Recovery of daily-life walking after total knee arthroplasty: A two-year longitudinal study and comparison with healthy controls.

OBJECTIVE

Total knee arthroplasty (TKA) aims to improve walking in individuals with end-stage knee osteoarthritis, but the extent of daily-life walking recovery remains unclear. This study assessed whether individuals regain daily-life walking comparable to healthy people one year after surgery and examined recovery over two years.

METHOD: This longitudinal study assessed daily-life walking with inertial sensors before, and one and two years after TKA. Thirty-one individuals with unilateral knee osteoarthritis were compared to thirty-one healthy participants without joint pain. The primary outcome was daily-life gait speed at one year. Differences between the TKA group and healthy participants at one year were assessed with t-tests. Pre-to-post-TKA comparisons were analyzed using linear mixed models.

RESULTS

One year after surgery, gait speed of the TKA group was 0.10 m/s lower compared to healthy participants. From preoperatively to one year postoperatively, gait speed increased by 0.10 m/s (95% CI: 0.04 to 0.15), with 12 out of 27 individuals improving beyond the threshold of ≥0.1 m/s change. Stride length and stride time improved at one year post-surgery, but the maximum gait bout length did not improve. No improvements were observed from 1 to 2 years postoperatively.

CONCLUSION

One year after TKA, individuals exhibited only minor daily-life walking limitations compared with healthy peers. Although walking parameters improved relative to preoperative values, these changes were modest and of questionable clinical relevance, likely reflecting the relatively high functional status of patients before surgery.