Abstract
BACKGROUND: Functional asymmetry and sensorimotor control impairments often persist in patients following total knee arthroplasty (TKA), yet they remain under-evaluated in routine clinical settings using simple, scalable tools. Understanding the relationship between these deficits and postoperative outcomes is critical for optimizing rehabilitation strategies. OBJECTIVES: To assess the prevalence and degree of functional asymmetry in individuals 6-12 months post-TKA using standardized physical therapy assessments, and to evaluate the predictive value of asymmetry and sensorimotor deficits on both functional performance and patient-reported outcomes. METHODS: A cross-sectional study was conducted on 125 patients aged 55-80 years, 6-12 months after unilateral primary TKA. Functional asymmetry was measured using the Single-Leg Sit-to-Stand (SLSST), Step-Down Test, and modified Star Excursion Balance Test (mSEBT). Functional outcomes included the Timed Up and Go (TUG) and 30-Second Chair Stand Test (30CST). In contrast, self-reported outcomes were assessed he KOOS-ADL and the KOOS-Function in Sport and Recreation (KOOS-Sport/Rec) subscales were administered. Correlations and multiple regression models were used to analyze relationships between asymmetry measures and outcomes. RESULTS: Significant correlations were found between asymmetry measures and both functional and self-reported outcomes (e.g., SLSST asymmetry and TUG: r = 0.47, p = 0.005; KOOS-ADL: r = -0.45, p = 0.007). Regression models identified SLSST, Step-Down, and mSEBT asymmetry as significant predictors of TUG (R(2) = 0.48, p < 0.001) and KOOS-ADL (R(2) = 0.53, p < 0.001). Patients with high asymmetry exhibited significantly poorer outcomes across all measures (all p < 0.01). CONCLUSION: Functional asymmetry and sensorimotor deficits are independently associated with poorer mobility and self-reported function post-TKA and can be effectively identified using clinically accessible tools, supporting their integration into routine postoperative assessment and rehabilitation planning.