ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2025
A clinical risk score enables early prediction of dissatisfaction 1 year after total knee arthroplasty.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 2 of them syntheses that pooled it.
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Who cites it
6 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Evaluating methodological quality of prognostic prediction models on patient-reported outcome measurements after total hip and total knee arthroplasty : a systematic review.Bone & joint open · 2026Pooled it
- Comparative efficacy and safety of bicompartmental versus total knee arthroplasty: a systematic review and update meta-analysis.Journal of orthopaedic surgery and research · 2025Pooled it
- Assessing symptom clusters in post-total knee arthroplasty patients: development and validation of a new scale.BMC musculoskeletal disorders · 2026Article
- A two to fifteen year follow-up case series of ninety one patients after onlay patellofemoral arthroplasty highlighting the impact of preoperative symptoms and mental health.International orthopaedics · 2026Article
- Pain catastrophizing immediately after surgery predicts postoperative patient satisfaction one year after total knee arthroplasty.Bone & joint open · 2025Article
- A clinical risk score enables early prediction of dissatisfaction 1 year after total knee arthroplasty.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Article
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6 authors.
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Abstract
purposeDissatisfaction after total knee arthroplasty (TKA) is a prevalent and clinically relevant problem that affects approximately 10%-20% of patients. The aim of this study is to identify factors associated with dissatisfaction 1 year after TKA.
methodsA total of 236 patients undergoing TKA were included in this prospective cohort study. Demographic data, preoperative clinical parameters (e.g., axial alignment, osteoarthritis severity) and patient-reported outcome measures (PROMs) were collected preoperatively, at 1 month and 1 year after TKA, encompassing the Knee Society Score (KSS) and Knee injury and Osteoarthritis Outcome Score (KOOS). The primary outcome was dissatisfaction 1 year after TKA, defined as ≤20 points on the KSS satisfaction scale. A risk score based on multiple regression and area under the curve (AUC) analyses was calculated to predict dissatisfaction.
resultsOne year after TKA, 16% of the patients were dissatisfied. Dissatisfied patients were significantly younger (p = 0.023) and had a higher body mass index (BMI) (p = 0.007). No differences were observed in preoperative objective (p = 0.903) and functional KSS (p = 0.346), pain (p = 0.306), osteoarthritis severity (p = 0.358), axial knee alignment (p = 0.984) or psychological distress (p = 0.138). The likelihood of dissatisfaction at 1 year was 3.0, 4.0, 7.4, 4.3 and 2.8 times higher amongst patients aged <63.5 years, with a BMI > 30.1 kg/m
conclusionDissatisfaction 1 year after TKA can be predicted by a weighted risk score that includes patient age, BMI, pain, subjective functionality and unmet expectation 1 month postoperatively. Using the risk score, early detection of dissatisfaction has the potential to enable targeted interventions and improve patients' quality of life. LEVEL OF EVIDENCE: Level II, Prognostic study.
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