Gait assessment as an outcome measure in total knee replacement

self-selected speed along a 15mwalkway. A spearman correlation coefficient (r) was used to examine the association between ipsilateral trunk lean and the mean external knee and hip adduction moment. The significance level was set at p<0.05. Results: Linear correlations between ipsilateral trunk lean and the external knee and/or hip adduction moment were detected for patients with LCPD, AMC and MMC. In contrast, children with CP did not show such a relationship (Table 1). Patients with bilateral CP were walking with a significantly increased mean endorotation of the foot during stance phase (11.2±6.9◦) compared to the mean exorotation of the control group (−5.1±3.0◦) and compared to the patients with other pathologies which also showed a mean exorotation of the foot during stance phase. Discussionandconclusions: Besides theunloadingmechanism for the hip joint, ipsilateral trunk lean may also have a negative effect on the knee joint. This altered gait pattern increases the lever arm around the knee joint by shifting the ground reaction vector more lateral to the knee joint center which could be sufficient to deform the lateral compartment of the knee in young patients with normally aligned knees and no signs of medial knee OA. The influence of ipsilateral trunk lean on the hip and knee joint in patients with bilateral CP is probably less pronounced due to rotational gait changes. In particular, internal foot placement shifts the loadsmore onto the knee’s medial compartment [5]. In conclusion, Duchenne limping should not be considered and recommended as unloading mechanism for the hip joint on its own but also as a potential increased joint loading of the lateral knee compartment.