Abstract
BACKGROUND: Total knee replacement (TKA) is a frequent modality performed in patients with knee osteoarthritis (OA). The aim of this study was to perform a meta-analysis and systematic review to evaluate the efficacy after TKA by gait analysis in patients with OA. METHODS: PubMed, EMBASE, the Cochrane library, and Web of Science were searched for relevant studies from inception to July 2024. STATA SE 14.0 software was used for statistical analysis according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) guideline. RESULTS: A total of 2525 reports were identified with 24 studies meeting pre-designed inclusion criteria. Several gait parameters were investigated. In patients with knee OA after TKA, there existed an increase in the Max knee flexion (WMD, 3.12; 95% CI, 0.93 to 5.32; I(2) = 73.9%, P < 0.001), the Cadence (WMD, 4.05; 95% CI, 2.28 to 5.82; I(2) = 48.9%, P = 0.068), the stride length (WMD, 0.05; 95% CI, 0.01 to 0.09; I(2) = 77.1%, P < 0.001), the walking speed (WMD, 0.08; 95% CI, 0.02 to 0.14; I(2) = 93.3%, P < 0.001), and the step length (WMD, 0.04; 95% CI, 0.00 to 0.07; I(2) = 89.3%, P < 0.001) while a decrease in the double support time (WMD, -0.04; 95% CI, - 0.08 to -0.01; I(2) = 0.0%, P = 0.585). Besides, no statistically significant differences were observed in the Knee range of motion (ROM), the Max knee rotation at stance phase, the Max knee extension, the step width, the stride time and the step time. Sensitivity analysis showed that all the results were robust. CONCLUSIONS: In summary, the study found that, in patients with knee OA undergoing TKA may have great effects on improving gait parameters. If there are more high-quality studies in the future, we should make a more comprehensive evaluation of walking function by gait analysis together with other evaluation systems such as muscle strength and proprioception measurement.