Differences in ankle and knee muscle architecture and plantar pressure distribution among women with knee osteoarthritis.

BACKGROUND: The aim of this study was to compare the plantar pressure distribution and knee and ankle muscle architecture in women with and without knee osteoarthritis (OA). METHODS: Fifty women with knee OA (mean age = 52.11 ± 4.96 years, mean Body mass index (BMI) = 30.94 ± 4.23 kg/m2) and 50 healthy women as a control group (mean age = 50.93 ± 3.78 years, mean BMI = 29.06 ± 4.82 kg/m2) were included in the study. Ultrasonography was used to evaluate knee and ankle muscles architecture and femoral cartilage thickness. The plantar pressure distribution was evaluated using the Digital Biometry Scanning System and Milleri software (DIASU, Italy). Static foot posture was evaluated using the Foot Posture Index (FPI), and pain severity was assessed using the Visual Analog Scale. RESULTS: The OA group exhibited lower muscle thickness in Rectus Femoris (RF) (p = 0.003), Vastus Medialis (VM) (p = 0.004), Vastus Lateralis (p = 0.023), and Peroneus Longus (p = 0.002), as well as lower Medial Gastrocnemius pennation angle (p = 0.049) and higher Fat thickness (FT) in RF (p = 0.033) and VM (p = 0.037) compared to the control group. The OA group showed thinner femoral cartilage thickness (p = 0.001) and higher pain severity (p = 0.001) than the control groups. FPI scores were higher (p = 0.001) in OA group compared to the control group. The plantar pressure distribution results indicated an increase in total surface (p = 0.027), total load (p = 0.002), medial load (p = 0.005), and lateral load (p = 0.002) on dominant side in OA group compared to the control group. CONCLUSIONS: Knee and ankle muscle architecture, knee extensor muscle FT, and plantar pressure distribution in the dominant foot differed in individuals with knee OA compared to the control group.

Translation and Cross-Cultural Adaptation of the Anterior Cruciate Ligament Donor Site Morbidity Questionnaire Into Turkish.

This study aimed to translate the ACL Donor Site Morbidity (ACL-DSM) questionnaire into Turkish and assess the reliability and validity of the Turkish version of the ACL-DSM questionnaire (ACL-DSM-Tr) among individuals following anterior cruciate ligament (ACL) reconstruction. The process involved forward and back-translation, cultural adaptation, and validation of the ACL-DSM-Tr questionnaire on ninety-nine patients (mean age 30.73 ± 8.55 years). Participants completed ACL-DSM-Tr, International Knee Documentary Committee (IKDC) subjective form, ACL Return to Sport (ACL-RSI), and Forgotten Joint Scale (FJS) questionnaires. The internal consistency, reliability, and validity of the ACL-DSM-Tr were analyzed. The ACL-DSM-Tr demonstrated a high internal consistency (Cronbach's alpha .755) and excellent test-retest reliability (Spearman correlation r = .811, p < .001; Cronbach's alpha .890). The ACL-DSM-Tr score exhibited a strong positive correlation with the IKDC score (r = .690, p < .001) and a moderate positive correlation with the FJS score (r = .535, p < .001). Despite a fair correlation between ACL-DSM-Tr and ACL- RSI subgroup scores, no significant correlation was observed with the ACL-RSI total score (p = .297). In conclusion, the ACL-DSM-Tr demonstrated internal consistency, reliability, and validity in patients with ACL reconstruction. This questionnaire has the potential to yield significant benefits in monitoring patient satisfaction and evaluating the level of comfort experienced at the donor site following ACL reconstruction.

Altered Ankle Muscle Activation at 2-Year Post Achilles Tendon Repair: An Age, Gender, and Activity Level-Matched Comparison With Healthy Subjects.

