Impact of Gluteus Medius Strengthening Based Knee Rehabilitation on Radiographic Knee Alignment and Muscle Function in Patients Following Total Knee Arthroplasty

Total knee arthroplasty (TKA) can correct lower-limb alignment; however, postoperative muscle weakness may persist and affect functional recovery. This study investigated the effects of early gluteus medius–based rehabilitation on knee muscle function and coronal lower-limb alignment following TKA. Eighty-eight patients undergoing TKA were randomly assigned to either a con-ventional knee rehabilitation (CKR) group or a gluteus medius–based rehabilitation (GBR) group. Both groups completed a 12-week rehabilitation program beginning 2 days after surgery. The hip–knee–ankle (HKA) angle was assessed using weight-bearing radiographs, and isokinetic knee ex-tensor and flexor strength and endurance were measured at angular velocities of 60°/s and 180°/s. Outcomes were analyzed using a two-way repeated-measures analysis of variance. HKA align-ment improved significantly over time in both groups (p < 0.001). Compared with the CKR group, the GBR group demonstrated greater improvements in knee extensor and flexor strength and en-durance (p < 0.001) and less variability in post-intervention HKA values. These findings suggest that early gluteus medius–based rehabilitation may enhance postoperative knee muscle recovery and support more consistent coronal alignment following TKA.