Date of Award
11-13-2025
Document Type
Dissertation
Degree Name
Doctor of Philosophy (Ph.D.)
School Name
College of Health Professions
Department
Health Professions
Major Advisor
Dr. Barbara Jackson
Second Advisor
Dr. Megan Danzl
Third Advisor
Dr. Lyndsey Blair
Abstract
Arthritis is a major concern across the globe and in the United States. This joint disease is a large contributor to debility and loss of function as well as increasing medical costs in this country. While conservative treatments are available for the treatment of arthritis, joint replacement is an option for those for whom these treatments are not successful. Many factors contribute to outcomes following a total knee arthroplasty. Some of the factors previously examined are patient comorbidities, psychological factors, rehabilitation following the procedure, and preoperative functional status, but to date, no research examines how the time of year that surgery is performed affects patient outcomes following a total knee arthroplasty. Clinically, patients often comment they feel stiff or have more trouble with functional tasks on cold, damp days. The purpose of this retrospective study was to use a multivariate model to analyze preoperative function, pain, quadriceps strength, range of motion, and time of year that surgery is performed, to predict patient functional outcomes following total knee arthroplasty. The primary question examined is if these preoperative variables predict functional outcomes following rehabilitation after knee replacement. A retrospective chart review using a random sample was conducted, and charts were stratified by season in which surgery was performed to ensure an equal number of cases per season. All data collected were then analyzed to evaluate outcomes following total knee replacement. Results from the study show that preoperative pain, strength, and range of motion do not influence outcomes following total knee arthroplasty. The season surgery is performed and preoperative function predicted functional outcome after total knee replacement. Comprehensive management of total knee replacement, considering both the timing of surgery and the patient’s function prior to surgery, is indicated. Findings suggest that outcomes following total knee replacement are more favorable when surgeries are performed in
the spring and fall compared to winter and summer. Environmental conditions, seasonal activity levels, and possibly psychological factors related to the time of year may influence recovery. Findings also reveal the importance of teaching future clinicians to recognize how factors beyond biomechanics can impact recovery following total knee replacement. Integrating this evidence into educational curricula encourages a more holistic approach to patient care during the total joint replacement process.
Recommended Citation
Kremer, Matthew John, "Preoperative Predictors for Outcomes Following Total Knee Arthroplasty for Individuals with Degenerative Arthritis" (2025). Graduate Theses, Dissertations, and Capstones. 209.
https://scholarworks.bellarmine.edu/tdc/209