The Time Course of Knee Swelling Post Total Knee Arthroplasty and Its Associations with Quadriceps Strength and Gait Speed

This study examines the time course of knee swelling post total knee arthroplasty (TKA) and its associations with quadriceps strength and gait speed. Eighty-five patients with unilateral TKA participated. Preoperatively and on post-operative days (PODs) 1, 4, 14, and 90, knee swelling was measured using bioimpedance spectrometry. Preoperatively and on PODs 14 and 90, quadriceps strength was measured using isokinetic dynamometry while fast gait speed was measured using the timed 10-meter walk. On POD1, knee swelling increased ~ 35% from preoperative levels after which, knee swelling reduced but remained at ~ 11% above preoperative levels on POD90. In longitudinal, multivariable analyses, knee swelling was associated with quadriceps weakness (P < 0.01) and slower gait speed (P = 0.03). Interventions to reduce post-TKA knee swelling may be indicated to improve quadriceps strength and gait speed.