Bas L Fransen1, Nina M C Mathijssen2, Karin Slot3, Nicole H H de Esch2, Hennie Verburg2, Olivier P P Temmerman3, Marco J M Hoozemans4, Jaap H van Dieën5. 1. CORAL - Centre for Orthopaedic Research Alkmaar, Department of Orthopaedic Surgery, Noordwest Ziekenhuisgroep Alkmaar, Wilhelminalaan 12, 1815 JD Alkmaar, the Netherlands; Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Van der Boechorststraat 9, 1081 BT Amsterdam, the Netherlands. Electronic address: b.l.fransen@nwz.nl. 2. Department of Orthopaedic Surgery, Reinier de Graaf Hospital, Reinier de Graafweg 5, 2625 AD Delft, the Netherlands. 3. CORAL - Centre for Orthopaedic Research Alkmaar, Department of Orthopaedic Surgery, Noordwest Ziekenhuisgroep Alkmaar, Wilhelminalaan 12, 1815 JD Alkmaar, the Netherlands. 4. CORAL - Centre for Orthopaedic Research Alkmaar, Department of Orthopaedic Surgery, Noordwest Ziekenhuisgroep Alkmaar, Wilhelminalaan 12, 1815 JD Alkmaar, the Netherlands; Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Van der Boechorststraat 9, 1081 BT Amsterdam, the Netherlands. 5. Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Van der Boechorststraat 9, 1081 BT Amsterdam, the Netherlands.
Abstract
BACKGROUND: With an increasingly younger population and more active patients, assessment of functional outcome is more important than ever in patients undergoing total knee arthroplasty. Accelerometers have been used successfully to objectively evaluate gait quality in other fields. The aim of this study was to assess gait quality with accelerometers before and after surgery, and to assess added value of resulting parameters to patient reported outcome measures scores. METHODS: Sixty-five patients (mean age 65 years (range 41-75)) who underwent primary total knee arthroplasty were evaluated using a tri-axial trunk accelerometer preoperatively and 1 year after surgery. Gait quality parameters derived from the accelerometry data were evaluated in three dimensions at both time points. Factor analysis was performed on all outcome variables and changes from before to 1 year after surgery in the most representative variable for each factor were studied. FINDINGS: Factor analysis identified three separate gait quality factors, with questionnaire and gait quality parameters loading on different factors. Both gait quality factor scores and questionnaire factor scores improved significantly 1 year after surgery. As expected based on the factor analysis, only weak to moderate associations were found between patient reported outcome measures and gait quality before surgery, after surgery and in change scores. INTERPRETATION: The independence of patient reported outcome measures and gait quality parameters measured with trunk accelerometry indicates that gait quality parameters provide additional information on functional outcome after total knee arthroplasty. Providing caretakers with objectively measurable targets using accelerometry could help improve outcome of these patients.
BACKGROUND: With an increasingly younger population and more active patients, assessment of functional outcome is more important than ever in patients undergoing total knee arthroplasty. Accelerometers have been used successfully to objectively evaluate gait quality in other fields. The aim of this study was to assess gait quality with accelerometers before and after surgery, and to assess added value of resulting parameters to patient reported outcome measures scores. METHODS: Sixty-five patients (mean age 65 years (range 41-75)) who underwent primary total knee arthroplasty were evaluated using a tri-axial trunk accelerometer preoperatively and 1 year after surgery. Gait quality parameters derived from the accelerometry data were evaluated in three dimensions at both time points. Factor analysis was performed on all outcome variables and changes from before to 1 year after surgery in the most representative variable for each factor were studied. FINDINGS: Factor analysis identified three separate gait quality factors, with questionnaire and gait quality parameters loading on different factors. Both gait quality factor scores and questionnaire factor scores improved significantly 1 year after surgery. As expected based on the factor analysis, only weak to moderate associations were found between patient reported outcome measures and gait quality before surgery, after surgery and in change scores. INTERPRETATION: The independence of patient reported outcome measures and gait quality parameters measured with trunk accelerometry indicates that gait quality parameters provide additional information on functional outcome after total knee arthroplasty. Providing caretakers with objectively measurable targets using accelerometry could help improve outcome of these patients.
Authors: Ramon J Boekesteijn; José M H Smolders; Vincent J J F Busch; Alexander C H Geurts; Katrijn Smulders Journal: BMC Musculoskelet Disord Date: 2021-03-03 Impact factor: 2.362
Authors: Bas L Fransen; Mirjam Pijnappels; Ise K Butter; B J Burger; J H van Dieën; M J M Hoozemans Journal: Arch Orthop Trauma Surg Date: 2021-05-06 Impact factor: 2.928
Authors: Ramon Boekesteijn; José Smolders; Vincent Busch; Noël Keijsers; Alexander Geurts; Katrijn Smulders Journal: PeerJ Date: 2022-09-28 Impact factor: 3.061