SynthesisArchives of orthopaedic and trauma surgery2023
The course of knee extensor strength after total knee arthroplasty: a systematic review with meta-analysis and -regression.
Synthesis in Archives of orthopaedic and trauma surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 22 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 2 syntheses or guidelines pooled it, 25 citations in OpenAlex.
- The role of quadriceps strength and quadriceps-focused rehabilitation following medial meniscus posterior root repair: a systematic review.Journal of orthopaedic surgery and research · 2026Pooled it
- Pooled it
- Preserving Patient-Specific Knee Motion: A Randomized Clinical Trial of Unicompartmental and Total Knee Arthroplasty.Journal of orthopaedic research : official publication of the Orthopaedic Research Society · 2025Trial
- Quadriceps muscle status after medial-pivot versus ultracongruent total knee arthroplasty using localized bioimpedance analysis: a randomized exploratory study.Arthroplasty (London, England) · 2026Article
- Gait Biomechanics, Symmetry Restoration, and Functional Recovery Following Total Knee Arthroplasty: A Prospective Longitudinal Cohort Study.Life (Basel, Switzerland) · 2026Article
- Major discrepancies in recommendations regarding long-term activity restrictions following knee replacement: a survey among Swedish physiotherapists.BMC musculoskeletal disorders · 2026Article
- Application of wearable neuromuscular electrical stimulation in home-based rehabilitation following total knee arthroplasty- a retrospective cohort comparison.BMC musculoskeletal disorders · 2026Article
- Impact of therapeutic exercises on pain-related outcomes in patients with knee osteoarthritis: an umbrella review of 116 systematic reviews.Frontiers in pain research (Lausanne, Switzerland) · 2026Review
- Objective functional performance 1 year after total knee arthroplasty does not differ for patients with symptoms of anxiety, depression or pain catastrophizing: A prospective study of 289 patients.Journal of experimental orthopaedics · 2026Article
- Localized bioimpedance reactance as a biophysical parameter of muscle recovery following total knee arthroplasty: a prospective self-controlled study.Frontiers in physiology · 2026Article
- Muscle Strength Training and Monitoring Device Based on Triboelectric Nanogenerator for Knee Joint Surgery.Micromachines · 2025Article
- Reliability of a portable device for measuring lower-limb muscle strength in patients who underwent total knee arthroplasty.Journal of physical therapy science · 2025Article
- Knee extensor muscle strength, physical function and patient-reported outcomes the first year after total knee arthroplasty: a prospective longitudinal study.BMC musculoskeletal disorders · 2025Observational
- Reduced Muscle Strength Can Alter the Impact of Gait Modifications on Knee Cartilage Mechanics.Journal of orthopaedic research : official publication of the Orthopaedic Research Society · 2025Article
- External femoral rotation of 2 degrees is associated with the lowest stuffing rates around the femur in functionally aligned TKA.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Article
- Article
- Functional quadriceps endurance, dynamic balance, and patient-reported recovery after total knee arthroplasty: a cross-sectional analysis of functional capacity and perceived disability.Frontiers in medicine · 2025Article
- Article
- Effect of lower-limb isokinetic muscle strengthening on knee function and joint contact force in knee osteoarthritis patients awaiting total knee arthroplasty: study protocol for a randomized controlled trial.Journal of orthopaedic surgery and research · 2024Article
- High expression of transcription factor EGR1 is associated with postoperative muscle atrophy in patients with knee osteoarthritis undergoing total knee arthroplasty.Journal of orthopaedic surgery and research · 2024Article
Corrections and comments
- Erratum issued
Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeMuscular strength loss and atrophy are postoperative complications. This systematic review with meta-analysis investigated the course of on knee extensor mass and strength from pre-surgery over total knee arthroplasty to rehabilitation and recovery.
methodsA systematic literature search was conducted in PubMed (Medline), Cochrane Library (CINAHL, Embase) and Web of Science (until 29th of June 2022). Main inclusion criteria were ≥ 1 preoperative and ≥ 1 measurement ≥ 3-months post-operation and ≥ 1 objective assessment of quadriceps strength, muscle mass or neuromuscular activity, measured at both legs. Studies were excluded if they met the following criteria: further impairment of treated extremity or of the contralateral extremity; further muscle affecting disease, or muscle- or rehabilitation-specific intervention. The Robins-I tool for non-randomized studies, and the Cochrane Rob 2 tool for randomized controlled studies were used for risk of bias rating. Pre-surgery, 3 months, 6 months and 1 year after surgery data were pooled using random effects meta-analyses (standardized mean differences, SMD, Hedge's g) in contrast to the pre-injury values.
results1417 studies were screened, 21 studies on 647 participants were included. Thereof, 13 were non-randomized controlled trails (moderate overall risk of bias in most studies) and 7 were randomized controlled trials (high risk of bias in at least one domain in most studies). Three (k = 12 studies; SMD = - 0.21 [95% confidence interval = - 0.36 to - 0.05], I
conclusionWe found moderate certainty evidence that deficits in muscle strength of the knee extensors persist and progress until 3 months post-total knee arthroplasty in patients with end-stage knee osteoarthritis. Very low certainty evidence exists that preoperatively existing imbalance of muscle strength and mass in favor of the leg not undergoing surgery is not recovered within 1 year after surgery.
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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.