The Temporal-Spatial Parameters of Gait After Total Knee Arthroplasty.

Gait abnormalities in advanced knee osteoarthritis (KOA) are characterized by decreased stride length, walking speed, and cadence. Total knee arthroplasty (TKA) is intended to improve temporal-spatial gait parameters; however, the extent and timing of functional recovery remain under investigation. To assess changes in stride length, walking speed, and cadence following TKA in short- and long-term perspectives, and to compare outcomes with a non-operated KOA cohort. A prospective observational study was conducted involving 46 patients with unilateral KOA (grades III-IV, Kellgren-Lawrence scale) who underwent cemented TKA via a medial parapatellar approach. Group I ( = 34) was assessed one day prior to surgery and six weeks postoperatively. Group II ( = 12), a follow-up subset, was reassessed 1.5 years postoperatively. Group III ( = 34) served as a non-operated control group, assessed only preoperatively. Temporal-spatial gait parameters were evaluated under standardized conditions using a two-dimensional video analysis (Kinovea software version 0.8.27). Stride length (m) and walking speed (m/s) were assessed during continuous walking along a 15 m corridor, with at least three valid gait cycles averaged per trial. Cadence (steps/min) was determined during a one-minute walk and verified frame-by-frame. No structured outpatient physiotherapy was provided; all patients followed a standardized in-hospital rehabilitation protocol. In Group I, the mean stride length increased from 0.40 ± 0.10 m to 0.42 ± 0.10 m ( = 0.247), walking speed improved from 0.41 ± 0.027 m/s to 0.47 ± 0.022 m/s ( = 0.063), and cadence increased significantly from 72.9 ± 7.8 to 77.1 ± 8.6 steps/min ( = 0.044). In Group II, the mean stride length rose from 0.39 ± 0.10 m to 0.52 ± 0.09 m ( < 0.001), walking speed improved from 0.44 ± 0.02 m/s to 0.69 ± 0.01 m/s ( < 0.001), and cadence increased from 73.7 ± 8.8 to 103.6 ± 7.4 steps/min ( < 0.001). Compared to the control group (Group III: stride length 0.42 ± 0.09 m; walking speed 0.41 ± 0.02 m/s; cadence 73.9 ± 7.9 steps/min), Group II demonstrated superior values across all parameters ( < 0.001 for each comparison). No significant correlations were observed between BMI and gait outcomes. Total knee arthroplasty resulted in progressive improvement in temporal-spatial gait parameters. While early postoperative gains were limited, substantial functional restoration was observed at long-term follow-up, emphasizing the importance of extended recovery monitoring in post-TKA evaluation.