Correlation Between Functional Scores and Objective Gait Parameters Following Rotating Hinge Knee Megaprosthesis...

Area of Science:

• Orthopedic Surgery
• Biomechanics
• Rehabilitation Medicine

Background:

• Rotating hinge knee (RHK) megaprosthesis reconstruction is a complex procedure.
• Postoperative functional assessment commonly uses Musculoskeletal Tumor Society (MSTS) score, Toronto Extremity Salvage Score (TESS), and Knee Society Score (KSS).
• The accuracy of these scores in reflecting objective gait performance after RHK is not well-established.

Purpose of the Study:

• To evaluate the correlation between MSTS, TESS, and KSS scores and objective gait parameters in patients following RHK reconstruction.
• To determine which scoring system most accurately represents gait recovery post-RHK.

Main Methods:

• Retrospective analysis of 21 patients who underwent RHK reconstruction.
• One-year postoperative assessment included MSTS, TESS, and KSS functional scores.
• Gait parameters were objectively measured using the Intelligent Device for Energy Expenditure and Activity (IDEEA).
• Linear regression and stepwise multiple linear regression analyzed correlations between scores and gait parameters.

Main Results:

• All three scoring systems (MSTS, TESS, KSS) significantly correlated with multiple gait parameters (p < 0.05).
• TESS demonstrated significantly stronger correlations (higher R² values) than MSTS and KSS, particularly for walking velocity, step length, initial contact phase, and stride length.
• MSTS 'walking' and KSS 'function' subitems were significant predictors of gait parameters like velocity, step length, and cadence.

Conclusions:

• MSTS, TESS, and KSS scores all correlate with key gait parameters after RHK surgery.
• TESS appears to be a more representative measure of gait recovery due to its stronger and more consistent correlations with objective gait parameters.
• This suggests TESS may be a more valuable tool for assessing functional outcomes in RHK patients.