Development of a Prediction Model to Estimate the Risk of Walking Limitations in XXXX with Total Knee Arthroplasty.

@entity1 @entity348 @entity158
OBJECTIVE: Early and accurate risk prediction of walking limitations after @entity348 ( @entity348 ) is important for clinical and economic reasons. However, to our knowledge, no studies have systematically integrated multiple predictors into a single, clinically practical model. Our study aimed to develop a prediction model to estimate the risk of post- @entity348 walking limitations. METHODS: We performed a prospective cohort study of 1096 @entity1 who underwent elective, primary @entity348 between July 2013 and September 2014. Candidate predictors included @entity1 demographics, surgical factors, and pre- and early (1-mo) post- @entity348 functional measures. The outcome of interest was self-reported walking limitations at 6 months of post- @entity348 . We used multivariable proportional odds regression with bootstrap internal validation to develop the model. RESULTS: In all, 12% of @entity1 reported walking limitations (maximum walk time  <= 15 min) at 6 months postsurgery. The main predictors of increasing levels of walking limitations were preoperative walking limitations (overall p < 0.001), higher levels of body mass index [interquartile range (IQR)-OR 1.3, 95% CI 1.2-1.5], lower values of 1-month post- @entity348 gait speed (IQR-OR 1.9, 95% CI 1.3-2.6), the presence of contralateral knee @entity158 (OR 1.9, 95% CI 1.2-3.0), and the use of a quadstick preoperatively (OR 3.5, 95% CI 1.7-7.3). The prediction model had an optimism-corrected concordance index of 0.71. CONCLUSION: A small but sizable proportion of @entity1 with @entity348 had persistent mobility limitations. Our prediction model may help to risk-stratify @entity1 , and external validation is required before the model can be used in clinical practice.
