BACKGROUND:Before total knee arthroplasty (TKA), males walk with biomechanics that are distinct from females. It is not known whether these sex-specific profiles are maintained after TKA and whether any differences reflect those typical of unimpaired males and females. The aim of this study was to compare knee biomechanics of males and females with TKA with unimpaired controls during walking. METHODS:Eighty-five participants (44 females and 41 males) who were at least 12 months after unilateral TKA and 39 matched control participants (21 females and 18 males) were included in this observational cohort study. All participants were assessed with 3-dimensional motion analysis during comfortable speed walking. RESULTS:All key biomechanics parameters during walking were significantly different between males with TKA and male controls (P < .01). There were no differences in the same parameters between females with TKA and female controls. CONCLUSION:Sex-specific biomechanics profiles are maintained after TKA. Biomechanics of females with TKA were closer to normal than males, suggesting that previous studies that investigate a mixed-sex cohort may have underestimated biomechanics outcome from TKA for females. Future studies should consider evaluating outcome from TKA independently for males and females.