ReviewKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2017
Greater pre-operative anxiety, pain and poorer function predict a worse outcome of a total knee arthroplasty.
Review in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 81 papers, 5 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Optimizing Implementation of Mental Health Intervention Within Orthopedic Care
Open-Label Randomized Controlled Trial to Assess Preoperative Acupuncture for Patients Undergoing Total Knee or Hip Arthroplasty
Acceptability and Feasibility of Acceptance and Commitment Therapy in Total Knee Arthroplasty Patients
Who cites it
81 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Postoperative Rehabilitation Interventions in Patients at Risk of Poorer Outcomes Following Total Knee Arthroplasty: A Systematic Review.Musculoskeletal care · 2025Pooled it
- Effects of Prehabilitation With Advanced Technologies in Patients With Musculoskeletal Diseases Waiting for Surgery: Systematic Review and Meta-Analysis.Journal of medical Internet research · 2024Pooled it
- Prehabilitation for Patients Undergoing Orthopedic Surgery: A Systematic Review and Meta-analysis.JAMA network open · 2023Pooled it
- Preoperative predictors of health-related quality of life changes (EQ-5D and EQ VAS) after total hip and knee replacement: a systematic review.BMC musculoskeletal disorders · 2022Pooled it
- The influence of perioperative interventions targeting psychological distress on clinical outcome after total knee arthroplasty.Rheumatology international · 2020Pooled it
- Predictors of Functional Recovery in Individuals Exposed to Late-Stage Exercise Programs After Total Knee Replacement: A Secondary Analysis of a Randomized Controlled Trial.Physical therapy · 2026Trial
- Optimism and pessimism are antithetically associated with post-operative knee function in patients' undergoing total knee arthroplasty.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Trial
- Local Efficacy of Corticosteroids as an Adjuvant for Periarticular Cocktail Injection in Simultaneous Bilateral Total Knee Arthroplasty: A Prospective Randomized Double-Blind Controlled Trial.Pain research & management · 2021Trial
- Timing of periarticular injection has no effect on postoperative pain and functional recovery in simultaneous bilateral total knee arthroplasty: a prospective randomized, double-blinded trial.BMC musculoskeletal disorders · 2019Trial
- Robotic-specific patient education reduces preoperative anxiety and improves outcomes after total knee arthroplasty.Journal of robotic surgery · 2026Article
- TASC: a time-aware sequence clustering framework with uncertainty quantification for electronic health record trajectories.BioData mining · 2026Article
- Distal Femoral Triangle Combined With Distal Adductor Canal Block Offers Superior Analgesia and Functional Recovery After Total Knee Arthroplasty Compared to Adductor Canal Block and iPACK: A Randomized Clinical Trial.Arthroplasty today · 2026Article
- No Additive Analgesic Effect of Interspace Between Popliteal Artery and Capsule of the Knee Block Over Local Infiltration Analgesia Only Around Arthrotomy Site in Bilateral Total Knee Arthroplasty.Arthroplasty today · 2026Article
- On the Move to Surgery: A Scoping Review of Patient-Reported Outcomes for Preoperative Walking Into the Operating Theatre.Journal of advanced nursing · 2026Article
- Use of Wearable Devices to Augment Traditional Measurements of Postoperative Outcomes Following Total Joint Arthroplasty: Systematic Review.JMIR rehabilitation and assistive technologies · 2026Review
- Article
- The Rollercoaster of Recovery: Changes in patient satisfaction after total knee arthroplasty in the prospective FInGK study.Orthopedic reviews · 2026Article
- Intravenous Dexamethasone Administered Perioperatively vs 8 Hours Prior to Incision to Control Pain after Total Knee Arthroplasty. A Prospective Randomized Clinical Trial.Arthroplasty today · 2025Article
- Effects of preoperative psychological stress on selected parameters in older patients undergoing total hip arthroplasty.World journal of psychiatry · 2025Article
- Catastrophism and anxiety are risk factors of chronic pain after total knee arthroplasty : a prospective cohort study.Bone & joint open · 2025Article
21 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeAround 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.
methodsA 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.
resultsTen 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.
conclusionPatients 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.
Indexed as
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.