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Patients exhibit persistent inter-limb asymmetries in kinematics (reduced knee flexion\/range of motion), kinetics (elevated knee adduction moment and increased contralateral loading), plantar pressure distribution, and muscle strength (15\u201330% quadriceps deficit), even with bilaterally matched disease severity. These asymmetries endure for months to years after total knee arthroplasty (TKA), manifesting as reduced weight-bearing on the operated limb and compensatory overloading of the contralateral limb. The high incidence of contralateral TKA (39% within 10 years) underscores the clinical importance of persistent biomechanical asymmetry as a prominent and modifiable contributor to OA progression in the opposite knee. 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