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Purpose <p>To investigate factors associated with achieving both postoperative knee flexion range of motion (ROM) ≥ 125° and Numerical Rating Scale (NRS) pain score ≤ 1 at one year after posterior cruciate-retaining total knee arthroplasty (CR-TKA).</p> Methods <p>This retrospective cohort study included 100 patients who underwent CR-TKA between 2018 and 2021. Patients were divided into a good outcome group (G group; n = 43), defined as achieving both postoperative one&#xa0;year knee flexion ROM ≥ 125° and NRS ≤ 1, and a non-good outcome group (NG group; n = 57). Baseline demographic and clinical variables, including age, sex, operative side, body mass index (BMI), preoperative ROM, preoperative NRS, Oxford Knee Score (OKS), and surgical technique, were compared between groups. Univariate analysis and multivariable logistic regression analysis were performed to identify factors associated with favourable postoperative outcomes. Receiver operating characteristic (ROC) curve analysis was conducted to evaluate the discriminative ability of BMI.</p> Results <p>In the univariate analysis, BMI was significantly lower in the G group than in the NG group (24.54 ± 3.50 vs. 26.35 ± 3.90&#xa0;kg/m<sup>2</sup>, p = 0.045). No significant differences were observed for age, sex, operative side, surgical technique, preoperative ROM, preoperative NRS, body weight, height, or OKS. Multivariable logistic regression analysis demonstrated that lower BMI was significantly associated with achieving favourable postoperative outcomes (odds ratio 0.828, 95% confidence interval 0.708–0.968, p = 0.017). ROC curve analysis demonstrated only modest discriminative ability of BMI, with an area under the curve of 0.614 (95% confidence interval 0.510–0.772). The optimal BMI cutoff value was approximately 26&#xa0;kg/m<sup>2</sup>.</p> Conclusion <p>Lower BMI was associated with achieving both good knee flexion and pain-free recovery at one year after CR-TKA. However, because the discriminative ability of BMI alone was modest and residual confounding cannot be excluded, BMI should be interpreted as one associated factor rather than a standalone predictor of postoperative success.</p>

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Factors associated with achieving knee flexion around one hundred and twenty five degrees and numerical rating scale around one at one year after posterior cruciate-retaining total knee arthroplasty

  • 期刊论文

  • 发表日期：

    2026年6月15日

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  • Hironao Shioiri,
  • Tsuneari Takahashi,
  • Takumi Matsumoto

摘要

Purpose

To investigate factors associated with achieving both postoperative knee flexion range of motion (ROM) ≥ 125° and Numerical Rating Scale (NRS) pain score ≤ 1 at one year after posterior cruciate-retaining total knee arthroplasty (CR-TKA).

Methods

This retrospective cohort study included 100 patients who underwent CR-TKA between 2018 and 2021. Patients were divided into a good outcome group (G group; n = 43), defined as achieving both postoperative one year knee flexion ROM ≥ 125° and NRS ≤ 1, and a non-good outcome group (NG group; n = 57). Baseline demographic and clinical variables, including age, sex, operative side, body mass index (BMI), preoperative ROM, preoperative NRS, Oxford Knee Score (OKS), and surgical technique, were compared between groups. Univariate analysis and multivariable logistic regression analysis were performed to identify factors associated with favourable postoperative outcomes. Receiver operating characteristic (ROC) curve analysis was conducted to evaluate the discriminative ability of BMI.

Results

In the univariate analysis, BMI was significantly lower in the G group than in the NG group (24.54 ± 3.50 vs. 26.35 ± 3.90 kg/m2, p = 0.045). No significant differences were observed for age, sex, operative side, surgical technique, preoperative ROM, preoperative NRS, body weight, height, or OKS. Multivariable logistic regression analysis demonstrated that lower BMI was significantly associated with achieving favourable postoperative outcomes (odds ratio 0.828, 95% confidence interval 0.708–0.968, p = 0.017). ROC curve analysis demonstrated only modest discriminative ability of BMI, with an area under the curve of 0.614 (95% confidence interval 0.510–0.772). The optimal BMI cutoff value was approximately 26 kg/m2.

Conclusion

Lower BMI was associated with achieving both good knee flexion and pain-free recovery at one year after CR-TKA. However, because the discriminative ability of BMI alone was modest and residual confounding cannot be excluded, BMI should be interpreted as one associated factor rather than a standalone predictor of postoperative success.