Exploring the relationship of gait function pre and post total knee replacement (TKR) in two groups of patients. Three-dimensional gait analysis was performed at Cardiff University, UK, and Karolinska University Hospital, Sweden, on 29 and 25 non-pathological (NP) volunteers, and 39 and 28 patients with end-stage knee osteoarthritis (OA), respectively. Patients were assessed pre and one-year post-TKR. Data reduction was performed via Principal Component (PC) analysis on twenty-four kinematic and kinetic waveforms in both NP and pre/post-TKR. Cardiff's and Karolinska's cohorts were analysed separately. The Cardiff Classifier, a classification system based on the Dempster-Shafer theory, was trained with the first 3 PCs of each variable for each cohort. The Classifier classifies each participant by assigning them a belief in NP, belief in OA (BOA) and belief in uncertainty, based on their biomechanical features. The correlation between patient's BOA values (range: 0–1, 0 indicates null BOA and 1 high BOA) pre and post-TKR was tested through Spearman's correlation coefficient in each cohort. The related-samples Wilcoxon signed-rank test (α=0.05) determined the significant changes in BOA in each cohort of patients. The Mann-Whitney U test (α=0.05) was run to explore differences between the patients’ cohorts.Abstract
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Exploring the association of objective lower limb function pre and post total knee replacement (TKR). 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.Abstract
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Useful feedback from a Total Knee Replacement (TKR) can be obtained from post-surgery in-vivo assessments. Dynamic Fluoroscopy and 3D model registration using the method of Banks and Hodge (1996) [1] can be used to measure TKR kinematics to within 1° of rotation and 0.5mm of translation, determine tibio-femoral contact locations and centre of rotation. This procedure also provides an accurate way of quantifying natural knee kinematics and involves registering 3D implant or bone models to a series of 2D fluoroscopic images of a dynamic movement. The aim of this study was to implement a methodology employing the registration methods of Banks and Hodge (1996) [1] to assess the function of different TKR design types and gain a greater understanding of non-pathological (NP) knee biomechanics.INTRODUCTION
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