Walking Ability After Total Knee Arthroplasty: A Comprehensive Review

Total knee arthroplasty (TKA) is a highly effective surgical intervention for alleviating pain and restoring function in patients with end-stage knee osteoarthritis. Walking ability, a critical measure of post-operative success, directly impacts patients' independence, mobility, and quality of life. This review comprehensively examines the factors influencing walking ability after TKA, encompassing pre-operative, surgical, and post-operative considerations. Pre-operative factors, such as patient demographics, functional status, psychological well-being, and comorbidities, significantly shape post-operative outcomes. Surgical techniques, including the choice of approach, implant design, alignment, and minimally invasive or robotic-assisted methods, also play a pivotal role in determining walking ability. Post-operative rehabilitation, particularly early mobilization, physical therapy, and exercise protocol adherence, is essential for optimizing recovery. Long-term outcomes reveal that, while most patients experience significant improvements in walking ability, some face persistent limitations due to age, comorbidities, or suboptimal surgical results. Emerging technologies, such as wearable devices, robotic-assisted surgery, and personalized rehabilitation programs, offer promising avenues for enhancing post-operative walking ability. Biological augmentation techniques, like platelet-rich plasma and stem cell therapy, are also being explored to improve tissue healing and functional recovery. This review underscores the importance of a multidisciplinary, patient-centered approach to maximize walking ability and overall satisfaction after TKA, synthesizing evidence from clinical studies, meta-analyses, and systematic reviews. Future research should focus on refining surgical techniques, advancing rehabilitation strategies, and integrating personalized medicine to improve outcomes.