A Decline in Walking Speed Is Associated With Incident Knee Replacement in Adults With and at Risk for Knee
Matthew S Harkey1, Kate L Lapane2, Shao-Hsien Liu2
1M.S. Harkey, Postdoctoral Research Fellow, PhD, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, and Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, Boston, Massachusetts; mharkey@tuftsmedicalcenter.org.
Objective:
To determine if a 1-year change in walking speed is associated with receiving an incident knee replacement during the following year in adults with and at risk for knee osteoarthritis (OA).
Methods:
Using data from the Osteoarthritis Initiative, we determined a 1-year change in the 20-meter walk speed from 3 observation periods (i.e., 0-12, 12-24, and 24-36 months). We operationally defined 1-year change in walking speed as either (1) decline: ≤ -0.1 m/s change, (2) no change: between -0.1 and 0.1 m/s change, and (3) increase: ≥ 0.1 m/s change. Incident knee replacement was defined using each subsequent 1-year period (i.e., 12-24, 24-36, and 36-48 months). Combining data from the 3 observation periods, we performed a Poisson regression with robust error variance to determine the relative risk between a change in walking speed (exposure) and incident knee replacement over the following year (outcome).
Results:
Of the 4264 participants included within this analysis (11,311 total person visits), 115 (3%) adults received a knee replacement. Decline in walking speed was associated with a 104% increase in risk [adjusted relative risk (RR) 2.04, 95% CI 1.40-2.98], while an increase in walking speed associated with a 55% decrease in risk (RR 0.45; 95% CI 0.22-0.93) of incident knee replacement in the following year compared to a person with no change in walking speed.
Conclusion:
A 1-year decline in walking speed is associated with an increased risk, while a 1-year increase in walking speed is associated with a decreased risk of future incident knee replacement.
