Joint awareness after total knee arthroplasty is affected by pain and quadriceps strength

Orthop Traumatol Surg Res. 2016 Jun;102(4):435-9. doi: 10.1016/j.otsr.2016.02.007. Epub 2016 Apr 1.


Introduction: There is a growing interest in the use of patient-reported outcomes to provide a more patient-centered view on treatment. Forgetting the artificial joint can be regarded as the goal in joint arthroplasty. The goals of the study were to describe changes in joint awareness in the artificial joint after total knee arthroplasty (TKA), and to determine which factors among pain, knee range of motion (ROM), quadriceps strength, and functional ability affect joint awareness after TKA.

Hypothesis: Patients undergoing TKA demonstrate changes in joint awareness and joint awareness is associated with pain, knee ROM, quadriceps strength, and functional ability.

Patients and methods: This prospective cohort study comprised 63 individuals undergoing TKA, evaluated at 1, 6, and 12 months postoperatively. Outcomes included joint awareness assessed using the Forgotten Joint Score (FJS), pain score, knee ROM, quadriceps strength, and functional ability.

Results: Fifty-eight individuals completed all postoperative assessments. All measures except for knee extension ROM improved from 1 to 6 months. However, there were no differences in any measures from 6 to 12 months. FJS was affected most greatly by pain at 1 month and by quadriceps strength at 6 and 12 months.

Discussion: Patients following TKA demonstrate improvements in joint awareness and function within 6 months after surgery, but reach a plateau from 6 to 12 months. Quadriceps strength could contribute to this plateau of joint awareness.

Level of evidence: Prospective cohort study, IV.

Keywords: Forgotten joint score; Joint awareness; Patient-reported outcome; Total knee arthroplasty.

Publication types

  • Clinical Trial

MeSH terms

  • Activities of Daily Living
  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Knee / psychology*
  • Awareness / physiology*
  • Female
  • Follow-Up Studies
  • Humans
  • Knee Joint / physiopathology*
  • Male
  • Middle Aged
  • Muscle Strength*
  • Pain, Postoperative / psychology*
  • Prospective Studies
  • Quadriceps Muscle / physiopathology*
  • Range of Motion, Articular