Prognostic Factors: Body mass index (BMI); Depression;
Preoperative range of motion (ROM), Physical function, and Strength;
Age; Diabetes; Number of comorbidities; and Sex
➤ Physical therapist management should take into consideration the following
factors when determining prognosis, treatment, and informed decision-
making and expectation-setting with patients undergoing TKA:
a. Higher BMI is associated with more postoperative complications and worse
postoperative outcomes.
b. Depression is associated with worse postoperative outcomes.
c. Preoperative ROM is positively associated with postoperative ROM but has
minimal, if any, effect on physical function and quality of life.
d. Preoperative physical function is positively associated with postoperative
physical function.
e. Preoperative strength is positively associated with postoperative physical
function.
f. Age is associated with mixed patient-reported, performance-based, and
impairment-based outcomes.
g. Diabetes is not associated with worse functional outcomes.
h. A greater degree of comorbidity is associated with worse patient-reported
outcomes.
i. Sex is associated with both positive and negative effects on postoperative
outcomes.
(Evidence Quality: High, Recommendation Strength: Moderate)
★★★★
Prognostic Factors: Tobacco AND Patient Support
➤ It is the consensus of the work group that active tobacco use and lack of
patient support (i.e., environmental factors including, but not limited to,
support and relationships) should be considered as prognostic/risk factors
associated with less than optimal functional outcomes. (Evidence Quality:
Insufficient, Recommendation Strength: Best Practice)
★★★★
Postoperative Physical Therapist Supervision
➤ Supervised physical therapist management should be provided for patients
who have undergone TKA. The optimal setting should be determined by the
patients' safety, mobility, environmental, and personal factors. (Evidence
Quality: Moderate, Recommendation Strength: Moderate)
★★★★