Abstract
Abstract
Objectives
Exploring the association of objective lower limb function pre and post total knee replacement (TKR).
Methods
3D gait analysis was performed on 28 non-pathological participants (NP) and 40 patients with advanced knee osteoarthritis (OA) before and approximately one year after TKR. For NP and OA patients pre/post-TKR, 12 waveforms on kinetic and kinematic variables of the operative side were chosen to perform data reduction through Principal Component (PC) Analysis. The Cardiff Classifier, a classification system based on Dempster-Shafer theory, was trained with the first 3 PCs of each variable. The 18 highest-ranking PCs classifying the biomechanical features of each participant as Belief in Healthy, Belief in OA (BOA) or Belief in Uncertainty were used to quantify biomechanical changes pre- to post-TKR. The correlation between patients’ BOA values (range: 0 to 1, 0 indicates null BOA and 1 high BOA) pre- and post-TKR was tested through Spearman's correlation coefficient. Wilcoxon matched-pair test (α<0.05) determined the significance of the change in BOA.
Results
NP (57% women) had a mean age of 38 (SD=18.13), mean height and weight of 1.70 m (SD=0.09) and 68 Kg (SD=15.24), respectively. Their mean BOA was 0.05 (SD=0.08), in line with inclusion criteria. OA patients (38% women) had a mean age of 68.5 (SD=7.59), mean height and weight of 1.68 m (SD=0.10) and 92.6 Kg (SD=21.22), respectively. Their mean pre-TKR BOA was 0.81 (SD=0.18), falling to 0.64 (SD=0.26) post-TKR. The change in BOA (0.16, SD=0.19) pre- to post-TKR was significant (p=0.000). BOAs pre- and post-TKR were non-normally distributed therefore, a Spearman's rank-order correlation was run, revealing a positive, statistically significant (p=0.000), strong correlation (rS =0.657) between BOA pre- and post-TKR.
Conclusions
This study found that worse objective pre-operative lower limb function in people with advanced knee OA was strongly correlated with poorer one-year post-TKR function (rS=0.657, p<0.01).
Declaration of Interest
(b) declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported:I declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.
