Open Access Research article

The effects of knee arthroplasty on walking speed: A meta-analysis

Hamid Abbasi-Bafghi12, Hamid R Fallah-Yakhdani12, Onno G Meijer134*, Henrica CW de Vet56, Sjoerd M Bruijn78, Li-Yong Yang9, Dirk L Knol6, Barend J Van Royen10 and Jaap H van Dieën1

Author Affiliations

1 Research Institute MOVE, Faculty of Human Movement Sciences, VU University, Amsterdam, The Netherlands

2 Department of Physical Education and Sports Science, Yazd University, Yazd, Iran

3 Orthopedic Biomechanics Laboratory, Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, P.R. China

4 Department of Rehabilitation, Fujian Medical University, Fuzhou, Fujian, P.R. China

5 EMGO Institute for Health and Care Research, VU University medical center, Amsterdam, The Netherlands

6 Department of Epidemiology and Biostatistics, VU University medical center, Amsterdam, The Netherlands

7 Motor Control Laboratory, Research Center for Movement Control and Neuroplasticity, Department of Biomedical Kinesiology, KU, Leuven, Belgium

8 Department of Orthopedics, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, P.R. China

9 Union Hospital Affiliated to Fujian Medical University, Fuzhou, Fujian, P.R. China

10 Research Institute MOVE, VU University medical center, Amsterdam, The Netherlands

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BMC Musculoskeletal Disorders 2012, 13:66  doi:10.1186/1471-2474-13-66

Published: 6 May 2012

Abstract

Background

Patients with knee osteoarthritis patients have problems with walking, and tend to walk slower. An important aim of knee arthroplasty is functional recovery, which should include a post-operative increase in walking speed. Still, there are several problems with measuring walking speed in groups of knee osteoarthritis patients. Nevertheless, test-retest reliability of walking speed measurements is high, and when the same investigators monitor the same subjects, it should be possible to assess the walking speed effects of knee arthroplasty. The present study reports a meta-analysis of these effects.

Methods

A total of 16 independent pre-post arthroplasty comparisons of walking speed were identified through MEDLINE, Web of Science, and PEDro, in 12 papers, involving 419 patients.

Results

For 0.5–5 months post-operatively, heterogeneity was too large to obtain a valid estimate of the overall effect-size. For 6–12 and 13–60 months post-operatively, heterogeneity was absent, low, or moderate (depending on estimated pre-post correlations). During these periods, subjects walked on average 0.8 standard-deviations faster than pre-operatively, which is a large effect. Meta-regression analysis revealed significant effects of time and time squared, suggesting initial improvement followed by decline.

Conclusion

This meta-analysis revealed a large effect of arthroplasty on walking speed 6–60 months post-operatively. For the first 0.5–5 months, heterogeneity of effect-sizes precluded a valid estimate of short-term effects. Hence, patients may expect a considerable improvement of their walking speed, which, however, may take several months to occur. Meta-regression analysis suggested a small decline from 13 months post-operatively onwards.

Keywords:
Knee osteoarthritis; Knee arthroplasty; Walking speed; Meta-analysis; Meta-regression analysis