Clinical outcomes and quality of life after Total Knee Replacement (TKR) - A systematic review
Bibliographic record
Abstract
Abstract Background The current review aimed to refresh the existing evidence on clinical effectiveness of Total Knee Replacement (TKR) in various settings, using a wide follow-up window, and to examine the determinants influencing the success of TKR, so the evidence can be systematically synthesized. Methodology Studies only with pre-post study designs, measuring patient reported outcome measures (PROMs) at two time points, pre-TKR and post-TKR, were included. Commonly used PROMs, such as Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Short Form (SF-36) were harmonized across studies from worst to best and in the range of 0-100 scale. Effect Sizes (ES) were computed using pre-post mean differences in PROMs, quantifying post-TKR changes in the OA-affected knee. Results A total of 27 studies were included in this review. During short-term follow-up (≤ 6 months), greater improvement in WOMAC components such as pain (ES = 2.0) and function (ES = 2.3) was observed as opposed to stiffness. There was an improvement in all the scales of SF-36 except general health post-TKR. Gender (female), co-morbidities and post-operative complications were associated with poor outcomes of TKR. Discussion Improvement in clinical outcomes and performance was observed after TKR, especially between 6 months and 1 year. There was less improvement in PROMs in the long term but without any deterioration within 10 years of follow-up period. Conclusion The overall findings of this review conclude the confirmation of older knowledge with fresh evidence that TKR is definitely a clinically effective and beneficial treatment for individuals with OA knee and that too in different settings. Systematic review registration The systematic review protocol was registered in INPLASY (Registration No: INPLASY202240166)
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.031 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.008 | 0.006 |
| Bibliometrics | 0.008 | 0.009 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".