Algorithm helps predict outcomes after total knee arthroplasty

A research team led by David C. Ayers, MD, has identified important factors in total knee replacement that predict outcomes five years after surgery.

The manuscript is currently available online and will be published in the Journal of Arthroplasty. It identifies the following key predictors for patient outcomes five years after total knee replacement: patient age, BMI, medical and musculoskeletal comorbidities; baseline pain and functional status; and mental health.

By understanding these factors, surgeons can better stratify patients based on risk, customize perioperative and postoperative management, and set realistic expectations for recovery and functional improvement. This algorithm will assist patients and surgeons in shared decision making as they choose the most appropriate time to proceed with surgery.

“This will enable patients and surgeons to improve patient outcomes with regard to pain, physical function and quality of life by optimizing modifiable risk factors preoperatively,” Ayers said.

“Identifying and addressing these predictive factors fosters personalized treatment plans, reduces the likelihood of complications, and improves long-term outcomes and patient satisfaction,” Ayers said.

The study is co-authored by members of UMass Chan’s Function and Outcomes Research for Comparative Effectiveness in Total Joint Replacement, or FORCE-TJR, team, including Dr. Ayers, the Arthur M. Pappas, MD, Professor and chair emeritus and distinguished professor of orthopedics & physical rehabilitation; Hua Zheng, Ph.D., assistant professor of orthopedics & physical rehabilitation; Wenyun Yang, MS, assistant professor of orthopedics & physical rehabilitation; and Mohamed Yousef, MD, Ph.D., a resident in the UMass Chan orthopedic surgery residency program and former research fellow in FORCE-TJR.

The team was recognized with the Chitranjan S. Ranawat Award from the Knee Society at the American Academy of Orthopedic Surgeons Annual Meeting.

More information:
David C. Ayers et al, The Chitranjan S. Ranawat Award: Factors That Predict Outcome Five Years Following Total Knee Arthroplasty, The Journal of Arthroplasty (2025). DOI: 10.1016/j.arth.2025.03.006