CONTEXT: The study purpose was to compare the ankle muscle activation and dynamic ankle joint stability of subjects who underwent endoscopy-assisted Achilles tendon repair (ATR; at ≥ 2 y postsurgery) with age, gender, and activity level-matched healthy control group subjects. DESIGN: Prospective, cross-sectional study. All functional tests were performed on the involved ankle of the ATR group, and at the matched side of healthy age, gender, and activity-level control group subjects. METHODS: Fifteen men in each group were evaluated for medial and lateral gastrocnemius, soleus, tibialis anterior, and peroneus longus muscle activation during modified star excursion balance test and heel-rise test performance. The weight-bearing lunge test (ankle dorsiflexion) and heel-rise test distance (ankle plantar flexion) also determined weight-bearing, active ankle mobility magnitudes. The Achilles Tendon Total Rupture Score and Foot and Ankle Outcome Score provided patient-reported outcome perceptions specific to Achilles tendon rupture and comprehensive foot and ankle symptoms and function, respectively. RESULTS: Medial (P = .005) and lateral (P = .012) gastrocnemius displayed greater activation amplitudes in the ATR group during the star excursion balance test, and peroneus longus displayed greater activation amplitudes during the heel-rise test (P = .006). The star excursion balance test reach distance was comparable between groups. Active weight-bearing ankle plantar flexion (heel-rise test) and dorsiflexion (weight-bearing lunge test) mobility magnitudes were lower in the ATR group. CONCLUSIONS: Subjects who underwent endoscopy-assisted percutaneous ATR had reduced active weight-bearing ankle dorsiflexion and plantar flexion mobility magnitudes and greater gastrocnemius and peroneus longus neuromuscular activation when performing the same tasks as healthy control group subjects. As surgical approaches evolve to less invasive, soft tissue preserving methods with less tissue morbidity and faster healing, rehabilitation approaches may likewise need to evolve. LEVEL OF EVIDENCE: Level III.

Manual lymphatic drainage and Kinesio taping applications reduce early-stage lower extremity edema and pain following total knee arthroplasty.

BACKGROUND: Controlling early symptoms following total knee arthroplasty (TKA) is critical for long-term outcomes. OBJECTIVE: The purpose of this study was to compare the efficacy of manual lymphatic drainage (MLD) and Kinesio Taping®(KT) applications in terms of reducing lower extremity edema, pain, and improving function in the early postoperative period of TKA. METHODS: Forty-five female patients with unilateral TKA were allocated to an additional postoperative MLD treatment (n = 15) with exercises, additional Kinesio Taping® (n = 15) with exercises, or exercise-only (n = 15). Lower limb circumference, range of motion (ROM), pain level, and knee osteoarthritis outcome score (KOOS) were compared. RESULTS: Both MLD (p < .001; effect size range = 0.65-0.87) and the KT group (p = .001; effect size range = 0.74-0.78) had lower edema and pain levels (MLD group: p < .001; effect size = 0.84; KT group: p < .001; effect size = 0.78) compared to the control group on postoperative day 4. These beneficial effects continued only two weeks postoperatively, and no group differences were found by six weeks. CONCLUSION: Additional MLD or KT applications to standard exercises were both effective on early-stage lower extremity edema and pain levels. Clinicians might implement one of these applications to the standard rehabilitation programs to control pain and edema following TKA.

Frontal plane lower extremity alignment in adolescent athletes with chronic hip adductor-related groin injury symptoms: A case-control study.

OBJECTIVE: To compare trunk and lower extremity frontal plane projection angles (FPPA) during single leg squat (SLS) performance, perceived hip and groin function and symptoms, and isometric hip strength of adolescent athletes with chronic hip adductor-related groin injury (HARGI) symptoms and age, gender, and sport-matched healthy subjects. DESIGN: Case-control study. SETTING: Junior Olympic Development Training Centre. PARTICIPANTS: Twenty-six athletes at 59.1 ± 60 weeks (range = 12-208 weeks) post-index grade II HARGI injury who had continued sport training (injury group) and 26 control group subjects. MAIN OUTCOME MEASURES: SLS trunk, hip, and knee FPPA, isometric hip strength standardized to bodyweight, and Copenhagen Hip and Groin Outcome Scores (HAGOS). RESULTS: The injury group had greater bilateral knee FPPA, and greater injury side hip FPPA during maximum SLS. Injury group HAGOS subscale scores were lower than control group scores. Hip abductor, adductor, external rotator, and internal rotator strength was lower at the injury side of the injury group compared to the matched control group limb. Forward stepwise multiple regression analysis of the injury group found that 50% of injury side knee FPPA was predicted by hip internal rotator strength and time post-index HARGI; and 47% of injury side hip FPPA was predicted by other side hip flexor strength and the HAGOS function, sport and recreation subscale score (p = 0.002). CONCLUSIONS: Greater injury side hip and bilateral knee FPPA during maximum SLS, lower self-reported hip symptom and function scores, and less injury side hip abductor, adductor, external rotator and internal rotator strength suggests that adolescent athletes with chronic HARGI symptoms are at an increased risk for sustaining a non-contact knee injury. Impaired hip internal rotator strength at the side of the chronic HARGI was related to increased knee FPPA, and impaired hip flexor strength at the other side of the HARGI was related to increased hip FPPA. Findings support using SLS performance testing in this athlete group to help determine safe return to sport training readiness.

