Objective monitoring of functional recovery after total knee and hip arthroplasty using sensor-derived gait measures

Ramon Boekesteijn; José Smolders; Vincent Busch; Noël Keijsers; Alexander Geurts; Katrijn Smulders

doi:10.7717/peerj.14054

Objective monitoring of functional recovery after total knee and hip arthroplasty using sensor-derived gait measures

PeerJ. 2022 Sep 28:10:e14054. doi: 10.7717/peerj.14054. eCollection 2022.

Authors

Ramon Boekesteijn^{1

2}, José Smolders³, Vincent Busch³, Noël Keijsers¹, Alexander Geurts², Katrijn Smulders¹

Affiliations

¹ Department of Research, Sint Maartenskliniek, Nijmegen, The Netherlands.
² Department of Rehabilitation, Donders Institute for Brain Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.
³ Department of Orthopedic Surgery, Sint Maartenskliniek, Nijmegen, The Netherlands.

Abstract

Background: Inertial sensors hold the promise to objectively measure functional recovery after total knee (TKA) and hip arthroplasty (THA), but their value in addition to patient-reported outcome measures (PROMs) has yet to be demonstrated. This study investigated recovery of gait after TKA and THA using inertial sensors, and compared results to recovery of self-reported scores of pain and function.

Methods: PROMs and gait parameters were assessed before and at two and fifteen months after TKA (n = 24) and THA (n = 24). Gait parameters were compared with healthy individuals (n = 27) of similar age. Gait data were collected using inertial sensors on the feet, lower back, and trunk. Participants walked for two minutes back and forth over a 6m walkway with 180° turns. PROMs were obtained using the Knee Injury and Osteoarthritis Outcome Scores and Hip Disability and Osteoarthritis Outcome Score.

Results: Gait parameters recovered to the level of healthy controls after both TKA and THA. Early improvements were found in gait-related trunk kinematics, while spatiotemporal gait parameters mainly improved between two and fifteen months after TKA and THA. Compared to the large and early improvements found in of PROMs, these gait parameters showed a different trajectory, with a marked discordance between the outcome of both methods at two months post-operatively.

Conclusion: Sensor-derived gait parameters were responsive to TKA and THA, showing different recovery trajectories for spatiotemporal gait parameters and gait-related trunk kinematics. Fifteen months after TKA and THA, there were no remaining gait differences with respect to healthy controls. Given the discordance in recovery trajectories between gait parameters and PROMs, sensor-derived gait parameters seem to carry relevant information for evaluation of physical function that is not captured by self-reported scores.

Keywords: Accelerometer; Arthroplasty; Gait; Gyroscope; Osteoarthritis; PROMs; Wearable sensors.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Arthroplasty, Replacement, Hip* / methods
Arthroplasty, Replacement, Knee* / methods
Gait
Humans
Knee Joint
Osteoarthritis*

Grants and funding

The Innovation Fund of the Sint Maartenskliniek sponsored this study. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.