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Published on: March 23, 2019
Gait function and improvements across patient groups after total knee replacement: A retrospective between-cohort
Marina De Vecchis1, Cathy A Holt1, Anders Holsgaard-Larsen2
1Biomechanics & Bioengineering Centre Versus Arthritis, Cardiff University, Cardiff, United Kingdom; Cardiff School of Engineering, College of Physical Sciences and Engineering, Cardiff University, Cardiff, United Kingdom.
Clinical Biomechanics (Bristol, Avon)
|May 27, 2026
Summary
The Cardiff Classifier effectively measures gait changes after total knee replacement (TKR), showing responsiveness across different labs and identifying key features for knee osteoarthritis recovery.
Area of Science:
- Biomechanics
- Orthopedics
- Gait Analysis
Background:
- Objective gait analysis offers insights beyond patient-reported outcomes for total knee replacement (TKR).
- The Cardiff Classifier shows potential as a gait function summary measure, but its cross-center robustness needs validation.
- This study assesses the Cardiff Classifier's comparability and responsiveness in TKR patients across different laboratories.
Purpose of the Study:
- To evaluate the comparability of gait function pre- and post-TKR using the Cardiff Classifier across two distinct cohorts.
- To determine the internal responsiveness of the Cardiff Classifier in quantifying gait changes following TKR.
- To identify common biomechanical features indicative of knee osteoarthritis and TKR recovery across different assessment centers.
Main Methods:
- Included British (24 TKR patients, 17 controls) and Swedish (27 TKR patients, 25 controls) cohorts.
- Performed 3D gait analysis preoperatively and one-year post-TKR for patients, and once for controls.
- Utilized fractional multinomial logit models to compare Classifier outputs between cohorts and effect sizes for responsiveness.
Main Results:
- Gait function differed between cohorts pre- and post-TKR, yet 56% of key discriminative biomechanical features were common.
- The Cardiff Classifier demonstrated large responsiveness in detecting gait changes from pre- to one-year post-TKR in both cohorts.
- Common features involved joint kinetics and ground reaction forces, highlighting consistent biomechanical alterations in TKR patients.
Conclusions:
- The Cardiff Classifier is sensitive to gait changes and identifies key knee osteoarthritis-related gait features across different cohorts.
- Findings support the Classifier's utility as a responsive measure for assessing gait recovery after TKR.
- The Classifier is suitable for multicenter evaluations of total knee replacement outcomes.