Supervised exercises have superior effects compared to home-based exercises for patients with knee osteoarthritis following platelet-rich plasma injection.

The purpose of the study was to compare the effectiveness of physiotherapist-supervised and home-based exercises after platelet-rich-plasma (PRP) injection in knee osteoarthritis (OA). Thirty women (mean age = 57.83 ± 7.26 years; mean weight = 72.13 ± 15.54 kg; mean height = 158.40 ± 4.49 cm; mean body mass index = 28.75 ± 6.18 kg/m2) were included. Patients randomized either supervised or home-basedexercise-group after PRP. Both groups performed 6-week (3 times/week) exercise. Pain, hip and knee muscle strength, and knee functions were assessed before and after exercise. The median improvement in the pain from baseline to 6th week was 3.80 (2.85-5.55) point in-supervised-exercise-group while it was 0.60 (-0.10-2.55) point in home-based-exercise-group (p = 0.002). The median improvement in knee function was 22.91 (13.02-30.20) in supervised-exercise-group overtime (p < 0.001). There was no improvement in knee function following home-based exercises (p = 1.000). The supervised-exercise-group revealed a significant improvement in hip (median difference = 32.00 (8.30-88.95), p = 0.011); quadriceps (median difference = 32.10 (21.65-60.05), p = 0.001) and hamstring (median difference = 27.90 (7.95-37.65), p = 0.022) strength overtime. The physiotherapist-supervised exercises after PRP had better effects on pain and knee function than the home-based exercises.

Shoulder Range of Motion, Rotator Strength, and Upper-Extremity Functional Performance in Junior Tennis Players.

PURPOSE: Repetitive and asymmetric movements in tennis can result in biomechanical adaptation in shoulder joint. The aim of this study was to investigate the differences in shoulder range of motion (ROM), strength, and functional performance tests between the dominant and nondominant shoulders, as well as to identify gender differences in junior tennis players. METHODS: Forty-two junior tennis players (age mean: 11.3 [1.2] y, body mass index 18.3 [2.4] kg/m2) were included in the study. Shoulder internal rotation (IR), external rotation (ER) ROM, and total ROM, IR and ER isokinetic strength and closed kinetic chain upper-extremity stability, seated medicine ball throw used, grip hold tests were applied bilaterally. Paired sample t test and Student t test were used to compare the differences. RESULTS: ER ROM was greater, while IR ROM and total ROM were lower on the dominant shoulder (all P values < .05). Nineteen players had glenohumeral IR deficit (IR ROM difference >13°). The players had a greater ER strength on the dominant side and similar IR strength between shoulders. There was significant difference in seated medicine ball throw results between the dominant and nondominant sides (P < .001). The mean distance for bilateral seated medicine ball throw was 377.02 (85.70) m, and closed kinetic chain upper-extremity stability results were calculated as a mean of 15.85 (1.72) touches. Differences between the genders: total ROM of the dominant shoulder was higher in female players (P = .045), the IR PT/BW at 60°/s angular speed was higher in male players' dominant shoulder (P = .030), and closed kinetic chain upper-extremity stability performance was higher in male players (P = .019). CONCLUSIONS: Adolescent tennis players demonstrated differences in strength, ROM, and functional performance results between the dominant and nondominant shoulders. Gender differences were also seen in the aforementioned parameters in junior tennis players. Determining these differences may improve our understanding of sport-specific shoulder joint adaptations in tennis.

Postoperative rehabilitation and outcomes following arthroscopic isolated meniscus repairs: A systematic review.

