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

**Authors:** Kunihiro Onishi, Yasushi Miura, Shigeharu Tanaka, Ryoma Nakatani, Nobuhisa Sato, Hiroyoshi Iwaki, Kazuhiro Matsui

PMC · DOI: 10.7759/cureus.80714 · Cureus · 2025-03-17

## TL;DR

This study explores how pre-surgery knee function and walking patterns affect recovery time after knee replacement surgery.

## Contribution

The study introduces accelerometers as a practical tool for assessing gait variability and its impact on post-surgery recovery.

## Key findings

- Better knee flexibility and strength are linked to faster recovery to cane-walking independence.
- Higher gait variability is associated with longer recovery times after surgery.
- Accelerometers can effectively measure gait stability and variability preoperatively.

## Abstract

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.

## Full-text entities

- **Diseases:** knee osteoarthritis (MESH:D020370), pain (MESH:D010146)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## References

26 references — full list in the complete paper: https://tomesphere.com/paper/PMC12002005/full.md

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Source: https://tomesphere.com/paper/PMC12002005