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Cited by 151Total Knee Arthroplasty OutcomesMusculoskeletal pain and rehabilitationAnesthesia and Pain Management

The DOI matches its Crossref record; 32 of the 32 references it cites were found in a registry or an index.

Greater pre-operative anxiety, pain and poorer function predict a worse outcome of a total knee arthroplasty

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Alattas, Sharifah Adla, Smith, Toby, Bhatti, Maria, Wilson-Nunn, Daniel, Donell, Simon·2017·Knee Surgery, Sports Traumatology, Arthroscopy
DOI 10.1007/s00167-016-4314-8PMC PMC5644683
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Abstract

PURPOSE: Around 10-30 % of patients are dissatisfied with the results of their total knee arthroplasty (TKA). This review aimed to identify and evaluate the predictors of outcome measured by the three domains of health-related quality of life (pain, stiffness and function). The focus was on pre-operative psychological factors as related to other patient-related variables. METHODS: A systematic search was performed using the following databases: MEDLINE, PubMed, AMED, CINAHL, PsychINFO, SciFinder, Scopus, EMBASE, Cochrane, Lilacs, Web of Science and ScienceDirect. The quality of identified studies was assessed using the Critical Appraisal Skills Programme Cohort checklist. RESULTS: Ten studies met the eligibility criteria. From these, nine patient-related predictors of outcome were identified (depression, anxiety, age at surgery, gender (being female), medical co-morbidities, BMI, level of education, pre-operative pain severity and pre-operative knee function). Greater anxiety, pre-operative pain and function were the most significant factors to predict a poorer outcome of a TKA. The results of depression, gender (female), medical co-morbidities, BMI and level of education were variable among the included studies. There was very little evidence to support older age at operation as a predictor of poorer outcome. CONCLUSION: Patients experiencing high levels of pain before surgery should be informed of the chances of improvement by having a TKA. A validated psychological screening tool that separates depression and anxiety is recommended as part of the pre-operative assessment stage. Patients presenting with symptoms of depression and anxiety should be identified and consulted before a TKA. LEVEL OF EVIDENCE: II.

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Metadata

Authors
Alattas, S. A., Smith, T., Bhatti, M., Wilson-Nunn, D., & Donell, S.
Affiliations
  • University of East Anglia (GB)
  • University of Warwick (GB)
Corresponding author
  • Alattas, Sharifah Adla
  • Smith, Toby
  • Bhatti, Maria
  • Wilson-Nunn, Daniel
  • Donell, Simon
ORCID
Venue
Knee Surgery, Sports Traumatology, Arthroscopy
Publisher
Wiley
Published
2016-10-12
Volume
25
Issue
11
Pages
3403-3410
ISSN
  • 0942-2056 (ISSN-L)
  • 1433-7347
DOI
10.1007/s00167-016-4314-8
PMC
PMC5644683
OpenAlex
W2531661140
Cited by
151
References
32
Citations by year
2026: 11 · 2025: 20 · 2024: 15 · 2023: 25 · 2022: 14 · 2021: 17 · 2020: 29 · 2019: 9 · 2018: 8 · 2017: 3
FWCI
1.32
Type
journal article
Language
en
Open access
Licence
Locations
  • Knee Surgery Sports Traumatology Arthroscopy (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • UEA Digital Repository (University of East Anglia) (acceptedVersion, cc-by)
Funders
University of East Anglia
Topics
  • Health Sciences › Medicine › Surgery › Total Knee Arthroplasty Outcomes
  • Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Anesthesia and Pain Management
Keywords
total knee arthroplasty, preoperative anxiety, preoperative pain, knee function, health-related quality of life, patient satisfaction, predictors of surgical outcome, depression, psychological screening, preoperative assessment, comorbidities, body mass index
MeSH terms
Adult, Aged, Aged, 80 and over, Anxiety, Depression, Female, Humans, Knee Joint, Male, Middle Aged, Quality of Life, Risk Factors, Cohort Studies, Treatment Outcome, Arthralgia, Arthroplasty, Replacement, Knee, Osteoarthritis, Knee

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