OBJECTIVES: The purpose of this study was to review the current literature on rehabilitation protocols following arthroscopic meniscus repair. METHODS: A systematic literature review was performed of Medline, Scopus, and Web of Science databases to identify relevant articles from January 1990 to April 2019. Search terms were (meniscus OR meniscal repair) AND (repaired OR repair) AND (rehabilitation OR physiotherapy OR physical therapy). Each study was independently scored for methodological research quality level using the Modified Coleman Methodology Score (MCMS). The following variables were extracted from each study: publication year, study type, evidence level, subject demographics, injury mechanism, meniscus tear type, surgical procedure, rehabilitation program [immobilization, weight bearing, ROM progression, therapeutic exercises, length of follow-up, patient-reported outcome measurements, return to sport timing/criteria and failure rate/criteria. RESULTS: Eighteen studies met the inclusion criteria. The overall MCMS was moderate 59.5 ± 11.7 (range = 42-90). The average MCMS score for postoperative rehabilitation was 4.7 ± 1.18. Only 1 (5.6%) study was a prospective randomized controlled trial and 14 studies (78%) had retrospective designs. Fourteen (78%) studies suggested that return to sports should occur between 3 and 6 months post-surgery. Early range of motion and immediate weight-bearing had no influence over patient-reported outcomes or failure rates for vertical meniscus tear repairs. CONCLUSION: Low MCMS scores, primarily retrospective study designs and poorly described postoperative rehabilitation protocols made it difficult to design an evidence-based therapeutic rehabilitation program for patients following arthroscopic repair of an isolated meniscus tear. An arthroscopic isolated meniscal tear repair rehabilitation protocol is being attempted to present based on a synopsis of existing evidence.

Higher Body Mass Index Adversely Affects Knee Function After Anterior Cruciate Ligament Reconstruction in Individuals Who Are Recreationally Active.

OBJECTIVE: Our aim was to investigate the effect of body mass index (BMI) levels on quadriceps and hamstring strength and functional outcomes up to 6 months after anterior cruciate ligament reconstruction (ACLR) with hamstring tendon autograft (HTG). DESIGN: Prospective, controlled study. SETTING: University clinical laboratory. PATIENTS: Ninety-one participants who had undergone unilateral ACLR with HTG were divided into 2 groups according to their BMI. The participants whose BMI were between 18.5 and 24.9 kg/m were included in group 1 (n = 50, age: 27.2 ± 6.7 years, BMI: 22.3 ± 1.6 kg/m) and those whose BMI > 24.9 kg/m were included in group 2 (n = 41, age: 30.2 ± 6.9 years, BMI: 28.0 ± 2.4 kg/m). INTERVENTIONS: Quadriceps and hamstring strength, functional performance including hop, jump, and balance performance, and IKDC score. MAIN OUTCOME MEASURES: Maximum voluntary isometric contraction of the quadriceps and hamstring muscles and the body mass were measured at 1, 3, and 6 months after surgery. Absolute peak torques and normalized peak torques to body weight for both limbs were recorded. Functional outcomes were evaluated at 6 months after surgery. RESULTS: Normalized quadriceps strength improvement was lower in group 2 when compared with group 1 (F(2,178) = 6.23, P = 0.003). Group 2 also demonstrated lower scores in functional performance (P < 0.05). Normalized hamstring and absolute quadriceps and hamstring strength improvement was not affected by higher BMI level (P > 0.05). CONCLUSIONS: Higher BMI levels adversely affect quadriceps strength capacity and performance in patients who have undergone ACLR with HTG. Clinicians should consider BMI levels of patients when assessing and targeting muscle recovery because it could negatively affect the success of the ACLR rehabilitation.

Quadriceps tendon autograft ACL reconstructed subjects overshoot target knee extension angle during active proprioception testing.

PURPOSE: To compare the active joint position sense (JPS), muscle strength, and knee functions in individuals who had anterior cruciate ligament (ACL) reconstruction with quadriceps tendon autograft, hamstring tendon autograft, tibialis anterior allograft and healthy individuals. It was hypothesized that when compared to an age and gender-matched healthy control group, subjects who were post-ACL reconstruction would display impaired active joint position sense, knee extensor and flexor strength symmetry and knee function at 1 year post-surgery. A secondary hypothesis was that differences would exist between the quadriceps tendon autograft, hamstring tendon autograft and tibialis anterior allograft groups. METHODS: Sixty-seven patients with ACL reconstruction and 20 healthy individuals were included. Active JPS reproduction was measured at 15°, 45° and 75° of knee flexion. International Knee Documentation Committee (IKDC) subjective score and one-leg hop test were used to assess the functional status of the patients. RESULTS: The JPS detection was different at the 15° target angle between groups (F3.86 = 24.56, p < 0.001). A significantly higher proportion of quadriceps tendon autograft group patients failed to identify the 15° active JPS assessment position compared to the other groups (p < 0.0001). The quadriceps index was lower in patients compared to healthy individuals (p < 0.001), while the hamstring index was similar (n.s.). The knee functional outcomes were similar between ACL reconstructed groups and healthy controls (n.s.). CONCLUSION: Knee proprioception deficits and impaired muscle strength were evident among patients at a mean 13.5 months post-ACL reconstruction compared with healthy controls. Patients who underwent ACL reconstruction using a quadriceps tendon autograft may be more likely to actively over-estimate knee position near terminal extension. Physiotherapists may need to focus greater attention on terminal knee extension proprioceptive awareness among this patient group. LEVEL OF EVIDENCE: III.

