Clinical and Functional Outcomes Following Primary Total Knee Arthroplasty in Patients With Knee Osteoarthritis: A Prospective Study

Background Osteoarthritis (OA) of the knee is a leading cause of disability among the elderly population, characterized by chronic pain and functional impairment. When conservative treatments fail to provide relief, total knee replacement (TKR) emerges as the gold standard surgical intervention. The effectiveness of TKR depends on appropriate patient selection, surgical technique, and structured post-operative rehabilitation. Methods A prospective cohort study was conducted at the Department of Orthopaedics, Shri B M Patil Medical College and Research Centre, Vijayapura, Karnataka, India, between April 2023 and December 2024. A total of 33 patients over the age of 50 years with grade 3 or 4 osteoarthritis were included after failure of non-operative therapy. All patients underwent TKR using the anteromedial parapatellar approach with a posterior-stabilized prosthesis. Patients were assessed pre-operatively and at post-operative day 5, 3 months, and six months using the Knee Society Score (KSS©). Statistical analysis was performed to evaluate score progression and its association with demographic variables. Results All patients had poor pre-operative KSS© (<60). By day 5 post-surgery, only 6.1% (2 out of 33) showed fair scores, while the majority remained poor. At the three-month follow-up, 72.7% (24 out of 33) of patients achieved excellent scores, and 27.2% (9 out of 33) had good scores. By six months, 100% of patients had excellent KSS©. Statistically significant associations were noted between KSS© scores at three months and both age (p=0.007) and gender (p<0.001). Complications were minimal, with only 9.1% (3 out of 33) reporting restricted range of motion and 3% (1 out of 33) experiencing superficial infection. Conclusion Primary TKR significantly improves clinical and functional outcomes in patients with osteoarthritic knees. Early post-operative recovery patterns may vary by age and gender, but outcomes equalize by six months. With proper surgical technique and rehabilitation, TKR proves to be a safe and highly effective treatment for end-stage knee osteoarthritis.