ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2019
Increased symptoms of stiffness 1 year after total knee arthroplasty are associated with a worse functional outcome and lower rate of patient satisfaction.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.
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Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Causes of stiffness after total knee arthroplasty: a systematic review.International orthopaedics · 2021Pooled it
- The negative effect of joint line elevation after total knee arthroplasty on outcome.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2019Pooled it
- Total joint arthroplasty patients who experience the minimal clinically important difference for worsening (MCID-W) have higher revision rates at 1, 3, and 5 years postoperatively.Archives of orthopaedic and trauma surgery · 2025Article
- A development of machine learning models to preoperatively predict insufficient clinical improvement after total knee arthroplasty.Journal of orthopaedic surgery and research · 2025Article
- Growth Mixture Modeling of Patient-reported Outcomes After Total Knee Arthroplasty: No Recovery Trajectory Shows Postoperative Decline or Stagnation.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2025Article
- Extracorporeal Shock Wave and Melatonin Alleviate Joint Capsule Fibrosis after Knee Trauma in Rats by Regulating Autophagy.Current molecular medicine · 2025Article
- Functional somatic syndromes are associated with inferior outcomes and increased complications after hip and knee arthroplasty: a systematic review.Arthroplasty (London, England) · 2024Article
- Proximal tibial osteotomy with absorbable spacer combined with fibular osteotomy has similar clinical outcomes to high tibial osteotomy in the treatment of knee osteoarthritis.International orthopaedics · 2023Article
- Comparison of short-time functional outcomes after TKA between Multigen Plus CR and Physica KR prostheses.Musculoskeletal surgery · 2023Article
- Patient Satisfaction Following Primary Total Knee Arthroplasty: Contributing Factors.The archives of bone and joint surgery · 2021Review
- A new prediction model for patient satisfaction after total knee arthroplasty and the roles of different scoring systems: a retrospective cohort study.Journal of orthopaedic surgery and research · 2021Article
- Article
- Internal rotation of the tibial component in total knee arthroplasty can lead to extension deficit.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2020Article
- One-year Oxford knee scores should be used in preference to 6-month scores when assessing the outcome of total knee arthroplasty.Knee surgery & related research · 2020Article
- Revision total knee arthroplasty versus primary total knee arthroplasty: a matched cohort study.Bone & joint open · 2020Article
- Patients' experiences of discontentment one year after total knee arthroplasty- a qualitative study.BMC musculoskeletal disorders · 2020Article
- Comparison of the accelerometer-based navigation system with conventional instruments for total knee arthroplasty: a propensity score-matched analysis.Journal of orthopaedic surgery and research · 2019Article
- Diabetes mellitus does not increase the risk of knee stiffness after total knee arthroplasty: a meta-analysis of 7 studies including 246 053 cases.Knee surgery & related research · 2019Article
- Improved clinical outcomes after revision arthroplasty with a hinged implant for severely stiff total knee arthroplasty.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2019Article
- How do orthopaedic surgeons inform their patients before knee arthroplasty surgery? A cross-sectional study.BMC musculoskeletal disorders · 2018Article
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5 authors.
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Abstract
purposeSymptoms of stiffness after total knee arthroplasty (TKA) cause significant morbidity, but there is limited data to facilitate identification of those most at risk after surgery. Stratifying risk can aid earlier directed treatment options.
methodsA retrospective cohort consisting of 2589 patients undergoing a primary TKA was identified from an established arthroplasty database. Patient demographics, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and short form (SF) 12 scores were collected pre-operatively and 1 year post-operatively. In addition, patient satisfaction was assessed for 1 year. Patients with a worse WOMAC stiffness score in 1 year were defined as the "increased" stiffness group and the other cohort as the non-stiffness group.
resultsAt 1 year after surgery 129 (5%) patients had a significant increase in their stiffness symptoms (20%, 95% confidence interval (CI) 17.9-22.0, p < 0.001), and had significantly (all p < 0.001) less of an improvement in their pain, function and total WOMAC scores, and SF-12 scores compared to the non-stiffness group (n = 2460). Patient satisfaction was significantly lower (odds ratio (OR) 0.178, CI 0.121 to 0.262, p < 0.001) for the increased stiffness group. Logistic regression analysis identified male gender (OR 1.66, p = 0.02), lung disease (OR 2.06, p = 0.002), diabetes (OR 1.82, p = 0.02), back pain (OR 1.81, p = 0.005), and a pre-operative stiffness score of 44 or more (OR 5.79, p < 0.001) were significantly predictive of increased stiffness.
conclusionPatients with increased symptoms of stiffness after TKA have a worse functional outcome and a lower rate of patient satisfaction, and patients at risk of being in this group should be informed pre-operatively. LEVEL OF EVIDENCE: Retrospective prognostic study, Level III.
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