title: A multivariate statistical ranking of clinical and gait measures before and after total knee replacement.
abstract: The purpose of this study was to assess the use of a multivariate statistical method to rank clinical and gait variables, thus describing a ranking of patient dysfunction prior to and following total knee replacement (TKR) surgery. Twenty end-stage knee osteoarthritis (KOA) subjects scheduled for TKR and 20 healthy controls performed level walking and stair ascent twice: pre- (P1) and 6 months post-surgery (P2). Clinical and gait measures were entered into a principle component analysis (PCA) to determine orthogonal principle components (PCs). The PCs were entered into a discriminant function analysis to determine the best predictors of group membership. The PCA extracted three PCs for both the P1 and P2 data sets. Three orthogonal dimensions were formed: "knee dysfunction", "gait dysfunction", and "stair ascent dysfunction". For P1 the "knee dysfunction" dimension composed of both subjective and objective measures, best discriminated between end-stage knee osteoarthritis patients and controls. For P2, the "stair ascent dysfunction" dimension best discriminated between 6 months post-TKR patients and controls. The results of this study suggest that a multivariate statistical method provides a clinically relevant ranking of patient dysfunction prior to and following TKR. This ranking of dysfunction could serve to identify rehabilitation priorities.
authors.affiliation: Motion Analysis Laboratory, Department of Human Physiology, University of Oregon, Eugene, OR 97403, USA.
authors.forename: David S
authors.initials: DS
authors.lastname: Mandeville
authors.forename: Louis R
authors.initials: LR
authors.lastname: Osternig
authors.forename: Brick A
authors.initials: BA
authors.lastname: Lantz
authors.forename: Craig G
authors.initials: CG
authors.lastname: Mohler
authors.forename: Li-Shan
authors.initials: LS
authors.lastname: Chou
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000534:rehabilitation*; D016022:Case-Control Studies; D004185:Disability Evaluation; D016002:Discriminant Analysis; D005260:Female; D005684:Gait; D006801:Humans; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D015999:Multivariate Analysis; D020370:Osteoarthritis, Knee / Q000503:physiopathology / Q000534:rehabilitation / Q000601:surgery*; D025341:Principal Component Analysis