Concept verification of a Remote Automatic Scoring System for Evaluating Knee Function after Total Knee Arthroplasty

Abstract

The Knee Society Score (KSS) is the most commonly used scale for evaluating postoperative pain and physical function after total knee arthroplasty (TKA). However, this scale requires clinic visiting, which is not quite convenient. Our concept verification study demonstrated a remote automatic system for evaluating knee function after TKA using the KSS. The remote scoring system consists of two modules for data acquisition, an application for patients, a cloud server, and an application for doctors. The kinematic data are collected by the data acquisition modules and transmitted to the patient application via Bluetooth. The data acquisition module contains a motion sensor, a microcontroller unit, a power supply, and a Bluetooth module. The motion sensor consists of an accelerometer, a gyroscope, and a geomagnetic sensor, all of which are three-axis instruments. Using the nine-axis data, the three-dimensional (3D) angles are calculated according to the theory of attitude and heading reference system. The KSS score is calculated using a scoring algorithm in the patient application and transmitted to the doctor application through the cloud server. The knee function of 10 patients treated with unilateral TKA was evaluated by both a doctor and the remote scoring system. The consistency in KSS between the doctor and the system was analyzed using the paired t-test. The remote scoring system successfully recorded knee function data and transmitted the scores from the patient application to the doctor application through the cloud server. There was no significant difference in the KSS scores evaluated by the doctor and that by the system (p = 0.326). This remote automatic scoring system provides a reliable and convenient method for evaluating knee function after TKA at home.

Keywords

knee society score - total knee arthroplasty - remote automatic scoring system

Note

The datasets generated and analyzed during the current study are available from the corresponding author on reasonable request.

Ethical Approval

This study was approved by the Ethics Committee of Beijing Jishuitan Hospital, Beijing, China. All participants gave written informed consent.

Authors' Contributions

H.Z. and Y.Z. contributed to the conception and design of the study; H.Z. and Y.Z. collected and analyzed data; H.Z. and Y.Z. wrote the manuscript; all authors reviewed and approved the final version of the manuscript.

Publikationsverlauf

Eingereicht: 24. September 2019

Angenommen: 31. März 2020

Artikel online veröffentlicht:
27. Mai 2020

• References

• 1 Mahler E, Cuperus N, Bijlsma J. et al. Responsiveness of four patient-reported outcome measures to assess physical function in patients with knee osteoarthritis. Scand J Rheumatol 2016; 45 (06) 518-527
• 2 Bolink SA, Grimm B, Heyligers IC. Patient-reported outcome measures versus inertial performance-based outcome measures: a prospective study in patients undergoing primary total knee arthroplasty. Knee 2015; 22 (06) 618-623
• 3 Torres-Claramunt R, Leal J, Hinarejos P, Pelfort X, Puig L. Correlation study between KSS, WOMAC and SF-36 scores in patients undergoing total knee arthroplasty in a Spanish speaking population. J Arthroplasty 2013; 28 (06) 950-953
• 4 Bream E, Charman SC, Clift B, Murray D, Black N. Relationship between patients' and clinicians' assessments of health status before and after knee arthroplasty. Qual Saf Health Care 2010; 19 (06) e6
• 5 Stevens-Lapsley JE, Schenkman ML, Dayton MR. Comparison of self-reported knee injury and osteoarthritis outcome score to performance measures in patients after total knee arthroplasty. PM R 2011; 3 (06) 541-549 , quiz 549
• 6 Silva ALPE, Croci AT, Gobbi RG, Hinckel BB, Pecora JR, Demange MK. Translation and validation of the new version of the Knee Society Score - The 2011 KS Score - into Brazilian Portuguese. Rev Bras Ortop 2017; 52 (04) 506-510
• 7 Walker LC, Clement ND, Deehan DJ. Predicting the outcome of total knee arthroplasty using the WOMAC score: a review of the literature. J Knee Surg 2019; 32 (08) 736-741
• 8 Maniar RN, Maniar PR, Chanda D, Gajbhare D, Chouhan T. What is the responsiveness and respondent burden of the New Knee Society Score?. Clin Orthop Relat Res 2017; 475 (09) 2218-2227
• 9 Insall JN, Dorr LD, Scott RD, Scott WN. Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res 1989; (248) 13-14
• 10 Martimbianco AL, Calabrese FR, Iha LA, Petrilli M, Lira Neto O, Carneiro Filho M. Reliability of the “American Knee Society Score” (AKSS). Acta Ortop Bras 2012; 20 (01) 34-38
• 11 Ghanem E, Pawasarat I, Lindsay A. et al. Limitations of the Knee Society Score in evaluating outcomes following revision total knee arthroplasty. J Bone Joint Surg Am 2010; 92 (14) 2445-2451
• 12 Gandsas A, Montgomery K, McIntire K, Altrudi R. Wireless vital sign telemetry to hand held computers. Stud Health Technol Inform 2001; 81: 153-157
• 13 Markert M, Trautmann T, Krause F. et al. A new telemetry-based system for assessing cardiovascular function in group-housed large animals. Taking the 3Rs to a new level with the evaluation of remote measurement via cloud data transmission. J Pharmacol Toxicol Methods 2018; 93: 90-97
• 14 Chou HC, Wang YM, Chang HY. Design intelligent wheelchair with ECG measurement and wireless transmission function. Technol Health Care 2015; 24 (Suppl. 01) S345-S355
• 15 Christakos S, Dhawan P, Verstuyf A, Verlinden L, Carmeliet G. Vitamin D: metabolism, molecular mechanism of action, and pleiotropic effects. Physiol Rev 2016; 96 (01) 365-408
• 16 Kanai A, Kiyama S, Goto H. et al. Use of the sit-to-stand task to evaluate motor function of older adults using telemetry. BMC Geriatr 2016; 16: 121
• 17 Juen J, Cheng Q, Prieto-Centurion V, Krishnan JA, Schatz B. Health monitors for chronic disease by gait analysis with mobile phones. Telemed J E Health 2014; 20 (11) 1035-1041
• 18 Euston M, Coote P, Mahony R, Kim J, Hamel T. . A complementary filter for attitude estimation of a fixed-wing UAV. IEEE/RSJ International Conference on Intelligent Robots and Systems 2008
• 19 Mahony R, Hamel T, Pflimlin JM. Nonlinear complementary filters on the special orthogonal group. Ieee T Automat Contr 2008; 53 (05) 1203-1218
• 20 Thadani PJ, Vince KG, Ortaaslan SG, Blackburn DC, Cudiamat CV. Ten- to 12-year followup of the Insall-Burstein I total knee prosthesis. Clin Orthop Relat Res 2000; (380) 17-29