Evidence map›Paper›PMID 40510505›Full record

ArticleJournal of orthopaedics2025

Preoperative range of motion as a predictor of postoperative outcomes in total knee arthroplasty under enhanced recovery after surgery protocols: Defining clinically relevant cut-offs.

R Radhakrishnan, A Padki, A X Han, X Liu, M H Liow, D K J Tay, S J Yeo, H N Pang, J Y Chen

Abstract read
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Article in Journal of orthopaedics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
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1 · What the graph read from 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.

2 · The registry

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3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

R RadhakrishnanDepartment of Orthopaedic Surgery, Singapore General Hospital, Singapore.
A PadkiDepartment of Orthopaedic Surgery, Singapore General Hospital, Singapore.
A X HanDepartment of Orthopaedic Surgery, Singapore General Hospital, Singapore.
X LiuDepartment of Orthopaedic Surgery, Singapore General Hospital, Singapore.
M H LiowDepartment of Orthopaedic Surgery, Singapore General Hospital, Singapore.
D K J TayDepartment of Orthopaedic Surgery, Singapore General Hospital, Singapore.
S J YeoDepartment of Orthopaedic Surgery, Singapore General Hospital, Singapore.
H N PangDepartment of Orthopaedic Surgery, Singapore General Hospital, Singapore.
J Y ChenDepartment of Orthopaedic Surgery, Singapore General Hospital, Singapore.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: The predictive role of preoperative range of motion (ROM) in total knee arthroplasty (TKA) under Enhanced Recovery After Surgery (ERAS) protocols remains underexplored. Objective: To identify clinically relevant preoperative ROM thresholds predictive of suboptimal postoperative motion in ERAS-based TKA. Methods: A retrospective cohort of 339 TKA patients managed under ERAS was analyzed. Preoperative ROM in extension (ROMS) and flexion (ROME) were assessed as predictors of postoperative ROM and functional outcomes. Correlation, regression, and ROC analyses were performed. Results: A preoperative ROMS cut-off of 30° demonstrated 100 % specificity for predicting poor postoperative extension (>10°) and flexion (<100°) (AUC = 0.361 and 0.420, respectively). Preoperative ROME predicted postoperative flexion with higher accuracy (AUC = 0.778) and an optimal threshold of 150°, achieving 100 % sensitivity and 99.6 % specificity. Preoperative ROM parameters, however, showed limited correlation with functional scores and patient-reported outcomes. Conclusion: A 30-degree preoperative ROMS serves as a highly specific predictor of postoperative ROM limitation, offering an actionable benchmark for patient selection and perioperative planning within ERAS pathways. Level of evidence: Level III, Retrospective cohort study.

Indexed as

Enhanced recovery after surgeryFixed flexion deformityKnee functionPredictive factorsPreoperative range of motionROC analysisTotal knee arthroplasty

Identifiers

PMID40510505
PMCPMC12152757

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