Identification of Metabolic Factors and Inflammatory Markers Predictive of Outcome after Total Knee Arthroplasty in Patients with Knee Osteoarthritis: A Systematic Review

Lotte Meert (), Michel GCAM Mertens, Mira Meeus, Sophie Vervullens, Isabel Baert, David Beckwée, Peter Verdonk and Rob J. E. M. Smeets
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Lotte Meert: Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, 2610 Wilrijk, Belgium
Michel GCAM Mertens: Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, 2610 Wilrijk, Belgium
Mira Meeus: Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, 2610 Wilrijk, Belgium
Sophie Vervullens: Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, 2610 Wilrijk, Belgium
Isabel Baert: Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, 2610 Wilrijk, Belgium
David Beckwée: Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, 2610 Wilrijk, Belgium
Peter Verdonk: Antwerp Orthopaedic Center, AZ Monica Hospitals, 2018 Antwerp, Belgium
Rob J. E. M. Smeets: Department of Rehabilitation Medicine, Research School CAPHRI, Maastricht University and CIR Revalidatie, 5628 WB Eindhoven, The Netherlands

IJERPH, 2023, vol. 20, issue 10, 1-41

Abstract: Objective: To identify metabolic factors and inflammatory markers that are predictive of postoperative total knee arthroplasty (TKA) outcome. Method: A systematic search of the existing literature was performed using the electronic databases PubMed, Web of Science and Embase until the 1 st of August 2022. Studies that evaluated the influence of metabolic or inflammatory markers (I) on postsurgical outcome (O) in end-stage knee osteoarthritis patients awaiting primary TKA (P) were included in this review. Results: In total, 49 studies were included. Risk of bias of the included studies was low for one study, moderate for 10 studies and high for the remaining 38 studies. Conflicting evidence was found for the influence of body mass index, diabetes, cytokine levels and dyslipidaemia on pain, function, satisfaction and quality of life at more than six months after TKA. Conclusions: Several limitations such as not taking into account known confounding factors, the use of many different outcome measures and a widely varying follow-up period made it challenging to draw firm conclusions and clinical implications. Therefore large-scaled longitudinal studies assessing the predictive value of metabolic and inflammatory factors pre-surgery in addition to the already evidenced risk factors with follow-up of one year after TKA are warranted.

Keywords: knee osteoarthritis; total knee arthroplasty; systematic review; postoperative outcome; metabolic factors; low-grade inflammation; chronic pain (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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