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Open Access June 25, 2025

Performance and Validity of Knee Function Assessment Tools After Total Knee Arthroplasty: A Systematic Review

Abstract Objective: To identify and evaluate the main functional assessment tools applied in the postoperative monitoring of patients undergoing total knee arthroplasty (TKA), and to synthesize the functional outcomes reported through these instruments in the current scientific literature. Methodology: A structured review was conducted following PRISMA 2020 guidelines. [...] Read more.
Objective: To identify and evaluate the main functional assessment tools applied in the postoperative monitoring of patients undergoing total knee arthroplasty (TKA), and to synthesize the functional outcomes reported through these instruments in the current scientific literature. Methodology: A structured review was conducted following PRISMA 2020 guidelines. Thirty-one peer-reviewed studies were selected through a targeted manual search based on predefined eligibility criteria. Included studies evaluated functional recovery following TKA using validated outcome measures such as the WOMAC, KSS, KOOS, IKDC, SF-36, and SANE. Data extraction focused on the instruments used, patient population characteristics, and reported outcomes. A descriptive synthesis was compiled in Table 1. Additionally, 15 studies with quantitative data were analyzed using a forest plot to illustrate risk ratios (RR) and 95% confidence intervals (CI) for functional improvement. Risk of bias was assessed qualitatively based on methodological rigor, clarity of reporting, and validation of the outcome tools. Results: All included studies reported improvements in functional status following TKA. Most risk ratios ranged from 0.66 to 0.85, indicating a consistent reduction in the risk of postoperative functional limitation. High-quality studies demonstrated more precise effect estimates and greater internal validity. The SANE scale emerged as a valid and practical tool with high responsiveness, including in its culturally adapted Brazilian version. Despite heterogeneity in study design, the direction of effect remained consistent across all included studies. Conclusion: Validated functional assessment tools are essential for monitoring recovery after total knee arthroplasty. Instruments such as WOMAC and SANE demonstrate strong clinical utility and psychometric validity. Their systematic use enhances outcome comparability, supports individualized rehabilitation planning, and improves decision-making in orthopedic care.
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Systematic Review
Open Access May 30, 2025

Advancing Women's Soccer: Historical Growth and Challenges Concerning Athlete Health and Diversity

Abstract This exploratory review article synthesizes existing literature on the evolution and increasing significance of women's soccer, particularly in the United States. While acknowledging the sport's progress and the achievements of the U.S. Women's National Team (USWNT), it critically examines two key challenges that impede further advancement: the alarmingly high incidence of knee injuries among [...] Read more.
This exploratory review article synthesizes existing literature on the evolution and increasing significance of women's soccer, particularly in the United States. While acknowledging the sport's progress and the achievements of the U.S. Women's National Team (USWNT), it critically examines two key challenges that impede further advancement: the alarmingly high incidence of knee injuries among female players and the persistent underrepresentation of Black women. The review highlights the biomechanical factors contributing to these issues, emphasizing the need for footwear designed to accommodate the specific anatomical and functional requirements of female athletes. Furthermore, it explores the systemic barriers that contribute to the lack of diversity within the sport, advocating for equitable opportunities and support for Black women. This review concludes by underscoring the necessity for innovative, interdisciplinary approaches to ensure the continued growth and well-being of all participants in women's soccer, and identifies critical areas for future research in kinesiology and related fields.
Review Article
Open Access March 29, 2025

Comprehensive Review of Conservative and Surgical Treatment Strategies for Knee Osteoarthritis: Efficacy, Safety, and Emerging Therapies

Abstract Knee osteoarthritis (KOA) is a chronic degenerative joint disorder that significantly impairs mobility and quality of life. While surgical interventions such as total knee arthroplasty (TKA) are effective in severe cases, conservative treatments are critical for early and intermediate disease management. This review evaluates the efficacy, safety, and clinical applications of both conservative and [...] Read more.
Knee osteoarthritis (KOA) is a chronic degenerative joint disorder that significantly impairs mobility and quality of life. While surgical interventions such as total knee arthroplasty (TKA) are effective in severe cases, conservative treatments are critical for early and intermediate disease management. This review evaluates the efficacy, safety, and clinical applications of both conservative and surgical treatment approaches, including lifestyle modifications, physical therapy, pharmacological interventions, regenerative medicine, and surgical procedures. The integration of a multidisciplinary approach is emphasized as a key strategy for optimizing clinical outcomes and tailoring interventions to disease severity.
Review Article
Open Access March 18, 2025

