A Decline in Walking Speed Is Associated With Incident Knee Replacement in Adults With and at Risk for Knee Osteoarthritis

Abstract

Objective: To determine if a 1-year change in walking speed is associated with receiving an incident knee replacement during the following year in adults with and at risk for knee osteoarthritis (OA).

Methods: Using data from the Osteoarthritis Initiative, we determined a 1-year change in the 20-meter walk speed from 3 observation periods (i.e., 0-12, 12-24, and 24-36 months). We operationally defined 1-year change in walking speed as either (1) decline: ≤ -0.1 m/s change, (2) no change: between -0.1 and 0.1 m/s change, and (3) increase: ≥ 0.1 m/s change. Incident knee replacement was defined using each subsequent 1-year period (i.e., 12-24, 24-36, and 36-48 months). Combining data from the 3 observation periods, we performed a Poisson regression with robust error variance to determine the relative risk between a change in walking speed (exposure) and incident knee replacement over the following year (outcome).

Results: Of the 4264 participants included within this analysis (11,311 total person visits), 115 (3%) adults received a knee replacement. Decline in walking speed was associated with a 104% increase in risk [adjusted relative risk (RR) 2.04, 95% CI 1.40-2.98], while an increase in walking speed associated with a 55% decrease in risk (RR 0.45; 95% CI 0.22-0.93) of incident knee replacement in the following year compared to a person with no change in walking speed.

Conclusion: A 1-year decline in walking speed is associated with an increased risk, while a 1-year increase in walking speed is associated with a decreased risk of future incident knee replacement.

Keywords: arthroplasty; gait; knee joint; osteoarthritis.