Are There Prognostic Factors for One-Year Outcome After Total Knee Arthroplasty? A Systematic Review

Harmelink, Karen E.M.; Zeegers, Adelgunde V.C.M.; Hullegie, Wim; Hoogeboom, Thomas J.; Sanden, M.W.G. Nijhuis-van der; Staal, J. Bart

doi:10.1016/j.arth.2017.07.011

Cited by 52 publications

(69 citation statements)

References 65 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The first was in relation to baseline function/disability with the majority of studies showing that worse baseline function predicted poor outcome, this was however not the case when studies looked at change scores rather than purely follow‐up outcome, for example Hofstede et al () found that a lower functional PROM score (indicating lower function) predicted worse outcome conforming to other studies but also to greater improvement (change). This was also found by Harmelink et al (), and Lungu, Maftoon, Vendittoli, and Desmeules (), Lungu, Vendittoli, and Desmeules (). This shows that patients with lower functional scores achieve a better outcome with regard to health gain but still a worse overall outcome than those with higher baseline scores in relation to follow‐up functional PROM scores achieved.…”

Section: Discussionsupporting

confidence: 81%

Predictors of functional outcome in musculoskeletal healthcare: An umbrella review

Burgess

Mansell

Bishop

et al. 2019

European Journal of Pain

View full text Add to dashboard Cite

Background Multiple cohort and systematic review studies exist, reporting independent predictive factors associated with outcome in musculoskeletal populations. These studies have found evidence for a number of “generic” factors that have been shown to predict outcome across musculoskeletal patient cohorts. This review provides a higher level review of the evidence with a focus on generic patient factors associated with functional musculoskeletal outcome with a view to informing predictive modelling. Objectives (a) Identify patient factors found to have evidence to support their association with functional outcome, and (b) review these findings across body areas/conditions to identify generic predictive factors. Databases and Data Treatment Electronic databases of MEDLINE, AMED, EMBASE, CINAHL and Cochrane were searched for eligible studies. Two reviewers independently extracted data and assessed quality using an established checklist for umbrella reviews. Results Twenty‐one systematic reviews met inclusion criteria, all were of moderate/high quality. Six independent predictors were found to have strong evidence of association with worse musculoskeletal functional outcome across anatomical body sites (worse baseline function, higher symptom/pain severity, worse mental well‐being, more comorbidities, older age and higher body mass index). Longer duration of symptoms, worse pain coping, presence of workers compensation, lower vitality and lower education were also found to have moderate evidence of association with worse functional outcome across body sites. Conclusions This study identifies a number of factors associated with musculoskeletal functional outcome. The generic predictive factors identified should be considered for inclusion into musculoskeletal prognostic models, including models used for case‐mix‐adjustment of patient reported outcome measure data. Significance This article identifies “generic” patient factors that predict functional outcome (measured using Patient Reported Outcome Measures (PROMs)) across musculoskeletal conditions. Findings provide support for the development and content of generic musculoskeletal prognostic models including models used to case‐mix adjust PROM data for baseline complexity. Generic musculoskeletal models and functional PROMs would facilitate more feasible comparison and benchmarking of musculoskeletal services in order to identify variation and address health inequalities.

show abstract

Section: Discussionsupporting

confidence: 81%

Predictors of functional outcome in musculoskeletal healthcare: An umbrella review

Burgess

Mansell

Bishop

et al. 2019

European Journal of Pain

View full text Add to dashboard Cite

show abstract

“…Third, studies report that pre-operative OA pain intensity has a strong influence on post-surgical outcomes [7]. It was recently argued that the evidence for this influence is of low-quality [9], and our results support the failure of pre-operative pain as a predictor of post-surgical outcomes. If we consider residual pain as the more direct metric of the influence of surgery on post-surgical OA pain, then we observe no relationship between pre-surgery OA pain and residual pain.…”

Section: Discussionsupporting

confidence: 75%

“…The proposed risk factors across studies are often diverse, tested thru univariable associations, different study designs and analysis methods. Overall, the quality of evidence on prognostic factors for recovery after total knee replacement (TKA) is low [9].…”

Section: Introductionmentioning

confidence: 99%

Prognostics for pain in osteoarthritis: Can clinical measures predict pain after total joint replacement?

