| Study | Participants | Number of patients | Follow-up period | Outcome Measure | Statistical method | Statistical adjustment | Results | ||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Diagnosis | Type of Surgery | Mean Age (SD) | Gender (%female) | Significant Determinants | Non-significant Determinants | ||||||
| Alzahrani et al. (2011) [33] | Primary or secondary OA | Primary unilateral TKA | Cohort A: 67.5 (9.6) | Cohort A: 62% | Cohort A: 457 | 1 year | No clinical improvement at 1 year: Minimal Clinically Important Difference WOMAC: ≤ 7.5/100 points OKS: ≤ 5.0/60 points | Logistic regression |
Age, Gender BMI Comorbidity |
Cohort A: Increased age at time of surgery (-): OR 1.06 (95% CI 1.02-1.09) | Cohort A Gender BMI Comorbidity |
| Cohort B: 69.0 (9.1) | Cohort B: 63% | Cohort B: 2720 | Cohort B: Male gender (+): OR 0.72 (95% CI 0.57-0.92) | Cohort B: Age BMI Comorbidity | |||||||
| Overall: 68.2 (9.4) | Overall: 63% | Overall: 3177 | |||||||||
| Ayers et al. (2005) [42] | OA | Primary unilateral TKA | 68.0 (9.8) | 62.4% | 165 | 12 months | 12 month WOMAC-Physical function score improvement (change score) | Blocked multiple regression | NONE | Age (unclear) Gender (unclear) Worse preoperative physical function (WOMAC function) (-) Higher pre-operative mental health (SF-36 mental component score) (+) |
NONE |
| Baker et al. (2012) [16] | OA | Primary unilateral TKA | Not available | Not available | 22691 | 6 - 12 months (median 199 days) |
6 – 12 month OKS improvement (change score) | Stepwise multiple linear regression | NONE |
Higher age (+): estimate = 0.06 (95% CI 0.04 to 0.07) Higher preoperative function and lower pain (-): estimate = -0.66 (95% CI -0.67 to -0.64) Higher number of comorbidities (-): estimate = -0.25 (95% CI -0.39 to -0.12) Presence of self-reported pre-operative disability (-) estimate = -1.49 (95% CI -1.75 to -1.23) Very good self-reported pre-operative general health (vs. excellent) (-): estimate = -1.12 (95% CI -1.78 to -0.45) Good self-reported pre-operative general health (vs. excellent) (-): estimate = -2.78 (95% CI -3.42 to -2.12) Fair self-reported pre-operative general health (vs. excellent) (-): estimate = -5.23 (95% CI -5.93 to -4.53) Poor self-reported pre-operative general health (vs. excellent) (-): estimate = - 8.13 (95% CI -9.09 to -7.16) Presence of depression (-): estimate = -0.95 (95% CI -1.44 to 0.46) Moderate anxiety/depression (vs. no anxiety/depression) (-): estimate = -1.17 (95% CI -1.45 to -0.90) Severe anxiety/depression (vs. no anxiety/depression) (-): estimate = -2.78 (95% CI -3.48 to -2.07) ASA Grade 3 (vs. Grade 1) (-): estimate = -1.00 (95%CI -1.52 to -0.49) PFC prosthesis brand (vs NexGen) (-): estimate = -0.98 (95%CI -1.35 to -0.62) Genesis 2 prosthesis brand (vs NexGen) (-): estimate = -1.50 (95%CI -2.02 to -0.98) AGC prosthesis brand (vs NexGen) (-): estimate = -1.20 (95%CI -1.68 to -0.72) Triathlon prosthesis brand (vs NexGen) (-): estimate = -1.74 (95%CI -2.16 to -1.36) Independent hospital (vs. NHS hospital) (+): estimate = 0.83 (95%CI 0.35 to 1.31) ISTC (vs. NHS hospital) (+): estimate = 1.84 (95%CI 1.23 to 2.45) |
ASA Grade 2 |
| Caracciolo et al. (2005) [37] | OA | Primary TKA | 71.6 (6.6) | 81% | 47 | 6 months | WOMAC function score at 6 months | Logistic regression | NONE | Higher preoperative function (+), OR = 1.15, 95% CI = 1.04 to 1.28, compared to lower preoperative function (worst quartile of WOMAC function score) |
Preoperative osteoarthritis morbidity: Charnley or Modified Charnley Class C |
| Clement et al. (2013) [32] | Primary OA | Primary unilateral TKA | 70.4 (9.4) | 57.5 | 2392 | 1 year | 1 year OKS score | Multivariate linear regression analysis | NONE |
