Deficits in functional performance and gait one year after total knee arthroplasty despite improved self-reported...

Area of Science:

• Orthopedics
• Biomechanics
• Rehabilitation Science

Background:

• Gait patterns and functional recovery after total knee arthroplasty (TKA) remain incompletely understood.
• Limited data exists on whether TKA patients achieve full functional restoration.

Purpose of the Study:

• To evaluate changes in gait, performance-based function, and self-reported function one year after TKA.
• To determine if patients with knee osteoarthritis return to pre-operative levels of function.
• To investigate the interrelationship between gait, performance, and self-reported function post-TKA.

Main Methods:

• Prospective cohort study involving 28 TKA patients and 25 age/gender-matched controls.
• Three-dimensional gait analysis for kinematic and kinetic deviations.
• Assessment using the Five Times Sit-to-Stand (5STS) test and Knee Injury and Osteoarthritis Outcome Score (KOOS) at baseline and one year post-surgery.

Main Results:

• Kinetic gait deviations persisted in TKA patients at one year, while kinematic patterns normalized.
• Significant improvements in 5STS performance and KOOS scores were observed, but did not reach control levels.
• 36% of TKA patients exceeded the minimally detectable change on the 5STS test.

Conclusions:

• TKA improves gait and function one year post-surgery, though not to the level of healthy controls.
• The 5STS test effectively identifies patients with substantial gait improvements post-TKA.
• Self-reported function (KOOS) did not differentiate between patients with varying degrees of 5STS improvement, underscoring the utility of the 5STS in clinical practice.