Eleven studies involving at least 259 knees (some studies reported patient numbers, so there is some uncertainty) were included in the review.
The quality of the included studies was mixed, with no study reporting a representative study population, and all except one providing an adequate description of the patient group and a planned analysis. All of the studies used appropriate statistics.
Walking speed: although methods of measurement varied, in 8 of the 11 trials patients walked at a significantly slower speed than control groups.
Kinematic data: all studies showed that patients walked with less total range of knee motion and a reduced range of flexion during the loading phase of gait, and all except one found patients had less knee flexion during the swing phase of gait compared with healthy controls.
Kinetic data: 5 studies assessed the presence of a biphasic sagittal knee movement pattern. They found that approximately 80% of the control participants employed this pattern compared with between 20% and 36% of TKR patients. A range of other measures including maximum magnitudes of flexion and extension were assessed, but the authors were unable to fully assess the results.