Presence of back pain (-): β = - 2.41 (95%CI -3.18 to -1.64) Presence of depression (-): β = - 4.17 (95%CI -5.42 to -2.92) Better pre-operative levels of pain and function (+): β = 0.45 (95%CI 0.39 to 0.51) Higher pre-operative mental health (+): β = 0.19 (95%CI 0.16 to 0.22) |
Gender Heart disease Hypertension Lung disease Vascular disease Neurological disease Diabetes mellitus Gastric ulceration Kidney disease Liver disease Anemia |
| Clement et al. (2013) [35] | N/A | Primary TKA | 70.4 | 56.6 | 2389 | 1 year | 1 year OKS score | Multivariate linear regression analysis | NONE |
Vascular comorbidity (-): β = -1.91, 95% CI -3.78 to -0.05 Depression (-): β = -4.19, 95% CI -5.44 to -2.95 Back pain (-): β = -2.38, 95% CI -3.14 to -1.61 Better pre-operative levels of pain and function (+): β = 0.45, 95% CI 0.39 to 0.51 Higher pre-operative mental health (+): β = 0.19 (95%CI 0.16 to 0.22) |
Heart disease
High blood pressure Lung disease Neurological disease Diabetes Stomach ulcer Kidney Disease Liver disease Anemia Pre-operative physical health |
| Clement et al. (2013) [40] | Primary OA | Primary TKA | 70.6 (7.0) | 57.6 | 966 | 1 year | Mean OKS improvement after 1 year | Multivariate linear regression analysis | NONE |
Presence of back pain (-): β = -2.53, 95% CI -3.75 –to -1.30 More than 4 comorbidities (-): β = -3.78, 95% CI -6.11 to -1.45 Higher preoperative function and lower pain (-): β = 0.58, 95% CI 0.50 to 0.87 Higher preoperative mental health (+): β =0.16, 95% CI 0.11 to 0.22 |
NONE |
| Davis et al (2008) [34] | Primary OA | Unilateral primary TKA | 71.1 (49 to 85)* | 51.0 | 974 | 12 and 24 months | 12 and 24 month total WOMAC score and WOMAC pain and function scores | Multivariate linear regression analysis |
Age, Gender Number of co-morbid conditions Country Center within country Pre-operative status |
WOMAC pain 12 months Low income (-):p = 0.014 |
WOMAC pain Low income at 24 months Education status at 3, 12 and 24 months WOMAC function Low income at 12 and 24 months Education status at 12 and 24 months |
| Desmeules et al. (2013) [17] | OA (96%), RA (4%) | Primary unilateral TKA | 67 (9.3) | 66% | 138 | 6 months | WOMAC pain and function scores at 6 months | Stepwise multiple regression analysis | NONE |
WOMAC pain (r2 = 0.11) Higher pre-operative pain level (-): β = 0.25, 95% CI 0.08-0.41 Cruciate retaining implant (-): β = -8.21, 95% CI -15.01 to -1.34 |
WOMAC pain Household living status Initial diagnosis (OA/RA) BMI Burden of comorbidities Duration of the disease Use of walking aid Pain contralateral knee Formal education Employment status Household income Size of social network Psychological distress Surgical variables – bearing type, patella resurfacing Marital status Occupational status |
|
WOMAC function (r2 = 0.16) Higher pre-operative function level (+): β = 0.35, 95% CI 0.16-0.54 Marital status (single, separated, divorced or widowed) (-): β = -6.84, 95% CI -14.74 to -0.95 Occupational status (unemployed or retired) (-): β = -7.77, 95% CI -14.70 to -0.87 |
WOMAC function Household living status Initial diagnosis (OA/RA) BMI Burden of comorbidities Duration of the disease Use of walking aid Pain contralateral knee Formal education Employment status Household income Size of social network Psychological distress Surgical variables – bearing type, patella resurfacing Implant type |
||||||||||
| Engel et al. (2004) [51] | OA | TKA | 67.1 (8.3) | 49.3% | 74 | 6 months | WOMAC pain and function scores at 6 months | Multiple hierarchical regression analysis |
Control of other variable (efficacy variables vs. expectancy variables) Adjustment for pre-operative WOMAC variables |
WOMAC pain
Higher coping efficacy (+): β = -0.338, p < 0.01 and High Arthritis Helplessness (-): β = 0.239, p < 0.05 adjusted r2 = 0.053 Expectancy variables: greater pessimism, grater expected chance of recovery, greater expected change in QoL: β not given, adjusted r2 = 0.067 |
