Sprzężenie termiczne i mobilności: ciągłe wzorce interakcji temperatury kolana i kroków przewidują funkcjonalną regenerację po całkowitej artroplastyce kolana

BACKGROUND: Wearables increasingly quantify mobility after total knee arthroplasty (TKA), but local joint inflammation is still evaluated intermittently. It is unknown whether the interaction between knee temperature and free-living activity predicts recovery. OBJECTIVES: To determine whether early thermo-mobility coupling (TMC), defined as the temporal relationship between peri-patellar skin temperature and step-derived mobility, predicts 12-week functional outcomes after primary total knee arthroplasty (TKA). METHODS: In a prospective cohort at a tertiary center, adults undergoing unilateral primary TKA wore a peri-patellar temperature patch and thigh-mounted accelerometer continuously for 6 weeks postoperatively. Daily temperature metrics and step-based mobility measures were derived. TMC indices included within-day temperature-activity cross-correlation and the temperature load index (TLI), a step-weighted measure of peri-patellar thermal elevation. The primary outcome was the Knee Injury and Osteoarthritis Outcome Score-Activities of Daily Living (KOOS-ADL) at 12 weeks. Secondary outcomes included knee flexion range of motion (ROM), Timed Up-and-Go (TUG), and time to opioid cessation. RESULTS: Among 142 patients (mean age 67 ± 8 years, 64% women), higher maladaptive TMC during postoperative weeks 2-4 was independently associated with worse KOOS-ADL (- 8.1 points per SD), reduced flexion ROM (- 6.2°), slower TUG (+ 2.1 s), and delayed opioid cessation (hazard ratio 0.71), after adjustment for covariates. Patients in the most adaptive TMC quartile more often achieved clinically important KOOS-ADL improvement than those in the least adaptive quartile (78% vs. 43%). CONCLUSIONS: Continuous thermo-mobility coupling profiles carried prognostic information on early postoperative functional recovery after TKA and may help identify patients with potentially maladaptive recovery trajectories. Longer-term validation is required to determine whether early TMC patterns predict sustained functional outcomes beyond the 12-week postoperative period.