Gait analysis after lower limb reconstruction

  • Research type

    Research Study

  • Full title

    Functional tissue reconstruction of the lower limb after major trauma / implant associated infection. Outcome assessment through (i) gait analysis (ii) virtual reality environmental simulation and (iii) validated lower limb questionnaires

  • IRAS ID

    256472

  • Contact name

    Steven Lo

  • Contact email

    steven.lo@nhs.net

  • Sponsor organisation

    NHS Greater Glasgow and Clyde

  • Duration of Study in the UK

    0 years, 7 months, 31 days

  • Research summary

    Introduction
    After tissue loss of the lower limb due to major trauma / implant associated infection, modern surgical concepts have evolved from limb amputation to limb reconstruction over the last three decades. However, a reconstructed limb does not necessarily equate to a functional limb. Patients may be left with significant disability, reliant on walking frames and thereby unable to return to normal activities of daily living.
    The aim of this study is not only to preserve the limb, but to measure and document the restored function of the limb, as this has not been assessed very well in previous studies. Hereby, we can offer our patients a maximum chance to return to activities such as sport, leisure and work postoperatively.

    Methods
    In addition to restoring tissue defects, advanced surgical techniques can be modified to such extent, that lost skeletal function of muscle or tendon can be reconstructed. This is achieved through advanced plastic surgical procedures either transferring missing tissue from unaffected areas of the body of the patient to the lower limb (often by means of microsurgical techniques; then called free functional muscle transfer), or performing local muscle transfers.

    Our assessment of the patient’s outcome is threefold:
    1. Instrumented gait analysis - this employs 3D cameras and force plates to objectively assess the patient’s ability to walk
    2. Environmental simulators - this employs a state-of-the-art simulator that can assess a patient’s ability to navigate in simulated environments e.g. walking uphill / going shopping.
    3. Subjective assessment through validated lower limb questionnaires (e.g. Oxford Knee Score / Toronto Extremity Salvage Score / Musculoskelettal Tumor Society Score / Foot and Ankle Outcome Score / ShortForm-36).

    Objective
    We will aim to determine if this outcome analysis will set a future standard for functional lower limb reconstruction, postoperative analysis and outcome documentation.

  • REC name

    South Central - Hampshire A Research Ethics Committee

  • REC reference

    19/SC/0119

  • Date of REC Opinion

    18 Mar 2019

  • REC opinion

    Further Information Favourable Opinion