Correlation study of kinesiophobia and functional rehabilitation after total knee arthroplasty

Total knee arthroplasty (TKA) is an effective surgical intervention for end-stage osteoarthritis, but patients often experience kinesiophobia after surgery, which may significantly impact their functional rehabilitation process. Kinesiophobia refers to an irrational fear of movement or re-injury, potentially leading to reduced activity, delayed recovery, and ultimately affecting the surgical treatment outcomes. Currently, systematic studies on the impact of kinesiophobia on functional rehabilitation after knee replacement remain limited. This retrospective cohort study reviewed the clinical data of 180 patients who underwent unicompartmental or total knee arthroplasty at a tertiary hospital between January 2022 and December 2024 through the electronic medical record system. Patient kinesiophobia levels were assessed using the Tampa Kinesiophobia Scale (TKS), and follow-up data from the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Short Physical Performance Battery (SPPB) were collected. The study analyzed patients' functional rehabilitation at 3, 6, and 12 months post-surgery, exploring the correlation between kinesiophobia and functional rehabilitation indicators. The study findings revealed a significant negative correlation between patients' kinesiophobia levels and functional rehabilitation status. Analysis of clinical data from 180 patients showed that those with higher TKS scores performed worse on WOMAC functional scores and SPPB tests. Specifically, patients with severe kinesiophobia (TKS score >40) demonstrated significantly lower joint range of motion, walking ability, and daily living activity capabilities at 6 months post-surgery compared to patients with lower kinesiophobia levels. Multivariate regression analysis indicated that kinesiophobia is an independent risk factor affecting functional rehabilitation after knee arthroplasty (p<0.01). The retrospective study results demonstrate that kinesiophobia significantly impacts the functional rehabilitation process of patients after knee replacement.