Preoperative kinesiophobia is associated with delayed early knee flexion ROM recovery after unicompartmental knee arthroplasty

Purpose To examine the association between preoperative kinesiophobia and postoperative recovery of passive knee range of motion (ROM) in patients undergoing unicompartmental knee arthroplasty (UKA).Materials and methods This retrospective observational study included 52 patients with knee osteoarthritis who underwent UKA. Preoperative kinesiophobia was assessed using the Tampa Scale for Kinesiophobia (TSK). Passive knee flexion and extension ROM were measured preoperatively and at 1 week, 2 weeks, 4 weeks, 3 months, and 6 months postoperatively. Associations between preoperative TSK and postoperative ROM trajectories were analysed using linear mixed-effects models with participant-specific random intercepts. Additional models were adjusted for age, sex, body mass index, and preoperative pain severity.Results For passive knee flexion ROM, significant TSK-by-time interactions were observed at 1 week, 2 weeks, 4 weeks, and 3 months, indicating that higher preoperative kinesiophobia was associated with smaller postoperative improvement during early recovery. The interaction at 6 months was not significant. These findings were unchanged after adjustment. No significant TSK-by-time interactions were found for passive knee extension ROM.Conclusions Higher preoperative kinesiophobia was associated with smaller early postoperative improvement in passive knee flexion ROM, but not knee extension ROM, after UKA. Preoperative psychological assessment may help identify patients who may experience slower early ROM recovery.