Osteoarthritis and cartilage open · 2025
Changes in knee pain and walking speed following primary, unilateral total knee arthroplasty and their association: A systematic review and meta-analysis.
СтатьяОбзорНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Faber Nico, Skrobot Matej, Duda Georg N, Brisson Nicholas M
Аннотация
OBJECTIVE: To quantify changes in knee pain and walking speed following primary, unilateral total knee arthroplasty (TKA) for knee osteoarthritis, and to examine their relationship during recovery. Walking speed is a key indicator of functional recovery and long-term health, but whether pain relief translates into improved mobility remains unclear.
DESIGN: A systematic review and meta-analysis was conducted following PRISMA guidelines. PubMed was searched to September 2025 for studies reporting pre- and post-TKA values of knee pain (WOMAC-pain or KOOS-pain) and self-selected walking speed in adults undergoing primary, unilateral TKA. Pooled changes were calculated using inverse-variance weighted random-effects models. Meta-regression explored associations between pain and walking speed, adjusting for covariates.
RESULTS: Eighteen studies (n = 819; 64.1 % female; age 65.1 ± 8.3 years; body mass index 28.4 ± 5.9 kg/m2) were included. Knee pain significantly decreased by 27-36 points (WOMAC-pain) and 19-40 points (KOOS-pain), exceeding minimal clinically important differences. Walking speed increased by +0.12 m/s at 3 months and +0.18 m/s at 12 months, both exceeding the +0.1 m/s threshold for clinically relevant change. No significant change in speed occurred before 3 months, and a non-significant decline appeared beyond 12 months. Meta-regression revealed greater knee pain (β = -0.005, p < 0.001) and use of WOMAC-pain (vs. KOOS-pain) (β = -0.224, p < 0.001) predicted slower walking speed (R2 = 0.48, p < 0.001).
CONCLUSIONS: TKA yields substantial pain relief and improved walking speeds by 3-12 months. However, mobility gains are not sustained beyond one year and are influenced by pain. Postoperative care should support both symptoms and mobility to improve long-term outcomes.
DESIGN: A systematic review and meta-analysis was conducted following PRISMA guidelines. PubMed was searched to September 2025 for studies reporting pre- and post-TKA values of knee pain (WOMAC-pain or KOOS-pain) and self-selected walking speed in adults undergoing primary, unilateral TKA. Pooled changes were calculated using inverse-variance weighted random-effects models. Meta-regression explored associations between pain and walking speed, adjusting for covariates.
RESULTS: Eighteen studies (n = 819; 64.1 % female; age 65.1 ± 8.3 years; body mass index 28.4 ± 5.9 kg/m2) were included. Knee pain significantly decreased by 27-36 points (WOMAC-pain) and 19-40 points (KOOS-pain), exceeding minimal clinically important differences. Walking speed increased by +0.12 m/s at 3 months and +0.18 m/s at 12 months, both exceeding the +0.1 m/s threshold for clinically relevant change. No significant change in speed occurred before 3 months, and a non-significant decline appeared beyond 12 months. Meta-regression revealed greater knee pain (β = -0.005, p < 0.001) and use of WOMAC-pain (vs. KOOS-pain) (β = -0.224, p < 0.001) predicted slower walking speed (R2 = 0.48, p < 0.001).
CONCLUSIONS: TKA yields substantial pain relief and improved walking speeds by 3-12 months. However, mobility gains are not sustained beyond one year and are influenced by pain. Postoperative care should support both symptoms and mobility to improve long-term outcomes.