Different improvement trends in gait function and quadriceps strength early after total knee arthroplasty.
Akira Iwata, Yuki Sano, Hideyuki Wanaka and 3 others
PMID 30774206WHAT IT FOUND
Early after knee replacement, strength in the operated leg barely predicts walking speed, but strength in the opposite leg does.
Pain also drives gait limits. Therapists should not assume operated-leg quad strength is the main bottleneck for early recovery.
Key findings
01Quadriceps strength of the operated leg was not a significant independent predictor of gait speed or TUG performance at any time point in the regression analysis.
02Quadriceps strength of the non-operated leg was significantly associated with gait function and was a strong independent predictor of both gait speed and TUG.
03Pain (VAS) was a significant determinant of gait speed preoperatively and at 2 weeks, and of TUG preoperatively and at 3 weeks.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Single-center study with a homogeneous sample (mostly female, elderly, Japanese population), which limits generalizability. Short follow-up period (only 3 weeks), so findings do not apply to long-term recovery. The study was observational, so it identifies associations but cannot prove that strengthening the non-operated leg causes improved gait. Postoperative management and rehabilitation programs were standardized at the single center, which may not reflect practice elsewhere.
Declared interests
None declared.
The easy way to misread this
Do not interpret the lack of correlation for the operated leg as evidence that quadriceps strength there is irrelevant to recovery. This study only looked at the first three weeks; long-term function likely depends on operated-leg strength, and the sample was small, elderly, and largely female.