WOMAC pain None |
|
WOMAC function Higher coping efficacy (+): β = -0.337, p < 0.05, adjusted r2 = 0.032 |
WOMAC function Arthritis Helplessness Expectancy variables: pessimism, expected chance of recovery, expected chance in QoL |
||||||||||
| Escobar et al. (2007) [24] | OA | Primary TKA | 71.8 (6.7) | 73.6% | 640 | 6 months | WOMAC Pain an function score at 6 months | General linear models | NONE |
WOMAC pain
Higher age (+): Diff β = -0.24, 95% CI -.045 to – 0.03 Presence of social support (+): Diff β = -5.13, 95% CI -9.31 to – 0.95 Absence of back pain (+): Diff β = -5.26, 95% CI -8.24 to -2.27 Charlson Index ≥ 2 (-): Diff β = 6.50, 95% CI 2.0 to 11.0 Higher pre-operative mental health (+): Diff β = -0.10, 95% CI -0.17 to – 0.04 Higher preoperative pain on WOMAC (-): Diff β = 0.26, 0.18 to 0.34 |
WOMAC pain Gender Charlson Index 1 |
|
WOMAC function
Presence of social support (+): Diff β = -7.25, 95% CI -9.31 to – 0.95 Absence of back pain (+): Diff β = -5.26, 95% CI -11.83 to -2.67 Charlson Index ≥ 2 (-): Diff β = 6.60, 95% CI 1.70 to 11.52 Higher pre-operative mental health (+): Diff β = -0.10, 95% CI -0.17 to – 0.03 Lower preoperative function on WOMAC (-): Diff β = 0.29, 0.19 to 0.38 |
WOMAC function Age Charlson Index 1 |
||||||||||
| Fortin et al. (1999) and Fortin et al. (2002) [9, 15] | OA | Primary TKA | 68.1± 9.1 | 56 % | 106 and 81 | 6 months and 2 years | WOMAC pain and function scores at 6 months and 2 years | Multiple linear regression | NONE |
WOMAC pain at 6 months: Higher preoperative pain (WOMAC pain score) (-): β = 0.44 ± 0.11, r2 = 0.25 |
WOMAC pain at 6 months: Age Gender Center Education Comorbidity |
| WOMAC function at 6 months: Lower preoperative function (WOMAC function score) (-): β = 0.61 ± 0.11, r2 = 0.36 |
WOMAC function at 6 months: Age Gender Center Education Comorbidity |
||||||||||
| Similar results for (2002); data not shown | |||||||||||
| Gandhi et al. (2010) [39] | Primary and secondary OA | Primary unilateral TKA | 66.5 | 61 | 889 | 1 year | WOMAC total score at 1 year | Linear regression modelling |
Age Gender Baseline total WOMAC score Comorbidity (excluding hypertension, hypercholesterolemia and diabetes) |
Obesity (BMI > 30) (-): β = 3.6, 95% CI 0.02 to 7.2 | Number of metabolic syndrome risk factors Hypertension Hypercholesterolemia Diabetes |
| Gandhi et al. (2013) [21] | OA | Unilateral TKA | 68.5 (9.4) | 57 | 28 | 2 years | Change in WOMAC pain score at 2 years | Linear regression modelling |
Age Gender BMI Comorbidity count |
Greater synovial fluid TNF- α levels (-): p = 0.001 Greater synovial fluid MMP-13 levels (-): p = 0.03 Greater synovial fluid IL-6 levels (-): p = 0.001 |
Serum levels of: IL-6 IL-1β MMP-9 MMP-13 MIP-1β MCP-1 Adiponectin Leptin TNF- α IFN-γ VCAM-1 |
| Synovial fluid levels of: IL-1β MMP-9 MIP-1β MCP-1 Adiponectin Leptin IFN-γ VCAM-1 |
|||||||||||
| Hanusch et al. (2014) [27] | OA | Primary TKA | 71 (42 to 92) | 45 | 100 | 1 year | 1 year OKS score | Stepwise multiple linear regression | NONE |
Model 1 None |
Model 1 Age Gender Pre-operative OKS score Consequences (patient’s beliefs about impact of illness on their life Emotional representation (patient’s negative emotions caused by their illness) |
|
Model 2 Better pre-operative function and lower pain (+): β = -0.296, p = 0.008 Higher anxiety (-): β = 0.270, p = 0.01 |
Model 2 Age Gender |
||||||||||
|
Model 3 Better pre-operative function and lower pain (+): β = -0.239, p = 0.04 Higher anxiety (-): β = 0.296, p = 0.01 |
Model 3 Age Gender |
||||||||||
| Jones et al. (2001) [41] | Osteoarthritis (93%) | Primary unilateral TKA | 70.6 | 59 | 257 | 6 months | Change in WOMAC pain and function scores at 6 months | Multiple linear regression models | NONE |
