Background: Total knee arthroplasty (TKA) is an effective procedure. However, for some patients, the outcomes are\r\nnot satisfactory. Identification of TKA determinants could help manage these patients more efficiently. The purpose\r\nof this study was to identify pre- and perioperative determinants of pain, functional limitations and health-related\r\nquality of life (HRQoL) 6 months after TKA.\r\nMethods: 138 participants were recruited from 3 hospitals in Quebec City, Canada and followed up until 6 months\r\nafter surgery. Data were collected through review of the subjects� medical files and structured telephone interviews\r\nbefore and 6 months after TKA. Pain and functional limitations were measured with the Western Ontario and\r\nMcMaster Osteoarthritis Index (WOMAC) and HRQoL was measured with the SF-36 Health Survey. Independent\r\nvariables included demographic, socioeconomic, psychosocial, clinical and surgical characteristics of participants as\r\nwell as data on health services utilization. Stepwise multiple regression analysis was used to assess the strength of\r\nthe associations between the independent variables and the WOMAC and SF-36 scores.\r\nResults: Higher preoperative pain, cruciate retaining implants and the number of complications were significantly\r\nassociated with worse pain 6 months after TKA (p < 0.05) and explained 11% of the variance of the WOMAC pain\r\nscore. Higher preoperative functional limitations, being single, separated, divorced or widowed, being unemployed\r\nor retired and the number of complications were significantly associated (p < 0.05) with worse functional limitations\r\n6 months after TKA and explained 16% of the variance of the WOMAC function score. Lower preoperative HRQoL,\r\ncontralateral knee pain, higher psychological distress and comorbidities were significantly associated (p < 0.05) with\r\nworse HRQoL 6 months after TKA and explained 23% of the variance of the SF-36 physical functioning score.\r\nConclusions: Several variables were found to be significantly associated with worse outcomes 6 months after TKA\r\nand may help identify patients at risk of poorer outcome. The identification of these determinants could help\r\nmanage patients more efficiently and may help target patients who may benefit from extensive rehabilitation.
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