The Temporal-Spatial Parameters of Gait After Total Knee Arthroplasty

Introduction: Antalgic gait is characteristic for knee osteoarthritis. It is marked by a shortened swing phase and an extended stance phase, significantly deviating from biomechanical norms and resulting in a reduced step length. We hypothesized that total knee arthroplasty (TKA) would improve the temporal-spatial parameters of gait. Therefore, stride length, walking speed, and the relationship between gait performance changes and selected demographic features of the study group were measured, compared, and analyzed. Material and Methods: A total of 46 consecutive patients (24 women and 22 men) with unilateral knee osteoarthritis who underwent surgical treatment were enrolled in this prospective study. Group I (n=34) was assessed one day before surgery and again six weeks postoperatively. Group II (n=12) was evaluated preoperatively and 1.5 years after surgery. The study included three stages. In the first stage, patients were assigned to their respective groups based on the planned follow-up period. In the second stage, preoperative assessments of step length (m), walking speed (m/s), and cadence (steps/min) were conducted. In the third stage, selected gait parameters were reassessed: six weeks postoperatively in Group I and 1.5 years postoperatively in Group II. During the evaluation of step length and walking speed, gait was digitally recorded to ensure measurement precision. Cadence was assessed during a one-minute walk test. Throughout the study, patients walked naturally, in a manner reflecting their everyday locomotion. Results: In Group I, the mean step length slightly increased from 0.40 m (Min 0.175; Max 0.60) before surgery to 0.42 m (Min 0.21; Max 0.75) postoperatively. The stride length increased by 0.02 m, but this change was not statistically significant. The mean walking speed rose significantly from 0.41 m/s (Min 0.20; Max 0.88) preoperatively to 0.47 m/s (Min 0.23; Max 1.20) six weeks after surgery. Cadence showed a statistically significant increase from 72.9 steps/min (Min 60; Max 92) to 77.06 steps/min (Min 64; Max 92) (p = 0.044). In Group II, the average step length rose significantly from 0.39 m (Min 0.27; Max 0.60) before surgery to 0.52 m (Min 0.42; Max 0.68) at the 1.5-year follow-up. Walking speed also increased significantly from 0.44 m/s (Min 0.29; Max 0.82) preoperatively to 0.69 m/s (Min 0.44; Max 1.46) postoperatively. Cadence significantly improved from a mean of 73.7 steps/min (Min 60; Max 92) to 103.6 steps/min (Min 87; Max 121) at the final follow-up. Statistical analysis revealed a highly significant difference between preoperative and 1.5-year postoperative measurements all p values < 0.001. Conclusion: Total knee arthroplasty improves the temporal-spatial parameters of gait, measured by stride length and walking speed, both six weeks and 1.5 years after surgery.