Change in pain Higher preoperative bodily pain (SF-36) (-): β = -0.42, 95% CI -0.56 to -0.27 Cementless prosthesis (-): β = -9.48, 95% CI -16.20 to -2.77 |
Change in pain
Age Gender Waiting time Number of comorbid conditions |
|
Change in function Lower preoperative joint pain (WOMAC) (-): β = -0.43, 95% CI -0.57 to -0.28 Higher number of comorbid conditions (-): β = -1.56, 95% CI -2.74 to -0.37 Higher preoperative bodily pain (SF-36) (-): β = -0.21, 95% CI -0.35 to -0.07 |
Change in function Age Gender Waiting time BMI Contralateral joint involvement Living alone |
||||||||||
| Jones et al. (2003) [10] | OA (94%) | Primary TKA | 69.2 (9.2) | 59 | 273 | 6 months | WOMAC function score at 6 months | Multiple linear regression | NONE |
Older age (+): β = 0.35, 95% CI 0.10 to 0.60 Higher preoperative function (WOMAC) (+): β = 0.30, 95% CI 0.16 to 0.43 Greater number of comorbid conditions (-): β = -1.62, 95% CI -2.75 to -0.49 Use of walking devices pre-operatively (-): β = -4.15, 95% CI -7.23 to -1.06 |
Gender |
| Judge et al (2012) [25] | OA (93.7%) | Primary TKA (92%) UKA (8%) | 71.7 (9.1) | 61 | 1991 | 6 months |
Model 1: Total OKS, OKS pain score and OKS function score at 6 months |
Model 1: Multiple linear regression |
Model 1: NONE |
Model 1: Total OKS Higher baseline OKS (+): multivariable coefficient = 1.70, 95% CI 1.43 to 1.96 Female sex (-): multivariable coefficient = -0.88, 95% CI -1.68 to -0.08 Higher preoperative BMI (-): multivariable coefficient = -0.44, 95% CI -0.86 to -0.01 Greater social deprivation (higher log of Index of Multiple Deprivation-IMD 2004) (-): multivariable coefficient = -1.40, 95% CI -1.96 to -0.85 RA diagnosis (vs. Primary OA) (+): multivariable coefficient = 2.90, 95% CI 0.42 to 5.37 Moderately anxious/depressed (vs. Not Anxious/Depressed) (-): multivariable coefficient = -0.85, 95% CI -1.68 to -0.03 Extremely anxious/depressed (vs. Not Anxious/Depressed) (-): multivariable coefficient = -2.21, 95% CI -4.34 to -0.09 |
Total OKS Age Operated side Diagnosis other than OA or RA ASA grade Year surgery was performed |
|
OKS pain score Higher baseline OKS (+): multivariable coefficient = 1.30, 95% CI 1.03 to 1.57 Greater social deprivation (higher log of IMD 2004)(-): multivariable coefficient = -0.64, 95% CI -0.91 to -0.37 RA diagnosis (vs. Primary OA) (+): multivariable coefficient = 1.75, 95% CI 0.61 to 2.89 Moderately anxious/depressed (vs. Not Anxious/Depressed) (-): multivariable coefficient = -0.43, 95% CI -0.83 to -0.03 Extremely anxious/depressed (vs. Not Anxious/Depressed) (-): multivariable coefficient = -1.19, 95% CI -2.19 to -0.18 |
OKS pain score Age Gender Preoperative BMI Operated side Diagnosis other than OA or RA ASA grade Year surgery was performed |
||||||||||
|
OKS function score Higher baseline OKS (+): multivariable coefficient = 1.82, 95% CI 1.58 to 2.06 Higher age (-): multivariable coefficient = -0.21, 95% CI -0.34 to -0.08 Female sex (-): multivariable coefficient = -0.79, 95% CI -1.25 to -0.33 Higher preoperative BMI (-): multivariable coefficient = -0.33, 95% CI -0.57 to -0.09 Greater social deprivation (higher log of IMD 2004)(-): multivariable coefficient = -0.79, 95% CI -1.11 to -0.46 |
OKS function score Operated side Diagnosis other than OA or RA RA diagnosis ASA grade Anxiety/depression level Year surgery was performed |
||||||||||
|
Model 2: PASS score for Total OKS, OKS pain score and OKS function score at 6 months |
Model 2: Logistic regression |
Model 2: NONE |
Model 2: PASS total OKS score Higher baseline OKS (+): OR = 1.52, 95% CI 1.40 to 1.66 Greater social deprivation (higher log of Index of Multiple Deprivation 2004) (-): OR = 0.73, 95% CI 0.62 to 0.87 RA diagnosis (+): OR = 2.17, 95% CI 1.02 to 4.60 |
