Franklin, Patricia DLi, WenjunAyers, David C.2022-08-232022-08-232008-11-012010-02-17Clin 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>0009-921X (Linking)10.1007/s11999-008-0428-818810570https://hdl.handle.net/20.500.14038/43022Total 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.en-USAgedAged, 80 and overArthralgiaArthroplasty, Replacement, KneeAwards and PrizesBody Mass IndexDisability EvaluationFemaleFollow-Up StudiesHumansMaleOrthopedicsOsteoarthritis, KneePain MeasurementRange of Motion, ArticularRetrospective StudiesSocieties, MedicalTime FactorsTreatment OutcomeWalkingOrthopedicsRehabilitation and TherapyJournal Articlehttps://escholarship.umassmed.edu/ortho_pp/31150379ortho_pp/3