Stepping beyond Counts in Recovery of Total Knee Arthroplasty: A Prospective Study on Passively Collected Gait Metrics

Abstract

Advances in algorithms developed from sensor-based technology data allow for the passive collection of qualitative gait metrics beyond step counts. The purpose of this study was to evaluate pre- and post-operative gait quality data to assess recovery following primary total knee arthroplasty. This was a multicenter, prospective cohort study. From 6 weeks pre-operative through to 24 weeks post-operative, 686 patients used a digital care management application to collect gait metrics. Average weekly walking speed, step length, timing asymmetry, and double limb support percentage pre- and post-operative values were compared with a paired-samples t-test. Recovery was operationally defined as when the respective weekly average gait metric was no longer statistically different than pre-operative. Walking speed and step length were lowest, and timing asymmetry and double support percentage were greatest at week two post-operative (p < 0.0001). Walking speed recovered at 21 weeks (1.00 m/s, p = 0.063) and double support percentage recovered at week 24 (32%, p = 0.089). Asymmetry percentage was recovered at 13 weeks (14.0%, p = 0.23) and was consistently superior to pre-operative values at week 19 (11.1% vs. 12.5%, p < 0.001). Step length did not recover during the 24-week period (0.60 m vs. 0.59 m, p = 0.004); however, this difference is not likely clinically relevant. The data suggests that gait quality metrics are most negatively affected two weeks post-operatively, recover within the first 24-weeks following TKA, and follow a slower trajectory compared to previously reported step count recoveries. The ability to capture new objective measures of recovery is evident. As more gait quality data is accrued, physicians may be able to use passively collected gait quality data to help direct post-operative recovery using sensor-based care pathways.

Multicenter, prospective cohort study: immediate postoperative gains in active range of motion following robotic-assisted total knee replacement compared to a propensity-matched control using manual instrumentation

“…We performed a secondary analysis on data collected from an ethically-approved (WCG IRB # 20182013) global, multicenter prospective cohort study. The clinical study, A Prospective Multicenter Longitudinal Cohort Study of the mymobility Platform [ 31 , 32 ], was initiated in 2018 and listed on clinicaltrials.gov (NCT# 03737149). Given the purpose of this analysis, we limited our review of the study data to patient demographics, comorbidities, and objective clinical evaluations (ROM).…”

Stepping Beyond Counts in Recovery of Total Hip Arthroplasty: A Prospective Study on Passively Collected Gait Metrics

“…Smartphone-based IMU data has been used to develop predictive models for adverse post-operative events and frailty detection based on gait in cardiac surgery patients [ 33 , 34 ] and assess abnormal gait in osteoarthritis patients [ 35 , 36 , 37 ]. More recently, passively collected data via a smartphone-based care management platform was used to describe the recovery trajectory of gait metrics following total knee arthroplasty [ 38 , 39 , 40 ]. To our knowledge, only one study has used passively collected, smartphone-based IMU data to investigate recovery trajectories following THA.…”