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dc.contributor.authorFranklin, Patricia D
dc.contributor.authorLi, Wenjun
dc.contributor.authorAyers, David C.
dc.date2022-08-11T08:10:08.000
dc.date.accessioned2022-08-23T16:56:52Z
dc.date.available2022-08-23T16:56:52Z
dc.date.issued2008-11-01
dc.date.submitted2010-02-17
dc.identifier.citationClin Orthop Relat Res. 2008 Nov;466(11):2597-604. <a href="http://dx.doi.org/10.1007/s11999-008-0428-8">Link to article on publisher's site</a>
dc.identifier.issn0009-921X (Linking)
dc.identifier.doi10.1007/s11999-008-0428-8
dc.identifier.pmid18810570
dc.identifier.urihttp://hdl.handle.net/20.500.14038/43022
dc.description.abstractTotal knee replacement effectively relieves arthritis pain but improvement in physical function varies. A clearer understanding of the patient attributes associated with differing levels of functional gain after TKR is critical to surgical decision making. We reviewed 8050 primary, unilateral TKR patients enrolled in a prospective registry between 2000 and 2005 who had complete data. We evaluated associations between 12-month function (SF12/PCS) and preoperative gender, age, BMI, emotional health (MCS), knee diagnosis, quadriceps strength, and physical function (PCS). More than 98% of patients reported pain relief (KS pain score). At 12 months, mean PCS gain was 13.6 points, but the distribution was bimodal. The mean gain in PCS in the 63% of patients with greater improvement was 21 (SD = 7), and 4.1 (SD = 7) in the remaining 37%. Increased likelihood of poor functional gain was associated with older age, body mass index (BMI) over 40, lower MCS, and poor quadriceps strength. While two-thirds of patients reported functional gain well above national average at 12 months post-TKR, 37% reported limited functional improvement. Further understanding of the patient attributes associated with limited improvement will guide the design of innovative strategies to improve functional outcomes. LEVEL OF EVIDENCE: Level II, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=18810570&dopt=Abstract">Link to Article in PubMed</a>
dc.relation.urlhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC2565049/
dc.subjectAged
dc.subjectAged, 80 and over
dc.subjectArthralgia
dc.subjectArthroplasty, Replacement, Knee
dc.subjectAwards and Prizes
dc.subjectBody Mass Index
dc.subjectDisability Evaluation
dc.subjectFemale
dc.subjectFollow-Up Studies
dc.subjectHumans
dc.subjectMale
dc.subjectOrthopedics
dc.subjectOsteoarthritis, Knee
dc.subjectPain Measurement
dc.subjectRange of Motion, Articular
dc.subjectRetrospective Studies
dc.subjectSocieties, Medical
dc.subjectTime Factors
dc.subjectTreatment Outcome
dc.subjectWalking
dc.subjectOrthopedics
dc.subjectRehabilitation and Therapy
dc.titleThe Chitranjan Ranawat Award: functional outcome after total knee replacement varies with patient attributes
dc.typeJournal Article
dc.source.journaltitleClinical orthopaedics and related research
dc.source.volume466
dc.source.issue11
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/ortho_pp/3
dc.identifier.contextkey1150379
html.description.abstract<p>Total knee replacement effectively relieves arthritis pain but improvement in physical function varies. A clearer understanding of the patient attributes associated with differing levels of functional gain after TKR is critical to surgical decision making. We reviewed 8050 primary, unilateral TKR patients enrolled in a prospective registry between 2000 and 2005 who had complete data. We evaluated associations between 12-month function (SF12/PCS) and preoperative gender, age, BMI, emotional health (MCS), knee diagnosis, quadriceps strength, and physical function (PCS). More than 98% of patients reported pain relief (KS pain score). At 12 months, mean PCS gain was 13.6 points, but the distribution was bimodal. The mean gain in PCS in the 63% of patients with greater improvement was 21 (SD = 7), and 4.1 (SD = 7) in the remaining 37%. Increased likelihood of poor functional gain was associated with older age, body mass index (BMI) over 40, lower MCS, and poor quadriceps strength. While two-thirds of patients reported functional gain well above national average at 12 months post-TKR, 37% reported limited functional improvement. Further understanding of the patient attributes associated with limited improvement will guide the design of innovative strategies to improve functional outcomes. LEVEL OF EVIDENCE: Level II, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.</p>
dc.identifier.submissionpathortho_pp/3
dc.contributor.departmentDepartment of Medicine, Division of Preventive and Behavioral Medicine
dc.contributor.departmentClinical and Population Health Research Program
dc.contributor.departmentDepartment of Orthopedics and Physical Rehabilitation
dc.source.pages2597-604


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