Effects on Lower Extremity Neuromuscular Control Exercises on Knee Proprioception, Muscle Strength, and Functional Level in Patients with ACL Reconstruction.

OBJECTIVE: The purpose of this study was to determine the effects of lower extremity motor control exercises on knee proprioception, muscle strength, and functional level in patients with anterior cruciate ligament reconstruction (ACL-R). MATERIALS AND METHODS: Thirty-two of the 57 patients with ACL-R using tibialis anterior allografts were divided into two groups. Group I: lower extremity motor control exercises were added to the standard rehabilitation program. Group II: standard rehabilitation program was applied. Effects of lower extremity motor control exercises on quadriceps and hamstring muscles strength, knee joint position sense, and hop test were evaluated. RESULTS: There were no differences in muscle strength and endurance of the quadriceps and hamstring between the operative and nonoperative sides in Group I (p > 0.05) while there were significant differences in strength of the quadriceps and hamstring between the operative and nonoperative sides in Group II (p < 0.05). There were significant differences in the endurance of the quadriceps and hamstring and knee joint position sense at 15°, 45°, and 75° between the operative sides of the patients in both groups (p < 0.05). CONCLUSIONS: The neuromuscular control exercises program was found to be more effective in reducing the difference in strength while the standard program was found to be more effective in reducing the difference in endurance between the operated knee and the other knee. This study revealed that neuromuscular control exercises should also be used to improve knee proprioception sense following ACL-R.

Correlation of force sense error test measured by a pressure biofeedback unit and EMG activity of quadriceps femoris in healthy individuals.

BACKGROUND: Our study developed a force sense error test (FSET) method for use on the quadriceps muscle, which could be employed in clinical practice to correlate the results of quadriceps muscle activity levels determined by surface electromyography (sEMG). METHODS: Twenty-four healthy individuals were included in the study. A pressure biofeedback unit (PBU) placed under the knee joint, was used for force sense error test (FSET) evaluation. First, a maximum contraction value was determined with the PBU. Next, 50% and 65% of the maximum contraction value were used for the analysis. Concurrently, norm values for the quadriceps muscle activity levels were determined by sEMG. Simultaneously, quadriceps muscle activity levels were recorded while testing the FSET using the PBU. Each measurement was repeated in triplicate, and the average constant errors observed by the PBU were recorded in mmHg. RESULTS: The FSET for both 50% and 65% of the normal mmHg value determined using the PBU positively correlated with activity change levels in the quadriceps muscle determined by sEMG (p < 0.05). CONCLUSIONS: The relationship between the FSET measured using PBU and changes in the level of activity in the quadriceps muscle showed that a PBU can be used in clinical practice for proprioceptive evaluation of the knee region.

Musculoskeletal treatment in haemophilia.

Haemophilia is a group of coagulation disorders inherited in an X-linked recessive pattern.Nearly three-quarters of all haemorrhages in haemophilia occur in the musculoskeletal system, usually in the large muscles and joints of the lower extremity.While prevention of bleeding with active prophylaxis is the recommended optimal therapy for severe haemophilia, there are many patients suffering from musculoskeletal system complications subsequent to uncontrolled bleeding.Recombinant clotting factor concentrates led to home treatment of acute bleeding episodes as well as allowing for minor and major surgical interventions.Avoiding of further complications by radiosynoviorthesis is the first-line recommendation, and arthroplasty is regarded as the effective salvage procedure for patients presenting with severe disability.Physiotherapy and rehabilitation in haemophilia patients are important to return the normal status of joint motion, to regain the muscle strength, to obtain the optimal functional levels and to improve patients' quality of life. Cite this article: EFORT Open Rev 2019;4 DOI: 10.1302/2058-5241.4.180068.

Relationship Between Middle Trapezius Muscle Activation and Acromiohumeral Distance Change During Shoulder Elevation With Scapular Retraction.