Model 2: PASS total OKS score Age Gender BMI Operated Side Diagnosis other than OA or RA ASA grade Anxiety/depression level Year surgery was performed |
|||||||
|
PASS OKS pain score Higher baseline OKS (+): OR = 1.81, 95% CI 1.52 to 2.17 Greater social deprivation (higher log of Index of Multiple Deprivation 2004) (-): OR = 0.80, 95% CI 0.68 to 0.94 RA diagnosis (+): OR = 2.33, 95% CI 1.03 to 5.29 Moderately anxious/depressed (vs. not anxious/depressed) (-):OR = 0.67, 95% CI 0.54 to 0.84 Extremely anxious/depressed (vs. not anxious/depressed) (-):OR = 0.51, 95% CI 0.31 to 0.84 |
PASS OKS pain score Age Gender BMI Operated Side Diagnosis other than OA or RA ASA grade Year surgery was performed |
||||||||||
|
PASS OKS function score Higher baseline OKS (+): OR = 2.08, 95% CI 1.82 to 2.39 Older age (-):OR = 0.93, 95% CI 0.87 to 0.99 Greater social deprivation (higher log of Index of Multiple Deprivation 2004) (-): OR = 0.76, 95% CI 0.64 to 0.89 Moderately anxious/depressed (vs. not anxious/depressed) (-):OR = 0.77, 95% CI 0.61 to 0.97 |
PASS OKS function score Gender BMI Operated Side Diagnosis other than OA or RA ASA grade Extremely anxious/depressed (vs. not anxious/depressed) Year surgery was performed |
||||||||||
| Kauppila et al. (2011) [4] | OA | Primary TKA | 70.7 (5.5) | 75 |
88 |
12 months | 12 month WOMAC function change score | Multiple linear regression | NONE |
Multiple linear regression Male gender (-): β = -12.0, 95% CI -23.1 to -0.9 Presence of osteoporosis (-): β = -17.5, 95% CI -32.9 to -2.1 Higher pre-operative function (-): β = 0.31, 95% CI 0.06 to 0.56 |
Multiple linear regression Age Pre-operative function of the opposite knee |
| OMERACT-OARSI responder criteria | Multivariate logistic regression |
Multivariate logistic regression Presence of osteoporosis (-): OR = 14.7, 95% CI 1.1 to 106.1 |
Multivariate logistic regression Data not shown |
||||||||
| Lingard et al. (2004) [26] | OA | Primary TKA | 69.9 | 59.2 | 860 | 12 and 24 months | WOMAC pain and function at 12 and 24 months | Hierarchical linear modelling | NONE | WOMAC pain | WOMAC pain |
|
At 12 months Female gender (-): F = 7.06, p < 0.05, parameter estimate = -3.77, 95% CI -6.55 to -0.99 Lower preoperative pain (WOMAC pain score) (-): F = 29.16, p < 0.0005, parameter estimate = 0.20, 95% CI 0.13 to 0.28 Lower preoperative mental health (SF-36 mental health score) (-): F = 17.53, p < 0.0005, parameter estimate = 0.16, 95% CI 0.09 to 0.24 More comorbid conditions (-): F = 5.85, p < 0.05, parameter estimate = -1.33, 95% CI -2.41 to -0.25 |
At 12 months Age Country |
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|
At 24 months Female gender (-): F = 3.98, p < 0.05, parameter estimate = -2.98, 95% CI -5.91 to -0.05 Lower preoperative pain (WOMAC pain score) (-): F = 25.13, p < 0.0005, parameter estimate = 0.20, 95% CI 0.12 to 0.28 Lower preoperative mental health (SF-36 mental health score) (-): F = 9.53, p < 0.005, parameter estimate = 0.13, 95% CI 0.05 to 0.21 More comorbid conditions (-): F = 4.59, p < 0.05, parameter estimate = -1.24, 95% CI -2.38 to -0.11 |
At 24 months Age |
||||||||||
| WOMAC function | WOMAC function | ||||||||||
|
At 12 months Higher age (-): F = 5.62, p < 0.05, parameter estimate = -0.19, 95% CI -0.35 to -0.03 Lower preoperative function (WOMAC function score) (-): F = 51.58, p < 0.0005, parameter estimate = 0.30, 95% CI 0.22 to 0.38 Lower preoperative mental health (SF-36 mental health score) (-): F = 17.04, p < 0.0005, parameter estimate = 0.17, 95% CI 0.09 to 0.25 Higher BMI (-): F = 4.70, p < 0.05, parameter estimate = -0.30, 95% CI -0.57 to -0.03 More comorbid conditions (-): F = 11.96, p < 0.005, parameter estimate = -1.95, 95% CI -3.05 to -0.84 |
At 12 months Gender |
||||||||||
|
