Modifiable and Nonmodifiable Predictive Factors Associated with the Outcomes of Total Knee Arthroplasty

Bonasia, Davide Edoardo; Palazzolo, Anna; Cottino, Umberto; Saccia, Francesco; Mazzola, Claudio; Rosso, Federica; Rossi, Roberto

doi:10.1055/s-0039-1678563

Cited by 16 publications

(6 citation statements)

References 47 publications

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“…The loss of motor function and muscle strength is compensated by various rehabilitation regimens and proper physical activity [60]. In fact, the best outcomes are achievable with complex perioperative interventions on muscle strength and management of nutrition, obesity, and other comorbidities [60][61][62][63].…”

Section: Total Knee Arthroplasty: Multimodality Means Successmentioning

confidence: 99%

Multimodal approach to intraarticular drug delivery in knee osteoarthritis

Georgiev

2020

Rheumatol Int

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The expectations from any future disease-modifying treatment for knee osteoarthritis (KOA) are extremely high as it has to impact the joint as a whole leading to favorable alterations of diverse tissues and functions. In this light, targeting the knee only from the inside may not be biologically justified for the management of a whole joint disease such as KOA. Our hypothesis to test is whether any injectable therapeutic intervention alone can lead to disease modification of KOA which is viewed in the complexity of the modern concept of osteoarthritis (OA) as a whole joint disease. Therefore, we aimed at analyzing the intraarticular route to the KOA patient in an attempt to unveil its "biological" constraints. A comprehensive search through databases was carried out using specific keywords to add objectivity to the main messages. The literature analysis has shown that "cutting-edge" intraarticular therapies may offer a key to non-invasive symptomatic relief. Changing the course of KOA, however, may necessitate a multimodal approach towards the knee joint including a combination of intraarticular injections with interventions on multiple levels. Importantly, our understanding of OA has evolved redefining the concept of the disease, being in interaction with the human body as a whole. Any future conservative disease-modifying treatment of KOA should aim at a multimodal, holistic approach towards the knee joint including but not limited only to intraarticular injections. A combination with other interventions should be further researched.

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Section: Total Knee Arthroplasty: Multimodality Means Successmentioning

confidence: 99%

Multimodal approach to intraarticular drug delivery in knee osteoarthritis

Georgiev

2020

Rheumatol Int

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“…Most factors we identified were non-modifiable factors. Understanding such factors allow healthcare professionals to stratify patients according to their risk of depression or depressive symptoms after hip fracture [ 44 ]. For example, the G allele of the 5HTR1A polymorphism, a serotonin receptor, is associated with depressive symptoms 1 year after hip fracture in the older population.…”

Section: Discussionmentioning

confidence: 99%

Prognostic factors of depression and depressive symptoms after hip fracture surgery: systematic review

et al. 2021

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Background Patients with hip fracture and depression are less likely to recover functional ability. This review sought to identify prognostic factors of depression or depressive symptoms up to 1 year after hip fracture surgery in adults. This review also sought to describe proposed underlying mechanisms for their association with depression or depressive symptoms. Methods We searched for published (MEDLINE, Embase, PsychInfo, CINAHL and Web of Science Core Collection) and unpublished (OpenGrey, Greynet, BASE, conference proceedings) studies. We did not impose any date, geographical, or language limitations. Screening (Covidence), extraction (Checklist for critical Appraisal and data extraction for systematic Reviews of prediction Modelling Studies, adapted for use with prognostic factors studies Checklist), and quality appraisal (Quality in Prognosis Studies tool) were completed in duplicate. Results were summarised narratively. Results In total, 37 prognostic factors were identified from 12 studies included in this review. The quality of the underlying evidence was poor, with all studies at high risk of bias in at least one domain. Most factors did not have a proposed mechanism for the association. Where factors were investigated by more than one study, the evidence was often conflicting. Conclusion Due to conflicting and low quality of available evidence it is not possible to make clinical recommendations based on factors prognostic of depression or depressive symptoms after hip fracture. Further high-quality research investigating prognostic factors is warranted to inform future intervention and/or stratified approaches to care after hip fracture. Trial registration Prospero registration: CRD42019138690.

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“…Obesity has been determined as a factor influencing outcomes after TKA. Increased complication risks, including infections, thrombotic events, and implant loosening, have been widely reported in patients with obesity compared with those without obesity [ 24 , 25 , 26 ]. However, the effect of obesity on patient-reported outcomes remains unclear.…”

Section: Introductionmentioning

confidence: 99%

Association between Obesity and Short-Term Patient-Reported Outcomes following Total Knee Arthroplasty: A Retrospective Cohort Study in Japan

Ishimoto,

Mutsuzaki,

Shimizu

et al. 2024

JCM

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Background: This study investigated the association between obesity and short-term patient-reported outcomes after total knee arthroplasty (TKA). Methods: The primary outcomes were the Western Ontario and McMaster Universities Osteoarthritis Index’s (WOMAC) pain and function scores. Data were collected preoperatively and 2 and 4 weeks after surgery. Patients were stratified into three groups based on body mass index (BMI): normal weight (BMI < 24.99 kg/m2), overweight (25 ≤ BMI < 29.99 kg/m2), and obese (BMI ≥ 30 kg/m2). The associations between BMI and the WOMAC pain and function scores were assessed using generalized linear mixed models. Results: Among the 102 patients (median age: 75.0, women [85.3%]), 29.4%, 48.0%, and 22.5% were normal weight, overweight, and obese, respectively. The mean pain and function scores at baseline were similar across the BMI-stratified groups (p = 0.727 and 0.277, respectively). The pain score significantly improved 2 weeks post-surgery (p = 0.001). The function score improved significantly 4 weeks post-surgery (p < 0.001). The group and group-by-time interaction effects lacked statistical significance. Conclusions: All patients statistically and clinically showed relevant pain reduction and functional improvement shortly after TKA, irrespective of their obesity status. These data may help healthcare professionals discuss the expectations of pain amelioration and functional improvement with TKA candidates.

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Modifiable and Nonmodifiable Predictive Factors Associated with the Outcomes of Total Knee Arthroplasty

Cited by 16 publications

References 47 publications

Multimodal approach to intraarticular drug delivery in knee osteoarthritis

Multimodal approach to intraarticular drug delivery in knee osteoarthritis

Prognostic factors of depression and depressive symptoms after hip fracture surgery: systematic review

Association between Obesity and Short-Term Patient-Reported Outcomes following Total Knee Arthroplasty: A Retrospective Cohort Study in Japan

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