| Summary: | Introduction: Osteoarthritis is one of the leading causes of disability, and the knee joint is the most commonly affected site in the body. The last resort for treatment of end-stage knee osteoarthritis is total knee arthroplasty surgery. Despite the plethora of implant designs, the current evidence on which bearings give the most natural movement and function is still scarce. Aims: the aim of this study was to compare the functional performance of fixed and mobile bearings, with different degrees of congruency. Methods: participants underwent 3D motion capture analysis during two activities of daily living. Patient participants were recorded before, four to six weeks after, and a year after the operation. Pain and satisfaction levels were also surveyed using bespoke questionnaires and the Oxford knee score. Participants’ functional performance was accessed by means of an innovative statistical procedure (i.e. hierarchical clustering), that fruitfully classified movement patterns, and discerned healthy from unhealthy movement behaviours. Results: osteoarthritic participants used different movement strategies compared to healthy individuals. Patient participants’ arm and feet behaviour was often categorised as asymmetrical, indicating the presence of compensation mechanisms due to weakness of the affected join. Post-operational behaviour tends to converge to the controls’ performance. No differences were observed due to knee implant allocation, or anthropometric characteristics. Questionnaire analysis revealed significant improvement post-operatively in the self-assessment of patient participants, but with no eminent correlation between implant design and outcome measures. Conclusion: the proposed hierarchical clustering procedure managed to adequately, rapidly and reliably evaluate changes in the movement habits of patients after total knee arthroplasty, and access their improvement throughout their rehabilitation process.
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