At 24 months Lower preoperative function (WOMAC function score) (+): F = 55.75, p < 0.0005, parameter estimate = 0.34, 95% CI 0.25 to 0.43 Lower preoperative mental health (SF-36 mental health score) (-): F = 6.02, p < 0.05, parameter estimate = 0.11, 95% CI 0.02 to 0.20 Restricted knee flexion (-): F = 6.04, p < 0.05, parameter estimate = 0.12, 95% CI 0.02 to 0.21 More comorbid conditions (-): F = 13.96, p < 0.0005, parameter estimate = -2.26, 95% CI -3.45 to -1.07 |
At 24 months Age Gender |
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| Lingard et al. (2004) [26] | OA | Primary TKA | 69.9 | 59.2 | 860 | 12 and 24 months | WOMAC pain and function at 12 and 24 months | Hierarchical linear modelling | NONE |
Lower preoperative function (WOMAC function score) (+): F = 55.75, p < 0.0005, parameter estimate = 0.34, 95% CI 0.25 to 0.43 Lower preoperative mental health (SF-36 mental health score) (-): F = 6.02, p < 0.05, parameter estimate = 0.11, 95% CI 0.02 to 0.20 Restricted knee flexion (-): F = 6.04, p < 0.05, parameter estimate = 0.12, 95% CI 0.02 to 0.21 More comorbid conditions (-): F = 13.96, p < 0.0005, parameter estimate = -2.26, 95% CI -3.45 to -1.07 |
|
| Lingard et al. (2007) [38] | OA | Primary TKA | 70.8 | 60.3 | 952 | 12 and 24 months | WOMAC pain and function at 12 and 24 months | General linear models |
Age Gender Number of comorbidities Country Center within country Preoperative scores |
With substitution of missing values | |
|
WOMAC pain
Higher preoperative mental health (SF-36) (+): At 12 months: parameter estimate = 0.128, p = 0.0008 At 24 months: parameter estimate = 0.096, p = 0.0109 |
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|
WOMAC function Higher preoperative mental health (SF-36) (+): At 12 months: parameter estimate = 0.150, p = 0.0001 At 24 months: parameter estimate = 0.106, p = 0.0071 |
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| Lopez-Olivo et al. (2011) [18] | OA | Primary TKA | 65 (9) | 65 | 232 | 6 months | WOMAC pain and function at 6 months | Multiple regression modelling | NONE |
WOMAC pain More education (+): β = -0.17, p =0.01 More comorbidities (-): β = 0.17, p = 0.008 More problem solving-style coping (+): β = -0.14, p =0.03 More dysfunctional coping (-): β = 0.13, p =0.04 More internal belief of control over health (+): β = -0.14, p =0.02 |
WOMAC pain BMI Baseline pain level |
|
WOMAC function More frequent availability of tangible support (+): β = - 0.15, p =0.01 Worse depressive state (-): β = 0.15, p = 0.02 More problem solving-style coping (+): β = -0.20, p =0.001 Lower baseline function level (-): β = 0.25, p =0.0001 |
WOMAC function BMI Comorbidities |
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| Neuburger et al. (2013) [23] | OA (90%) |
Primary TKA (95%) Revision TKA (5%) |
N/A | 57% | 62,303 | 6 months | Total OKS score at 6 months | Logistic regression analysis |
Model 1: Age Sex Ethnicity Self-reported comorbid conditions Self-reported general health Primary OA Primary TKA or revision TKA Hospital |
Model 1: More social deprivation (2nd quintile vs. 1st quintile) (-): β = -0.7, 95% -0.9 to -0.5 More social deprivation (3rd quintile vs. 1st quintile) (-): β = -1.1, 95% -1.3 to -0.9 More social deprivation (4th quintile vs. 1st quintile) (-): β = -2.2, 95% -2.4 to -2.0 More social deprivation (5th quintile vs. 1st quintile) (-): β = -3.5, 95% -3.8 to -3.3 |
Model 1: NONE |
|
Model 2: Age Sex Ethnicity Self-reported comorbid conditions Self-reported general health Primary OA Primary TKA or revision TKA Hospital Preoperative OKS Longstanding problems |
Model 2: More social deprivation (2nd quintile vs. 1st quintile) (-): β = -0.4, 95% -0.6 to -0.2 More social deprivation (3rd quintile vs. 1st quintile) (-): β = -0.6, 95% -0.8 to -0.4 More social deprivation (4th quintile vs. 1st quintile) (-): β = -1.5, 95% -1.8 to -1.3 More social deprivation (5th quintile vs. 1st quintile) (-): β = -2.4, 95% -2.7 to -2.2 |
