Gait comparison of unicompartmental and total knee arthroplasties with healthy controls

Bone and Joint Journal - Tập 98-B Số 10_Supple_B - Trang 16-21 - 2016
Gareth Jones1, Margarita Kotti1, A Wiik1, R. Collins1, M Brevadt2, Robin K. Strachan3, Justin Cobb1
1MSk Lab, Imperial College London, Charing Cross Hospital, Fulham Palace Road, London, W6 8RF, UK
2Chair in Orthopaedic Surgery MSk Lab, Imperial College London, Charing Cross Hospital, Fulham Palace Road, London, W6 8RF, UK
3Imperial College NHS Trust, Charing Cross Hospital, Fulham Palace Road, London, W6 8RF, UK.

Tóm tắt

Aims To compare the gait of unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA) patients with healthy controls, using a machine-learning approach. Patients and Methods 145 participants (121 healthy controls, 12 patients with cruciate-retaining TKA, and 12 with mobile-bearing medial UKA) were recruited. The TKA and UKA patients were a minimum of 12 months post-operative, and matched for pattern and severity of arthrosis, age, and body mass index. Participants walked on an instrumented treadmill until their maximum walking speed was reached. Temporospatial gait parameters, and vertical ground reaction force data, were captured at each speed. Oxford knee scores (OKS) were also collected. An ensemble of trees algorithm was used to analyse the data: 27 gait variables were used to train classification trees for each speed, with a binary output prediction of whether these variables were derived from a UKA or TKA patient. Healthy control gait data was then tested by the decision trees at each speed and a final classification (UKA or TKA) reached for each subject in a majority voting manner over all gait cycles and speeds. Top walking speed was also recorded. Results 92% of the healthy controls were classified by the decision tree as a UKA, 5% as a TKA, and 3% were unclassified. There was no significant difference in OKS between the UKA and TKA patients (p = 0.077). Top walking speed in TKA patients (1.6 m/s; 1.3 to 2.1) was significantly lower than that of both the UKA group (2.2 m/s; 1.8 to 2.7) and healthy controls (2.2 m/s; 1.5 to 2.7; p < 0.001). Conclusion UKA results in a more physiological gait compared with TKA, and a higher top walking speed. This difference in function was not detected by the OKS. Cite this article: Bone Joint J 2016;98-B(10 Suppl B):16–21.

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Bone and Joint Journal

Tập 98-B Số 10_Supple_B

16-21

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