SynthesisBosnian journal of basic medical sciences2020
Neurostructural correlates of strength decrease following total knee arthroplasty: A systematic review of the literature with meta-analysis.
Synthesis in Bosnian journal of basic medical sciences, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.
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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.
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Who cites it
14 citing papers in PubMed, 2 syntheses or guidelines pooled it, 23 citations in OpenAlex.
- Effects of amino acid supplementation on muscle mass, muscle performance and functional capacity in subjects undergoing total knee arthroplasty: a systematic review of randomized clinical trials.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2024Pooled it
- Effects of motor imagery on strength, range of motion, physical function, and pain intensity in patients with total knee arthroplasty: A systematic review and meta-analysis.Brazilian journal of physical therapyPooled it
- Number of conditioning trials, but not stimulus intensity, influences operant conditioning of brain responses after total knee arthroplasty.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Trial
- Home-based motor imagery intervention improves functional performance following total knee arthroplasty in the short term: a randomized controlled trial.Journal of orthopaedic surgery and research · 2020Trial
- Muscle-specific changes of lower extremities in the early period after total knee arthroplasty: Insight from tensiomyography.Journal of musculoskeletal & neuronal interactions · 2020Trial
- Trial
- Ultrasound-Guided Muscle Enhancement and Support Therapy (MEST): Protocol Standardization and a Pilot Study in Refractory Chronic Pain After Total Knee Arthroplasty.Journal of pain research · 2026Article
- Article
- Persistent Fear and Extended Swing Phase During Stair Descent Following Total Knee Arthroplasty: A Case Report.Cureus · 2025Article
- Description of pain associated with persistent postoperative pain after total knee arthroplasty.Scientific reports · 2024Article
- Effects of proprioceptive neuromuscular facilitation and both sides up ball exercise on pain level, range of motion, muscle function after total knee arthroplasty.Journal of exercise rehabilitation · 2024Article
- The Synergistic Effects of Hyaluronic Acid and Platelet-Rich Plasma for Patellar Chondropathy.Biomedicines · 2023Review
- Effects of 24 Weeks of a Supervised Walk Training on Knee Muscle Strength and Quality of Life in Older Female Total Knee Arthroplasty: A Retrospective Cohort Study.Healthcare (Basel, Switzerland) · 2023Article
- Motor Imagery and Action Observation as Appropriate Strategies for Home-Based Rehabilitation: A Mini-Review Focusing on Improving Physical Function in Orthopedic Patients.Frontiers in psychology · 2022Review
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Recent literature suggests that alterations in both neural and structural components of the neuromuscular system are major determinants of knee extensor muscle weakness after total knee arthroplasty (TKA). Therefore, the goal of this study was to investigate the maximal voluntary strength (MVS), voluntary muscle activation (VMA), and the cross-sectional area (CSA) of the muscle, up to 33 months after the TKA. We searched relevant scientific databases and literature for outcomes of interest, including quadriceps MVS, VMA, and CSA. Ten studies met the inclusion criteria and involved a total of 289 patients. The quality of the studies was evaluated by Methodological Index for Non-Randomized Studies (MINORS). Results showed that quadriceps MVS markedly declines in the early postoperative period, after which it slowly and linearly recovers over time. However, the same phenomenon was not observed for VMA and CSA, which were not significantly altered after the TKA. Furthermore, a meta-regression analysis revealed that the change in VMA accounted for 39% of the relative change in quadriceps strength (R2=0.39; p=0.015) in the early postoperative period. Patients treated with TKA had considerable weakness of the quadriceps muscle, which was detectable up to 3 months after surgery. Although the change in VMA largely explains quadriceps weakness, this change and CSA differences were not significant, suggesting that other neural correlates, such as hamstrings coactivation, might alter quadriceps muscle function. Thus, more attention should be paid to address VMA failure and coactivation of antagonist muscles. More comprehensive rehabilitation approaches may be required to target the whole neural circuit controlling the motor action.
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Registered trials
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