Model 2: NONE |
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|
Model 3: NONE |
Model 3: Age < 51 years (vs. 71-80 years) (-): β = -2.9, 95% -3.4 to -2.4 Age 51-60 years (vs. 71-80 years) (-): β = -1.6, 95% -1.8 to -1.3 Age > 80 years (vs. 71-80 years) (-): β = -0.5, 95% -0.7 to -0.2 South-Asian, black or other ethnicity (vs. white ethnicity) (-): β = -2.5, 95% -2.9 to -2.2 Heart disease (-): β = -0.6, 95% -0.8 to -0.3 High blood pressure (+): β = 0.3, 95% 0.2 to 0.5 Stroke (-): β = -0.9, 95% -1.5 to -0.3 Poor circulation (-): β = - 2.3, 95% -2.6 to -2.0 Diabetes (-): β = -0.7, 95% -1.0 to -0.5 Depression (-): β = - 1.8, 95% -2.1 to -1.5 Very good general health (vs. excellent) (-): β = -1.2, 95% -1.6 to -0.9 Good general health (vs. excellent) (-): β = -3.6, 95% -4.1 to -3.3 Fair general health (vs. excellent) (-): β = -7.3, 95% -7.7 to -6.9 Poor general health vs. excellent) (-): β = -11.0, 95% -11.6 to -10.4 Diagnosis of OA (-): β = -0.5, 95% -0.9 to -0.3 Revision operation (-): β = -6.3, 95% -6.7 to -5.8 Longstanding problems (+): β = 0.4, 95% 0.3 to 0.6 Better preoperative pain/function (2nd decile of preoperative OKS score vs. 1st decile – lowest) (+): β = 2.5, 95% 2.0 to 2.9 Better preoperative pain/function (3rd decile of preoperative OKS score vs. 1st decile – lowest) (vs. 1st decile - lowest (+): β = 3.9, 95% 3.5 to 4.2 Better preoperative pain/function (4th decile of preoperative OKS score vs. 1st decile – lowest) (+): β = 4.8, 95% 4.5 to 5.2 |
Model 3: Gender Age 61-70 years (vs. 71-80 years) Lung disease Cancer |
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| Papakostidou et al. (2012) [28] | OA (96%) | Primary TKA | 69.17 (6.69) | 79.4 | 204 | 12 months | WOMAC pain and function at 12 months | General linear modelling | NONE |
WOMAC pain Higher pre-intervention pain (-): Diff = 0.10, 95% CI 0.02 to 2.29 |
WOMAC pain Gender Age BMI Education Social support Residence |
|
WOMAC function Lower pre-intervention function (-): Diff = 0.17, 95% CI 0.06 to 0.28 |
WOMAC function Gender Age BMI Education Social support Residence |
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| Perruccio et al. (2012) [19] | OA | Primary unilateral TKA | 65 | 65 | 494 | 12 months | WOMAC pain and function at 12 months | Multiple linear regression | NONE |
Pain Symptomatic ankles/feet/toes (-): β = 1.24, 95% CI 0.48 to 2.00 Symptomatic neck (-): β = 1.07, 95% CI 0.17 to 1.98 Higher pre-surgery knee pain (-): β = 0.34, 95% CI 0.24 to 0.45 |
Pain Age Gender Education BMI Comorbidity count Symptomatic contralateral knee Symptomatic hips Symptomatic elbows/wrists/hands Symptomatic shoulder Symptomatic spine/lower back |
|
Physical function Symptomatic ankles/feet/toes (-): β = 3.14, 95% CI 0.69 to 5.59 Symptomatic neck (-): β = 3.46, 95% CI 0.54 to 6.38 Higher Pre-surgery knee function (+): β = 0.41, 95% CI 0.31 to 0.50 |
Physical function Age Gender Education Overweight BMI Comorbidity count Symptomatic contralateral knee Symptomatic hips Symptomatic elbows/wrists/hands Symptomatic shoulder Symptomatic spine/lower back |
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| Rajgopal et al. (2008) [20] | OA | Primary TKA (7.1% with history of contralateral TKA) | N/A | 59.3 | 550 | 1 year | Total WOMAC score at 1 year | Multiple linear regression | NONE |
Higher baseline mental health (+): β = 0.210, 95% CI 0.063 to 357 Charnley Class C (-): β = -4.897, 95% CI -8.701 to -1.093 Higher baseline WOMAC score (+): β = 0.301, 95% CI 0.202 to 0.399 BMI ≥40 (-): β = -5.188, 95% CI -9.771 to -0.606 |
Age Gender Prior contralateral TKA BMI |
| Ramaesh et al. (2013) [29] | Arthrosis | TKA | 70.5 | 58 | 205 | 1 year | Oxford Knee Score at 1 year | Multiple linear regression | NONE |