CONTEXT: The scapular retraction exercises are widely used among clinicians to balance the activity of the scapular muscles as well as the rotator cuff muscles in different shoulder abduction positions. OBJECTIVES: The aim of this study was to investigate the relationship between scapular (middle and upper trapezius) and shoulder muscles (middle deltoid and infraspinatus) activation level differences and acromiohumeral distance changes during shoulder abduction with scapular retraction. DESIGN: Cross-sectional study. SETTING: University research laboratory. PARTICIPANTS: Nineteen asymptomatic individuals were included (mean [SD]: age = 22.4 [1.8] y). MAIN OUTCOME MEASURE: The acromiohumeral distance was measured at 0° and 90° shoulder abduction when the scapula was in nonretracted and retracted position with ultrasound imaging. The relationship between muscle activation level changes and acromiohumeral distance difference was analyzed with the Pearson correlation test. RESULTS: Middle trapezius muscle activity change correlated with acromiohumeral distance difference (r = .55, P = .02) from 0° to 90° shoulder abduction when scapula was retracted. For both nonretracted and retracted scapular positions, no correlations were found between middle deltoid, infraspinatus, and upper trapezius muscle activity changes with acromiohumeral distance differences during shoulder abduction (P > .05). CONCLUSIONS: Active scapular retraction exercise, especially focusing on the middle trapezius muscle activation, seems to be an effective treatment option to optimize the acromiohumeral distance during shoulder abduction.

Active Scapular Retraction and Acromiohumeral Distance at Various Degrees of Shoulder Abduction.

CONTEXT: Performing shoulder-abduction exercises with scapular retraction has been theorized to reduce the potential for shoulder impingement. However, objective data to support this premise are lacking. OBJECTIVE: To evaluate the influence of active scapular retraction on acromiohumeral distance (AHD) at 4 shoulder-abduction angles using real-time ultrasound. DESIGN: Cross-sectional study. SETTING: University laboratory. PATIENTS OR OTHER PARTICIPANTS: Twenty asymptomatic individuals (10 men, 10 women; age = 22.9 ± 2.8 years, height = 169.3 ± 9.5 cm, mass = 65.5 ± 12.9 kg) were recruited. MAIN OUTCOME MEASURE(S): Real-time ultrasound images of AHD were obtained during nonretracted and retracted scapular conditions at 0°, 45°, 60°, and 90° of shoulder abduction. A 2-factor analysis of variance with repeated measures was used to evaluate the influence of shoulder retraction on AHD across shoulder-abduction angles. RESULTS: A scapular-retraction condition × shoulder-abduction-angle interaction for AHD was found ( F3,57 = 4.56, P = .006). The AHD was smaller at 0° (10.5 versus 11.2 mm, respectively; t19 = 2.22, P = .04) but larger at 90° (9.4 versus 8.7 mm, respectively; t19 = -2.30, P = .04) of shoulder abduction during the retracted than the nonretracted condition. No differences in AHD were observed between conditions at 45° ( t19 = 1.45, P = .16) and 60° ( t19 = 1.17, P = .86) of abduction. CONCLUSIONS: The observed differences in AHD at 0° and 90° of shoulder abduction were small and did not exceed the established minimal detectable change for either angle. Our findings suggest that active scapular retraction during shoulder abduction has a minimal influence on AHD at 0° and 90° in healthy individuals. Further investigations are needed to determine whether scapular retraction influences AHD in individuals with subacromial impingement.

Does kinesiophobia affect the early functional outcomes following total knee arthroplasty?

The purpose of this study was to investigate the effects of kinesiophobia on early functional outcomes in patients following total knee arthroplasty (TKA) and how kinesiophobia is related to functional outcomes and pain. The Tampa Scale for Kinesiophobia (TSK), 2-minute walk test (2-MWT), and the timed up and go test (TUG) were used to assess 46 TKA patients on discharge day. The pain levels and active knee flexion range of motion (ROM) were recorded. Patients were divided into two groups as high kinesiophobia (Group I, n = 22) and low kinesiophobia (Group II, n = 24) based on the TSK levels. The TUG results were similar between groups (p = 0.826). 2-MWT results (p < 0.001), pain levels (p = 0.003), and knee flexion ROM (p = 0.025) scores were better in Group II when compared to Group I. The TSK scores were significantly correlated with 2-MWT results (r = -0.40; p = 0.003), pain levels (r = 0.80; p < 0.001), and knee flexion ROM (r = -0.47; p = 0.001). The regression analysis revealed that 41% of 2-MWT score, 47% of knee flexion ROM, and 60% of pain level changes could be explained by kinesiophobia level. The results suggest that early outcomes following TKA were affected by the pain-related fear of movement. The clinicians need to consider the interrelationships between fear of movement and functional outcomes when designing, implementing, and monitoring daily therapeutic exercise programs.