Clinical and functional recovery after primary total knee replacement for osteoarthritis: A six-month prospective observational study

Total knee replacement (TKR) is the standard surgical treatment for end-stage knee osteoarthritis. Understanding the pace and pattern of functional recovery helps in counselling patients and planning rehabilitation. To evaluate changes in pain, joint function, range of motion, and activities of daily living over 6 months after primary unilateral TKR. In this prospective observational study, 30 patients with primary knee osteoarthritis undergoing primary unilateral TKR were enrolled by consecutive sampling. Patients were assessed preoperatively and at 6 weeks, 3 months, and 6 months using the Oxford Knee Score (OKS), the Numerical Rating Scale (NRS) for pain, goniometric knee flexion and extension deficit, and 0–100 functional scores for walking, stair climbing, sit-to-stand, and activities of daily living (ADL). The mean age was 64.6 ± 7.6 years, and 60% of patients were female. OKS improved from 18.71 ± 3.72 to 41.47 ± 3.48, NRS pain fell from 7.69 ± 1.09 to 1.36 ± 0.78, knee flexion increased from 85.32° to 116.98°, and extension deficit fell from 11.98° to 0.92° (all p < 0.001). Walking, stair climbing, sit-to-stand, and ADL scores each improved by 47 to 51 points (all p < 0.001). Most recovery occurred within 3 months, with smaller gains between 3 and 6 months. At least one complication occurred in 6 patients (20.0%); knee stiffness was the most common (10.0%). Primary TKR was associated with substantial, progressive improvement in pain, function, and mobility over 6 months, with the steepest gains in the first 3 months. Complications were not uncommon and warrant attention during follow-up.