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.

The objective of this review was to systematically summarize the existing literature on the effect of core muscle training on measures of balance and agility in athletes. A search was conducted to identify the eligible articles on core muscle training, balance, agility, and athletes in PubMed, Scopus, Web of Science, Cumulative Index to Nursing and Allied Health Literature, Cochrane Central Register of Controlled Trials, and Physiotherapy Evidence Database that were published from inception to April 15, 2022. The literature search retrieved 3,299 articles, of which 17 randomized controlled trials met the inclusion criteria of the review. Two reviewers independently performed study selection and assessed the quality of included studies using the Physiotherapy Evidence Database (PEDro) scale, and a third reviewer was consulted in case of disagreements. The quality of the studies was mixed. Core muscle training can be used to target balance and agility in athletes. Furthermore, core training of variable frequency, intensity, and type can be incorporated in athletic programs to improve balance and agility.

Total knee arthroplasty (TKA) is routinely performed for pain relief and to improve performance of the knee in individuals with severe knee osteoarthritis (OA). The quadriceps angle (Q-angle) is a key component of knee joint stability. However, there is a dearth of literature evaluating Q-angle as an outcome measure after TKA in individuals with severe knee OA. The objective of the study was to assess the Q-angle as an outcome measure before and after TKA and to find the correlation of Q-angle with pain, quadriceps strength, and knee flexion range of motion (ROM) after TKA in individuals with severe knee OA. The Q-angles of 34 individuals (male: female = 17:17) were measured using standardized procedures. Pain, quadriceps strength, and knee flexion ROM were measured. The measurements were taken preoperatively (one day before surgery), and postoperatively at the sixth week and third month after TKA. The mean Q-angle was 19.17° (SD = 1.92°) before TKA, 16.06° (SD = 1.87°) at the sixth week and 13.43° (SD = 1.77°) at the third month after TKA. Significant linear correlations were noted between the Q-angle and pain, quadriceps strength, and knee flexion ROM following TKA. The Q-angle was measured before and after TKA using a standardized clinical goniometric method. Understanding the Q-angle before and after TKA and its relationship with various clinical and functional variables is imperative in clinical practice for orthopedic surgeons and rehabilitation professionals.

Total knee arthroplasty (TKA) is commonly performed to relieve pain and improve knee function in individuals with severe knee osteoarthritis (OA). Abnormal foot mechanics can influence overall biomechanics and affect post-surgical outcomes. This study aimed to evaluate foot posture as a biomechanical outcome before and after TKA and to explore its relationship with pain, functional performance, and quadriceps (Q) angle. Seventy-seven individuals with knee OA who underwent TKA, and 77 healthy controls were assessed. Foot posture was measured using the Foot Posture Index (FPI), pain using the Numerical Pain Rating Scale (NPRS), and function using the Lower Extremity Functional Scale (LEFS), Timed Up and Go (TUG), and 6-Minute Walk Test (6MWT). Q-angle was assessed as a structural alignment measure. Evaluations were conducted preoperatively and at 6 weeks, 3, 6, and 12 months postoperatively. Preoperative FPI was significantly higher in the OA group than controls (1.52 ± 2.5 vs. 0.70 ± 2.2; p = 0.03). At 6 months post-TKA, FPI remained higher than controls ( p = 0.03), but the difference from controls was no longer statistically significant at 12 months. A weak correlation existed between FPI and pain ( p < 0.05); no correlation was found with functional or alignment outcomes. Foot posture provides limited longitudinal insight; broader biomechanical assessment is advised.

Postoperative follow-up after total knee arthroplasty (TKA) in individuals with knee osteoarthritis (OA) is essential for patients, surgeons, and rehabilitation specialists to monitor patient prognosis. Loss to follow-up is a common problem noted following surgery, and many factors influence follow-up. The objective of this study was to report patient-reported factors determining long-term follow-up after TKA in individuals with knee OA visiting a tertiary care hospital. Patients who underwent TKA from January 2021 to December 2022 at a tertiary care hospital in South India were contacted via telephone. Demographic details, follow-up history, reasons for loss to follow-up to the hospital, patient satisfaction, pain, patient-reported function, and quality of life (QoL) were noted. Among the patients, 26.8 % returned for long-term follow-up, whereas 73.2 % were lost to follow-up after TKA. A list of patient-reported factors determining long-term follow-up following TKA was noted. Overall, 81.8 % of patients reported satisfaction following surgery, whereas 18.2 % expressed dissatisfaction. The mean postoperative scores on the numerical pain rating scale (NPRS), lower extremity functional scale (LEFS) score, knee injury and osteoarthritis outcome score (KOOS), and short form-36 (SF-36) health survey questionnaire were noted. A range of patient-reported factors, such as the absence of symptoms, longer wait times in the hospital, increased travel distance to the hospital, the absence of caregivers, financial constraints, the COVID-19 pandemic, and other unspecified reasons were noted as reasons, for loss to follow-up following TKA.

Background/Objectives: Knee osteoarthritis (OA) alters lower limb biomechanics, often leading to an asymmetric plantar pressure distribution. Total knee arthroplasty (TKA) aims to restore joint function and may normalize plantar loading, but evidence from instrumented static pressure analysis is limited. The objective of this study was to compare static plantar pressure distributions before and after TKA in individuals with knee OA and in age- and sex-matched healthy controls. Methods: A pre-post study was conducted on 77 individuals with severe knee OA (Kellgren–Lawrence grade 4) who underwent TKA and 77 matched healthy controls. The plantar pressure area, average pressure, and maximal pressure were assessed preoperatively and at 6 and 12 months postoperatively using a Win-Track force platform. Standard postoperative rehabilitation was followed. Statistical analyses included independent t-tests and repeated-measures ANOVA (p ≤ 0.05). Results: Compared with controls, pre-TKA patients presented significantly lower plantar pressure area, average pressure, and maximal pressure than controls (p < 0.001). At 6 and 12 months post-TKA, the plantar pressure area (p < 0.001) and average pressure (p = 0.001) improved significantly, with more balanced bilateral loading and increased forefoot weight transfer. At 12 months, no significant differences in any plantar pressure parameters remained between the TKA and control groups. Conclusions: Severe knee OA is associated with altered static plantar pressure patterns, characterized by reduced loading and asymmetry. TKA effectively restores plantar pressure distribution, achieving normalization within 12 months. The incorporation of plantar pressure assessment into pre- and postoperative care may guide targeted rehabilitation and enhance functional recovery.