Knee osteoarthritis (OA) remains a leading aetiology of disability worldwide. With recent advances in gait analysis, clinical assessment of such a knee-related condition has been improved. Although motion capture (mocap) technology is deemed the gold standard for gait analysis, it heavily relies on adequate data processing to yield clinically significant results. Moreover, gait data is non-linear and high-dimensional. Due to missing data involved in a mocap session and typical statistical assumptions, conventional data processing methods are unable to reveal the intrinsic patterns to predict gait abnormalities.

Albeit studies have demonstrated the potential of Artificial Intelligence (AI) algorithms to address these limitations, these algorithms have not gained wide acceptance amongst biomechanists. The most common AI algorithms used in gait analysis are based on machine learning (ML) and artificial neural networks (ANN). By comparing the predictive capability of such algorithms from published studies, we assessed their potential to augment current clinical gait diagnostics when dealing with knee OA.

Thus, an evidence-based review and analysis were conducted. With over 188 studies identified, 8 studies met the inclusion criteria for a subsequent analysis, accounting for 78 participants overall.

The classification performance of ML and ANN algorithms was quantitatively assessed. The test classification accuracy (ACC), sensitivity (SN), specificity (SP) and area under the curve (AUC) of the ML-based algorithms were clinically valuable, i.e., all higher than 85%, differently from those obtained via ANN.

This study demonstrates the potential of ML for clinical assessment of knee disorders in an accurate and reliable manner.