Relationship Between Gait Stability After Total Knee Arthroplasty and Preoperative Physical Function and Gait Variability: A Cross-Sectional Study

Background Gait analysis studies have provided valuable insights into gait variability and patterns across various patient populations. However, limited research has examined the relationship between preoperative physical functions, gait variability, and walking independence following total knee arthroplasty (TKA). This study aims to evaluate the potential utility of accelerometers for assessing preoperative gait characteristics by investigating the association between preoperative gait variability, physical functions, and the time required to achieve cane-walking independence after TKA. Methods We assessed 68 patients who underwent unilateral TKA. Preoperative physical therapy evaluations included measurements of knee flexion range of motion (ROM), knee extensor strength, walking pain, 10-meter walking speed (10 MWS), and gait coefficient of variation (CV). An acceleration sensor was attached to the spinous process of the third lumbar vertebra during walking to obtain CV results. A correlation analysis was then performed to examine the relationship between preoperative assessments and the number of days required to achieve cane-walking independence after TKA. Results The number of days required for cane-walking independence after TKA was negatively correlated with knee flexion ROM (r = -0.264, p < 0.05), knee extensor strength (r = -0.410, p < 0.01), and 10 MWS (r = -0.365, p < 0.01). In contrast, it was positively correlated with gait cycle CV (r = 0.374, p < 0.01). Discussion Preoperative knee joint function appears to influence the rehabilitation process following TKA. Furthermore, assessing gait variability quantitatively is essential when evaluating gait stability after TKA and preoperative physical functions. Conclusions Accelerometers provide a simple and effective method for quantifying gait characteristics in patients with knee osteoarthritis.