of knee
replacements is increasing and fifty percent of
TKA will be less than 65 years old in the next
following years namely in the USA and will
then amplify the above stated figure [6].
Many authors have shown that poor outcome
of total knee arthroplasty depends upon a num-
ber of factors including knee prosthetic geom-
etry, preoperative clinical condition, knee
range of movement, surgical technique, reha-
bilitation protocol and proper knee kinematics
restoration [7]. One of the most common rec-
ognized factors of functional discontent is
abnormal knee kinematics. The aetiology of
abnormal knee kinematics is likely multifacto-
rial. Post operative knee kinematics have been
extensively studied using several methods such
as fluoroscopy, RSA and three D gait analysis
in the view of identifying factors responsible
for unsatisfactory functional outcome [8].
After TKA, functional outcomes are decipher-
able using gait clinical assessment. Studies shed
light on post operative knee joint replacement
kinematics abnormalities such as atypical axial
rotation, altered center of joint rotation changes
in the knee adduction moment, walking speed,
cadence, and symmetry [9]. Gait analysis stud-
ies using new technology identified features
demonstrating subtle functional variation after
TKA. McClelland showed that extension
moment and adduction moment have been help-
ful in predicting early failure and TKA
malalignment [10]. RSA readings after TKA
have demonstrated that higher peak flexion
moment in patients is at risk of early tibial com-
ponent loosening [11]. Andriacchi explained
that a patient with a painful knee reduces stride
length and the moment arms of the prosthetic
knee in walking more slowly. The same author
emphasized that biphasic moment pattern is a
consistent finding in normal subject, which is
never the case after TKA [12].
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ANALYSE À LAMARCHE DE DEUX SÉRIES
HOMOGÈNES DE 40 PATIENTS OPÉRÉS
DE PROTHÈSES TOTALES DE GENOU
NAVIGUÉES ET NON NAVIGUÉES
Gait analysis: a comparative study of two homogenous
groups of 40 navigated and conventional TKA.
F. PICARD, J. DILLON, J. CLARKE, A. GREGORI, A. KINNINMONTH