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Sensor-Based Gait Recovery Analysis After Total Hip and Knee Arthroplasty: A One-Year Follow-Up Study Integrating
Wei-Cheng Chen1, Chih-Li Wang2, Sheng-Hsun Lee2
1Department of Orthopaedic Surgery, Chang Gung Memorial Hospital (CGMH), No. 5 Fu-Hsing Street, Kweishan, Taoyuan, Taiwan; Bone and Joint Research Center, Chang Gung Memorial Hospital (CGMH), No. 5 Fu-Hsing Street, Kweishan, Taoyuan, Taiwan; College of Medicine, Chang Gung University (CGU), 259 Wen-Hwa 1st Road, Kweishan, Taoyuan, Taiwan; Geriatric Medical Center, Chang Gung Memorial Hospital (CGMH), No. 5 Fu-Hsing Street, Kweishan, Taoyuan, Taiwan.
Pre-operative muscle strength, not X-ray severity, predicts functional recovery after hip or knee replacement in elderly patients. This finding highlights the importance of strength assessment for personalized rehabilitation post-total joint arthroplasty.
Area of Science:
- Orthopedics
- Biomedical Engineering
- Rehabilitation Science
Background:
- Functional recovery after total joint arthroplasty (TJA) is influenced by multiple factors.
- Elderly patients undergoing total hip arthroplasty (THA) or total knee arthroplasty (TKA) experience varied recovery trajectories.
- Integrating objective gait analysis, muscle strength, and patient-reported outcomes (PROMs) is crucial for understanding TJA recovery.
Purpose of the Study:
- To characterize the one-year functional recovery trajectory in elderly patients after THA or TKA.
- To identify predictors of functional gait recovery, including pre-operative muscle strength and radiographic severity.
- To assess the impact of TJA on gait parameters, muscle strength, and patient-reported outcomes over 12 months.
Main Methods:
- Prospective cohort study of 84 elderly patients (≥70 years) with Grade III or IV osteoarthritis undergoing THA or TKA.
- Objective gait analysis using inertial sensors and isokinetic dynamometry for muscle strength assessment (hip abductors for THA, quadriceps for TKA).
- Collection of PROMs (HOOS-JR, KOOS-JR) pre-operatively and at multiple time points up to 12 months post-surgery.
Main Results:
- Total knee arthroplasty (TKA) patients showed persistent gait asymmetry for up to three months, normalizing by six months; total hip arthroplasty (THA) recovery was more symmetrical.
- Pre-operative muscle strength was the strongest predictor of 12-month gait speed (β = 0.42, P < 0.001), while radiographic severity did not significantly predict recovery (P = 0.38).
- By 12 months, both THA and TKA patients approached normative gait and strength values, with high percentages achieving the patient acceptable symptom state (PASS).
Conclusions:
- Pre-operative muscle strength, not radiographic severity, is a critical determinant of functional gait recovery after TJA in the elderly.
- Incorporating pre-operative muscle strength assessment into surgical planning can guide personalized post-operative rehabilitation.
- Future research should involve prospective randomized trials with pre-operative gait analysis and intervention arms to establish causal relationships.
