Meta-analysis finds initial walking speed positively impacted by knee arthroplasty

Javad Parvizi, MD

The article by Abbasi-Bafghi and colleagues unravels yet another attribute of total knee arthroplasty (TKA) in restoring function to our patients and alleviating their pain. The investigators, by conducting a meta-analysis of 16 published articles, have found that TKA improves walking speed of patients at 6 months to 12 months. As a knee surgeon, this is one aspect of function that I have so far been failing to discuss with my patients. Having read this well-written article, I will be sure to include this in future discussions.

The reason for improved walking speed of these patients, though multifactorial, in my opinion relates directly to alleviation of pain that is experienced after knee replacement. It is not surprising, though it is reassuring to see, why the walking speed and other functional parameters improve once the chronic arthritis with the underlying stiffness is removed and the near-normal biomechanical milieu is restored to the joint.

The meta-analysis is well executed and the findings can be relied upon for future discussions with patients. However, like any meta-analysis, there are some shortcomings of this study — most important of which relates to the fact that there were not many level 1 studies on the subject. The findings are compelling enough to persuade us to design relevant studies to investigate this interesting aspect of functional recovery of patients undergoing TKA.