UMass Chan Medical School Faculty Publications

UMMS Affiliation

Department of Population and Quantitative Health Sciences

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Article Postprint


Biomechanics | Diagnosis | Musculoskeletal Diseases | Musculoskeletal, Neural, and Ocular Physiology | Orthopedics | Rheumatology


OBJECTIVE: To determine if a one-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 one-year change in 20- meter walk speed from three observation periods (i.e., 0-12, 12-24, and 24-36 month). We operationally defined one-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, 3) increase: > 0.1 m/s change. Incident knee replacement was defined using each subsequent one-year period (i.e., 12-24, 24- 36, and 36-48 month). Combining data from the three 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 4,264 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% confidence interval (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 one-year decline in walking speed is associated with an increased risk, while one-year increase in walking speed is associated with a decreased risk of future incident knee replacement.


Gait, arthroplasty, knee joint, osteoarthritis, UMCCTS funding

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© 2020 The Journal of Rheumatology. This is a pre-copyediting, author-produced PDF of an article accepted for publication in The Journal of Rheumatology following peer review. Accepted manuscript posted after 12 month embargo as allowed by publisher's self-archiving policy at The definitive publisher-authenticated version is available online at

DOI of Published Version



Harkey MS, Lapane KL, Liu SH, Lo GH, McAlindon TE, Driban JB. A Decline in Walking Speed is Associated with Incident Knee Replacement in Adults with and at Risk for Knee Osteoarthritis. J Rheumatol. 2020 Jun 15:jrheum.200176. doi: 10.3899/jrheum.200176. Epub ahead of print. PMID: 32541076. Link to article on publisher's site

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Journal/Book/Conference Title

The Journal of rheumatology

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