{"doi":"10.1002/jor.70052","title":"Preoperative and Post‐Rehabilitation Predictors of Gait Biomechanics Six Months After Total Knee Arthroplasty","abstract":"ABSTRACT The primary purpose of this study was to determine the preoperative predictors of gait biomechanics 6 months after unilateral total knee arthroplasty (TKA). There were 126 participants (age 64.4 ± 7.1 years, 75 females) who underwent instrumented biomechanical assessments while walking at a self‐selected pace preoperatively, 10 weeks after (post‐rehabilitation), and 6 months after unilateral TKA. Outcomes were peak knee extension moment (pKEM), knee angle excursion, and vertical ground reaction force (vGRF) ratio (surgical/contralateral). Potential clinical, demographic, and biomechanical predictors were tested univariately and considered a candidate for the final model if p < 0.15. Each multivariate model initially contained all candidates, and backward selection was used to determine the final model. Greater 6‐month surgical limb pKEM was predicted ( r 2 = 0.31) by greater preoperative pKEM ( β = 0.44, p < 0.0001), better quadriceps activation ( β = 0.23, p = 0.004), and male sex ( β = −0.21, p = 0.009). Greater 6‐month surgical knee excursion was predicted ( r 2 = 0.34) by greater preoperative excursion ( β = 0.39, p < 0.0001), male sex ( β = −0.28, p = 0.0007), and preoperative quadriceps strength ( β = 0.16, p = 0.047). Six‐month vGRF ratio was predicted ( r 2 = 0.16) by preoperative vGRF ratio ( β = 0.37, p < 0.0001) and study treatment group ( β = 0.18, p = 0.03). Preoperative biomechanical variables at post‐rehabilitation were also the strongest predictors of 6‐month biomechanics. Statement of Clinical Significance: The strongest and most consistent predictor of gait biomechanics 6 months after TKA was the respective preoperative gait biomechanics variable, which may have important clinical implications for surgical decision making and prehabilitation/rehabilitation strategies. Biofeedback targeting vGRF predicted vGRF symmetry, but no other gait parameters, suggesting targeted interventions are needed. Improving quadriceps strength and activation may also facilitate knee biomechanics.","journal":"Journal of Orthopaedic Research®","year":2025,"id":574467,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9327,"is_data_producer":true,"deposit_databanks":{"ClinicalTrials.gov":["NCT03325062"]},"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":382947,"name":"Joseph Zeni","orcid":"0000-0003-2457-428X","position":1,"is_corresponding":false},{"id":491986,"name":"Jeri E. Forster","orcid":"0000-0002-7955-9127","position":2,"is_corresponding":false},{"id":524299,"name":"Victor Cheuy","orcid":"0000-0002-3033-2255","position":3,"is_corresponding":false},{"id":1286286,"name":"Amy Peters","orcid":null,"position":4,"is_corresponding":false},{"id":925525,"name":"Craig Hogan","orcid":"0000-0002-1277-0067","position":5,"is_corresponding":false},{"id":1477835,"name":"Charlie C. Yang","orcid":"0000-0002-8483-3493","position":6,"is_corresponding":false},{"id":366048,"name":"Cory L. Christiansen","orcid":"0000-0003-3273-1169","position":7,"is_corresponding":false},{"id":342385,"name":"Jennifer E. Stevens‐Lapsley","orcid":"0000-0002-8118-378X","position":8,"is_corresponding":false},{"id":522281,"name":"Michael Bade","orcid":"0000-0002-7985-8565","position":9,"is_corresponding":false},{"id":495268,"name":"Jacob J. Capin","orcid":"0000-0001-9361-3700","position":0,"is_corresponding":true}],"reference_count":43,"raw_metadata":null,"created_at":"2026-07-19T02:57:40.686992Z","pmid":"40923522","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}