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Gait comparison of unicompartmental and total knee arthroplasties with healthy controls

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Title: Gait comparison of unicompartmental and total knee arthroplasties with healthy controls
Authors: Jones, G
Kotti, M
Wiik, A
Collins, R
Brevadt, M
Strachan, R
Cobb, J
Item Type: Journal Article
Abstract: 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: 145 participants (121 healthy controls, 12 cruciate retaining TKA patients, and 12 mobile bearing UKA patients) were recruited. The TKA and UKA patients were a minimum of 12 months post-op, and matched for pattern and severity of arthrosis, age, and BMI. Methods: Participants walked on an instrumented treadmill until their maximum walking speed was reached. Temporospatial gait parameters, and vertical ground reaction force data was 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 [1.3-2.1]) was significantly lower than that of both the UKA group (2.2 m/s [1.8-2.7]) and healthy controls (2.2 m/s [1.5-2.7]) (p<0.001). Conclusion: UKA results in a more physiological gait compared to TKA, and a higher top walking speed. This difference in function was not detected by the OKS.
Issue Date: 30-Sep-2016
Date of Acceptance: 30-Jun-2016
URI: http://hdl.handle.net/10044/1/34899
DOI: https://dx.doi.org/10.1302/0301-620X.98B10.BJJ.2016.0473.R1
ISSN: 2049-4394
Publisher: British Editorial Society of Bone and Joint Surgery
Start Page: 16
End Page: 21
Journal / Book Title: Bone & Joint Journal
Volume: 98-B
Issue: 10 Suppl B
Copyright Statement: ©2016 Jones et al. This is an open-access article distributed under the terms of the Creative Com- mons Attributions licence (CC-BY-NC), which permits unrestricted use, distribu- tion, and reproduction in any medium, but not for commercial gain, provided the original author and source are credited.
Sponsor/Funder: Imperial College Trust
Frances & Augustus Newman Foundation
Funder's Grant Number: N/A
WSSU_P50422
Keywords: Gait
Patient-reported outcome measures
Total knee arthroplasty
Unicompartmental knee arthroplasty
Publication Status: Published
Appears in Collections:Division of Surgery
Faculty of Medicine



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