OBESITY AND OSTEOARTHRITIS: A BIOMECHANICAL AND GLOBAL HEALTH EVALUATION OF TOTAL KNEE ARTHROPLASTY PATIENTS AND HEALTHY CONTROLS

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2021

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Three-dimensional biomechanical gait analysis is a clinical tool to measure patient function prior to and following total knee arthroplasty (TKA). Patient-reported outcome (PRO) measures are psychometric questionnaires that also measure patient function prior to and following TKA. Different insight is gained from each of these measurement tools, the biomechanical data measures local factors, the PRO measures global factors, the current study utilized the Knee Injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS JR.) and the Patient-Reported Outcomes Measurement Information System (PROMIS) Global Physical Health (GPH) and Global Mental Health (GMH). Body mass index (BMI) is another important measurement tool that provides insight into patient health, BMI is a local factor as well. How do TKA patients recover over time in terms of their BMI, biomechanical gait, and PRO measures? Results of this dissertation suggest that biomechanically, there were significant group differences between healthy controls and TKA patients. Comparing healthy controls to TKA patients also revealed that there were baseline differences related to BMI, and group differences over time related to BMI that significantly affected the biomechanical gait outcomes. Furthermore, PRO measures for all TKA patients improved over time. The KOOS JR. and PROMIS GPH significantly improved at each timepoint, there was a lag effect for the PROMIS GMH. Patients with a higher BMI had worse baseline KOOS JR., GPH, and GMH scores. For the GPH and GMH the effect of BMI was non-significant over time. The KOOS JR. scores significantly interacted with BMI, over time at six months and one year, suggesting that heavier patients improve their scores more over time.

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Biomechanics, Kinesiology, Biomechanics, Gait, KOOS JR., Osteoarthritis, PROMIS, Total Knee Arthroplasty

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204 pages

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