More comorbidity (-): B = -1.77, 95% CI -2.35 to -1.19 Better preoperative function/pain level (+): B = 0.26, 95% CI 0.10 to 0.43 |
Age Gender Personality type |
| Riddle et al. (2010) [22] | OA | Primary TKA | 63.7 | 70.7 | 157 | 6 months | WOMAC pain and function change scores at 6 months | Logistic regression |
Age Gender BMI Comorbidity Rheumatoid arthritis status Race/ethnicity Preoperative WOMAC pain score |
WOMAC pain score | WOMAC pain score |
|
Model 1: change by <50% Greater pain catastrophizing (PCS score ≥ 16) (-): OR = 2.67, 95% CI 1.2 to 6.1 |
Model 1 None |
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|
Model 2: change ≤ 4 points Greater pain catastrophizing (PCS score ≥ 16) (-): OR = 6.04, 95% CI 1.75 to 20.82 |
Model 2 Self-efficacy Kinesiophobia |
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| WOMAC function score | WOMAC function score | ||||||||||
|
Model 1: change by <50% None |
Model 1: change by <50% None |
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|
Model 2: change ≤ 15 points None |
Model 2: change ≤ 15 points None |
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| Smith et al. (2004) [52] | OA | Primary TKA | 67.2 (8.3) | 52 | 64 | 6 months | WOMAC pain and function at 6 months | Multiple linear regression analysis |
Gender Education Pre-surgery health measure |
NONE |
WOMAC Pain: Optimism Pessimism Emotionality Purpose in life |
|
WOMAC Function: Optimism Pessimism Emotionality Purpose in life |
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| Sullivan et al. (2011) [30] | OA | Primary TKA | 67 | 60.8 | 120 | 12 months | WOMAC pain and function at 12 months | Hierarchical regression analysis | NONE |
WOMAC pain Greater preoperative pain catastrophizing (-): β = 0.27, p < 0.05 |
WOMAC pain Preoperative pain Preoperative function Age Sex BMI Comorbidites Surgery Duration Surgeon Kinesiophobia Depression |
|
WOMAC function Greater preoperative pain catastrophizing (-): β = 0.34, p < 0.01 |
WOMAC function Preoperative pain Preoperative function Age Sex BMI Comorbidites Surgery Duration Surgeon Kinesiophobia Depression |
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| Wylde et al. (2012) [31] | OA | Primary TKA | 70(9) | 62 | 220 | 1 year | WOMAC pain and function at 1 year | Ordinary least square regression | NONE |
WOMAC pain Higher pre-operative anxiety (-): Unstandardized regression coefficient = 1.082, 95% CI 0.283 to 1.881 Higher pre-operative pain severity (-): Unstandardized regression coefficient = 0.183, 95% CI 0.034 to 0.331 |
WOMAC pain Age Gender Other painful joints Number of comorbidities Depression Self efficacy |
|
WOMAC function Worse self efficacy (-): Unstandardized regression coefficient = -0.256, 95% CI -0.478 to -0.034 More painful joints elsewhere (-): Unstandardized regression coefficient = 1.928, 95% CI 0.634 to 3.222 Higher pre-operative anxiety (-): Unstandardized regression coefficient = 0.867, 95% CI 0.128 to 1.623 Worse preoperative function level (-): Unstandardized regression coefficient = 0.289, 95% CI 0.134 to 0.444 |
WOMAC function
Age Gender Depression |
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| Yakobov et al. (2014) [36] | OA | Primary TKA | 67 (range 50 to 85) | 61 | 116 | 1 year | WOMAC pain and function at 1 year | Hierarchical regression analysis | NONE |
WOMAC pain Higher perceived injustice (-): β = 0.29, p < 0.01 |
WOMAC pain Age Sex BMI Illness duration Preoperative pain Number of comorbid health conditions Pain catastrophizing Kinesiophobia |
|
WOMAC function Greater preoperative pain catastrophizing (-): β = 0.26, p < 0.01 |
WOMAC function Age Sex BMI Illness duration Preoperative pain Number of comorbid health conditions Kinesiophobia Perceived injustice |
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