Three-dimensional biomechanical gait characteristics at baseline are associated with progression to total knee arthroplasty.

摘要: Objective To determine if baseline 3-dimensional (3-D) biomechanical gait patterns differed between those patients with moderate knee osteoarthritis (OA) who progressed to total arthroplasty (TKA) and that did not, whether these differences had predictive value. Methods Fifty-four OA ground reaction forces segment motions collected during gait. 3-D hip, knee, ankle angles moments were calculated over the cycle. Amplitude temporal waveform characteristics determined using principal component analysis. At followup 5–8 years later, 26 reported undergoing TKA. Unpaired t-tests performed on demographic TKA no-TKA groups. Receiver operating curve analysis, stepwise discriminate logistic regression analysis combination of features best classified groups their ability. Results Baseline demographic, symptomatic, radiographic variables similar, but 7 (P < 0.05) A multivariate model including overall adduction moment magnitude, flexion/extension difference, stance–dorsiflexion a 74% correct classification rate, no overtraining based cross-validation. 1-unit increase in score increased by 6-fold odds progression TKA. Conclusion In addition link higher magnitude future TKA, an outcome clear clinical importance, novel findings include altered sagittal plane indicative reduced ability unload joint midstance. This dynamic factors TKA; adding not improve model.