Feasibility of using wearable inertial sensors for assessing gait changes after total knee arthroplasty: A systematic review and meta-analysis

INTRODUCTION: This systematic review and meta-analysis aims at synthesising and evaluating studies that used wearable inertial sensors for assessing gait-related kinematic variables in total knee arthroplasty (TKA) interventions. EVIDENCE ACQUISITION: PubMed/MEDLINE, EMBASE, Scopus, and PEDro databases were searched from inception to December 1, 2020. EVIDENCE SYNTHESIS: This study was conducted in agreement with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Three reviewers assessed studies for inclusion and extraction data. All studies that performed analysis with inertial measurement units (IMUs) before and after TKA have been included for the meta-analysis and the effect sizes and 95% confidence interval (CI) were calculated by random-effect models. Egger regression and the Begg-Mazumdar Rank Correlation Test were used to assess publication bias. A total of 7 studies involving 143 patients subjected to TKA met the inclusion criteria for the meta-analysis. The use of IMUs in the assessment of spatio-temporal parameters of gait after TKA showed a significant pooled effect size (P<0.05) in the assessment of gait speed, step frequency, step length, and step duration. High statistical heterogeneity across studies was detected for step frequency and duration, while moderate and low heterogeneity was observed for gait speed and step length, respectively. CONCLUSIONS: The findings of the present review support the feasibility of using IMUs in detecting changes in spatiotemporal parameters of gait after one year from TKA surgery. Specifically, step length and gait speed seem to be the most sensitive parameters for discriminating changes in gait performance. No sufficient data are available to recommend the use of other gait-related kinematic variables.