Department of Anatomy, Melaka Manipal Medical College- Manipal Campus, Manipal Academy of Higher Education (MAHE), Manipal, 576104, Karnataka, India.
Department of Physiotherapy, Centre for Podiatry & Diabetic Foot Care and Research, Manipal College of Health Professions (MCHP), Manipal Academy of Higher Education (MAHE), Manipal, 576104, Karnataka, India.
J Bodyw Mov Ther. 2024 Oct;40:1588-1604. doi: 10.1016/j.jbmt.2024.08.013. Epub 2024 Aug 23.
To systematically review, summarize and appraise evidence on the factors determining quality of life (QoL) after total knee arthroplasty (TKA) in individuals with knee osteoarthritis.
We searched six databases (PubMed, Scopus, Web of Science, CINAHL, EMBASE, and ProQuest) using appropriate search terms to identify the relevant literature published on the factors determining QoL following TKA. Two reviewers independently performed the study screening and study selection. A third reviewer was consulted in case of any disagreement. The methodological quality of the included studies was assessed using the Modified Downs and Black Index checklist. This review was registered in PROSPERO (CRD42022352887) and reported according to the PRISMA checklist.
We identified a total of 8517 studies, 29 of which were included. Advanced age; female sex; increased body mass index (BMI); the presence of comorbidities such as diabetes; contralateral knee pain; poor preoperative status; psychological and pain-related factors such as the presence of pain catastrophizing; central sensitization; kinesiophobia; anxiety; depression; chronic pain; psychological distress; low level of optimism; and reduced patient satisfaction were used to determine post-TKA QoL scores. High BMI and depression were the most common factors evaluated in these studies. Overall, the methodological quality of the included studies varied from high to low.
After TKA, the overall QoL score improved. However, there are a few physical, behavioral, and psychological factors that influence QoL. Identifying these factors could aid clinicians and health professionals in treating and rehabilitating patients by helping them improve patient prognosis after TKA.
系统地回顾、总结和评估膝关节骨关节炎患者全膝关节置换术后生活质量（QoL）的决定因素。
我们使用适当的检索词在 6 个数据库（PubMed、Scopus、Web of Science、CINAHL、EMBASE 和 ProQuest）中进行检索，以确定与 TKA 后 QoL 决定因素相关的文献。两名评审员独立进行研究筛选和研究选择。如有任何分歧，将咨询第三名评审员。使用改良的唐斯和布莱克指数清单评估纳入研究的方法学质量。本综述在 PROSPERO（CRD42022352887）中进行了注册，并按照 PRISMA 清单进行了报告。
我们共确定了 8517 项研究，其中 29 项被纳入。高龄；女性；体重指数（BMI）增加；合并症如糖尿病；对侧膝关节疼痛；术前状态差；心理和疼痛相关因素，如存在疼痛灾难化；中枢敏化；运动恐惧；焦虑；抑郁；慢性疼痛；心理困扰；低水平的乐观；以及降低的患者满意度被用来确定 TKA 后的 QoL 评分。高 BMI 和抑郁是这些研究中最常评估的因素。总体而言，纳入研究的方法学质量从高到低不等。
TKA 后，整体 QoL 评分有所提高。然而，有一些身体、行为和心理因素会影响 QoL。确定这些因素可以帮助临床医生和健康专业人员通过帮助他们改善 TKA 后患者的预后来治疗和康复患者。
