Abnormal loading and functional deficits are present in both limbs before and after unilateral knee arthroplasty

Metcalfe, Andrew; Stewart, Caroline; Postans, Neil; Biggs, Paul; Whatling, Gemma Marie; Holt, Catherine Avril; Roberts, Andrew

doi:10.1016/j.gaitpost.2017.04.008

Cited by 16 publications

(23 citation statements)

References 27 publications

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“…Instead, we chose not to control speed and present un-altered data and to accept that the causal relationship between biomechanical changes and gait velocity cannot be determined within this study. This is typical of numerous similar studies [9][10][11][12][13]15].…”

Section: Discussionsupporting

confidence: 68%

“…We initially selected the first three The Cardiff Classifier was then used to rank input variable importance. This ranking deviated from a previously reported method [10] -to reduce the risk of over-fitting, the training data was split into two equal halves and the classifier was used to rank the input variables within both data sets. There were 18 biomechanical variables which were identified as being highly ranked in each group and were retained for further analysis.…”

Section: Data Reductionmentioning

confidence: 98%

“…Longitudinal studies adopting 3DGA techniques have identified a number of abnormal biomechanical parameters which do not recover following TKR surgery [6,8,17,18,[9][10][11][12][13][14][15][16]. Of these studies, many do not include biomechanical parameters of the hip and ankle [6,[12][13][14][15][16], and/or exclude parameters within the frontal [6,[14][15][16][17] or transverse [6,8,17,[9][10][11][12][13][14][15][16] plane.…”

Section: Introductionmentioning

confidence: 99%

“…In our unit, the application of PCA has been combined with a classification method based on a Dempster-Shafer Theory (DST) of evidence, termed the 'Cardiff Classifier'. The principal application has been a summary gait measure, or index, which characterises the biomechanical changes associated with knee OA [25], and has used these features as an index to monitor recovery following TKR [10,26,27]. Metcalfe et al expanded the initial application of this technique by including sagittal and transverse kinetics and kinematics of the ankle and hip [10].…”

Section: Introductionmentioning

confidence: 99%

“…The principal application has been a summary gait measure, or index, which characterises the biomechanical changes associated with knee OA [25], and has used these features as an index to monitor recovery following TKR [10,26,27]. Metcalfe et al expanded the initial application of this technique by including sagittal and transverse kinetics and kinematics of the ankle and hip [10]. Of the 17 biomechanical features found to be discriminatory between OA and non-pathological gait, seven were features of the hip or ankle, and only three were of parameters at the knee.…”

Section: Introductionmentioning

confidence: 99%

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Which osteoarthritic gait features recover following Total Knee Replacement surgery?

Biggs

Whatling

Wilson

et al. 2018

Preprint

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299]Background Gait analysis can be used to measure variations in joint function in patients with knee osteoarthritis (OA), and is useful when observing longitudinal biomechanical changes following Total Knee Replacement (TKR) surgery. The Cardiff Classifier is an objective classification tool applied previously to examine the extent of biomechanical recovery following TKR. In this study, it is further developed to reveal the salient features that contribute to recovery towards healthy function. MethodsGait analysis was performed on 30 patients before and after TKR surgery, and 30 healthy controls. Median TKR follow-up time was 13 months. The combined application of principal component analysis (PCA) and the Cardiff Classifier defined 18 biomechanical features that discriminated OA from healthy gait. Statistical analysis tested whether these features were affected by TKR surgery and, if so, whether they recovered to values found for the controls. ResultsThe Cardiff Classifier successfully discriminated between OA and healthy gait in all 60 cases.Of the 18 discriminatory features, only six (33%) were significantly affected by surgery, including features in all three planes of the ground reaction force (p<0.001), ankle dorsiflexion moment (p<0.001), hip adduction moment (p=0.003), and transverse hip angle (p=0.007). All but two (89%) of these features remained significantly different to those of the control group after surgery. ConclusionsThis approach was able to discriminate gait biomechanics associated with knee OA. The ground reaction force provided the strongest discriminatory features. Despite increased gait velocity and improvements in self-reported pain and function, which would normally be clinical indicators of recovery, the majority of features were not affected by TKR surgery. This TKR cohort retained pre-operative gait patterns; reduced sagittal hip and knee moments, decreased knee flexion, increased hip flexion, and reduced hip adduction. The changes that were associated with surgery were predominantly found at the ankle and hip, rather than at the knee.

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Section: Discussionsupporting

confidence: 68%

Section: Data Reductionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Which osteoarthritic gait features recover following Total Knee Replacement surgery?

Biggs

Whatling

Wilson

et al. 2018

Preprint

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Gait function improvements, using Cardiff Classifier, are related to patient‐reported function and pain following hip arthroplasty

Biggs

Holsgaard-Larsen

Holt

et al. 2021

Journal Orthopaedic Research

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Summarizing results of three-dimensional (3D) gait analysis into a comprehensive measure of overall gait function is valuable to discern to what extent gait function is affected, and later recovered after surgery and rehabilitation. This study aimed to investigate whether preoperative gait function, quantified and summarized using the Cardiff Classifier, can predict improvements in postoperative patient-reported activities of daily living, and overall gait function 1 year after total hip arthroplasty (THA). Secondly, to explore relationships between pre-to-post surgical change in gait function versus changes in patient-reported and performance-based function. Thirty-two patients scheduled for THA and 25 nonpathological individuals were included in this prospective cohort study. Patients were evaluated before THA and 1 year postoperatively using 3D gait analysis, patient-reported outcomes, and performance-based tests. Kinematic and kinetic gait parameters, derived from 3D gait analysis, were quantified using the Cardiff Classifier. Linear regressions investigated the predictive value of preoperative gait function on postoperative outcomes of function, and univariate correlations explored relationships between pre-to-post surgical changes in outcome measures. Preoperative gait function, by means of Cardiff Classifier, explained 35% and 30% of the total variance in change in patient-reported activities of daily living, and in gait function, respectively. Moderate-to-strong correlations were found between change in gait function and change in patient-reported function and pain, while no correlations were found between change in gait function and performance-based function. Clinical significance: Preoperative gait function predicts postsurgical function to a moderate degree, while improvements in gait function after surgery are more closely related to how patients perceive function than their maximal performance of functional tests.

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A Survey of Knee Osteoarthritis Assessment Based on Gait

Kour

Gupta

Arora

2020

Arch Computat Methods Eng

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Abnormal loading and functional deficits are present in both limbs before and after unilateral knee arthroplasty

Cited by 16 publications

References 27 publications

Which osteoarthritic gait features recover following Total Knee Replacement surgery?

Which osteoarthritic gait features recover following Total Knee Replacement surgery?

Gait function improvements, using Cardiff Classifier, are related to patient‐reported function and pain following hip arthroplasty

A Survey of Knee Osteoarthritis Assessment Based on Gait

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