Barroso

Wakaizumi

Reckziegel³

et al. 2019

Preprint

View full text Add to dashboard Cite

A significant proportion of osteoarthritis (OA) patients continues to experience moderate to severe pain after total joint replacement (TJR). So far, preoperative factors related to pain persistence have been mainly studied using individual predictor variables and distinct pain outcomes, thus leading to lack of consensus in the field. In this prospective observational study, we evaluated knee and hip OA patients before, 3 and 6 months post-TJR searching for clinical predictors of pain persistence. We assessed multiple measures of quality, mood, affect, health and quality of life, together with radiographic evaluation and performance-based tasks, modeling four distinct pain outcomes. Multivariate regression models were built, and a network analysis was applied to pain related biopsychosocial measures and their change with surgery. A total of 106 patients completed the study. Pre-surgical pain levels were not related to post-surgical residual pain. Distinct pain scales were associated with different aspects of the pain experience. Multi-factorial models did not reliably predict post-surgical pain in knee OA across four distinct pain scales and did not generalize to hip OA; however, network analysis of pain related biopsychosocial measures showed significant changes post-surgery in both groups. Our results show that although tested clinical and biopsychosocial variables are reorganizing after TJR in OA, they do not present as a robust markers for post-surgery pain outcomes. A better understanding of mechanisms underlying pain persistence after TJR is necessary to derive clinical prognostic factors.

show abstract

“…Although these have been studied repeatedly, there is extensive variation of outcome measures used and there is no agreement on which measures are optimal to assess chronic pain after TJR [7]. The proposed risk factors across studies are often diverse, tested through univariate associations, based on different study designs and analysis methods, thus the quality of evidence on prognostic factors for recovery after total knee replacement (TKA) remains low [12].…”

Section: Introductionmentioning

confidence: 99%

Prognostics for pain in osteoarthritis: Do clinical measures predict pain after total joint replacement?

et al. 2020

View full text Add to dashboard Cite

A significant proportion of osteoarthritis (OA) patients continue to experience moderate to severe pain after total joint replacement (TJR). Preoperative factors related to pain persistence are mainly studied using individual predictor variables and distinct pain outcomes, thus leading to a lack of consensus regarding the influence of preoperative parameters on post-TJR pain. In this prospective observational study, we evaluated knee and hip OA patients before, 3 and 6 months post-TJR searching for clinical predictors of pain persistence. We assessed multiple measures of quality, mood, affect, health and quality of life, together with radiographic evaluation and performance-based tasks, modeling four distinct pain outcomes. Multivariate regression models and network analysis were applied to pain related biopsychosocial measures and their changes with surgery. A total of 106 patients completed the study. Pre-surgical pain levels were not related to post-surgical residual pain. Although distinct pain scales were associated with different aspects of post-surgical pain, multi-factorial models did not reliably predict post-surgical pain in knee OA (across four distinct pain scales) and did not generalize to hip OA. However, network analysis showed significant changes in biopsychosocial-defined OA personality post-surgery, in both groups. Our results show that although tested clinical and biopsychosocial variables reorganize after TJR in OA, their presurgical values are not predictive of post-surgery pain. Derivation of prognostic markers for pain persistence after TJR will require more comprehensive understanding of underlying mechanisms.

show abstract

Are There Prognostic Factors for One-Year Outcome After Total Knee Arthroplasty? A Systematic Review

Cited by 52 publications

References 65 publications

Predictors of functional outcome in musculoskeletal healthcare: An umbrella review

Predictors of functional outcome in musculoskeletal healthcare: An umbrella review

Prognostics for pain in osteoarthritis: Can clinical measures predict pain after total joint replacement?

Prognostics for pain in osteoarthritis: Do clinical measures predict pain after total joint replacement?

Contact Info

Product

Resources

About