Participants were recruited from an orthopedic outpatient clinic at Maharaj Nakorn Chiang Mai Hospital, Thailand, between September 2020 and August 2021. Patients were approached by the study coordinator during their attendance at the clinic following surgeon assessment for TKA and assessed for eligibility and willingness to participate. Eligible criteria included patients 50–80 years of age with a clinical and radiographic diagnosis of severe knee osteoarthritis (Kellgren and Lawrence grade IV) by one of the arthroplasty consultants and placed on the waiting list for unilateral TKA. Exclusion criteria were revision surgery, history of septic or inflammatory arthritis, body mass index (BMI) > 36 kg/m2, severe coronal deformity > 20° which would be potentially deleterious to postoperative outcome if the patient was randomized, and unable to ambulate independently preoperatively.
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