Factors characterizing gait performance of patients before and soon after knee arthroplasty.
Hideyuki Ito, Kiyoshi Ichihara, Kotaro Tamari and 3 others
PMID 33814716WHAT IT FOUND
Two weeks after knee replacement, walking speed and Timed Up and Go times worsened for the entire group.
Older patients and those with slower pre-surgery walking declined the most. Minimally invasive and unicompartmental surgeries resulted in less decline than conventional total knee replacement.
Key findings
01Median comfortable Timed Up and Go time worsened from 12.9 seconds before surgery to 14.9 seconds two weeks after, and maximum walking speed dropped from 1.04 m/s to 0.90 m/s.
02Age was a significant predictor of decline: older patients experienced a steeper post-operative slowing of both Timed Up and Go times and walking speed.
03Surgical method influenced the degree of decline, with unicompartmental knee arthroplasty (UKA) and minimally invasive total knee arthroplasty (MIS-TKA) showing smaller decreases in walking performance compared to conventional total knee arthroplasty (C-TKA).
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
The follow-up period was very short (two weeks), so the findings describe acute post-operative changes and cannot predict long-term functional recovery or final outcomes. The study excluded patients with neurological issues, significant pain in other joints, or cognitive dysfunction, so results may not apply to a broader, more complex clinical population. While the sample size was large, the analysis of factors like BMI and osteoarthritis severity lacked statistical power due to insufficient numbers in specific subgroups. This is an observational cohort study, not a randomized controlled trial, so it identifies associations rather than proving causation for the impact of surgical method or age on decline.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not interpret the observed decline in walking ability as a treatment failure or a sign of poor long-term prognosis. The study only measured patients two weeks after surgery, a period where temporary worsening is expected. These short-term changes do not predict how well the patient will walk months later.