ACL Tears and the Female Athlete

Abstract The anterior collateral ligament (ACL) is one of four ligaments in the knee, connecting the tibia and femur and acting as a key stabilizer. Factors influencing these injuries include playing surface, training programs, athlete strength, technique, and gender. Female athletes are at a higher risk of ACL injuries, being four to nine times more likely than males, often due to differences in [...] Read more.
The anterior collateral ligament (ACL) is one of four ligaments in the knee, connecting the tibia and femur and acting as a key stabilizer. Factors influencing these injuries include playing surface, training programs, athlete strength, technique, and gender. Female athletes are at a higher risk of ACL injuries, being four to nine times more likely than males, often due to differences in biomechanics and training patterns. It ss important that rehab focuses on both legs, as overworking the injured leg increases the risk of injuries elsewhere. Prevention training, such as proprioceptive-balance and plyometric agility training, has been shown effectiveness in minimizing ACL injuries. Despite some limitations in research, these programs highlight the importance of improved training techniques. Kinesio taping might help reduce pain but lacks strong evidence for preventing ACL tears.
Review Article
Open Access November 04, 2022

Long Term Outcomes and Survivorship of Bilateral Lower Limb Arthroplasties in Patients with Multiple Epiphyseal Dysplasia

Abstract Background: Multiple epiphyseal dysplasia (MED) a rare form of skeletal dysplasia with early-onset osteoarthritis affecting the hip and knee joints. There is paucity of evidence regarding the long term outcomes of arthroplasty in this patient cohort. This is the first study to describe the outcomes of bilateral arthroplasty of the hip and knee in patients with MED. Methods: A prospective study of patients with MED who underwent bilateral staged total hip arthroplasty (THA) and bilateral simultaneous total knee arthroplasty (TKA) between July 2013 to April 2014. Preoperative and postoperative clinical and radiographic assessment including functional outcomes namely Merle d’aubigne score, Harris hip score (HHS), Knee society score (KSS) and numeric rating scale (NRS) for pain were recorded in prospective database and evaluated. Results: 3 patients (female - 1 / male - 2) with MED who underwent bilateral lower limb arthroplasty of the hip and knee were reviewed periodically with an average followup of 7.31 years. Mean preoperative Merle d'Aubigné score (6.33 ± 0.58), HHS (31.83 ± 5.31) and KSS (28.67 ± 7.97) increased following bilateral lower limb arthroplasty with mean postoperative Merle d'Aubigné score (16.33 ± 0.58), HHS (84.33 ± 5.99) and KSS (86.33 ± 7.09) (P<0.001). Mean NRS decreased from 7.33 ± 0.58 in the preoperative period to 0.67 ± 0.58 at the most recent followup (P [...] Read more.
Background: Multiple epiphyseal dysplasia (MED) a rare form of skeletal dysplasia with early-onset osteoarthritis affecting the hip and knee joints. There is paucity of evidence regarding the long term outcomes of arthroplasty in this patient cohort. This is the first study to describe the outcomes of bilateral arthroplasty of the hip and knee in patients with MED. Methods: A prospective study of patients with MED who underwent bilateral staged total hip arthroplasty (THA) and bilateral simultaneous total knee arthroplasty (TKA) between July 2013 to April 2014. Preoperative and postoperative clinical and radiographic assessment including functional outcomes namely Merle d’aubigne score, Harris hip score (HHS), Knee society score (KSS) and numeric rating scale (NRS) for pain were recorded in prospective database and evaluated. Results: 3 patients (female - 1 / male - 2) with MED who underwent bilateral lower limb arthroplasty of the hip and knee were reviewed periodically with an average followup of 7.31 years. Mean preoperative Merle d'Aubigné score (6.33 ± 0.58), HHS (31.83 ± 5.31) and KSS (28.67 ± 7.97) increased following bilateral lower limb arthroplasty with mean postoperative Merle d'Aubigné score (16.33 ± 0.58), HHS (84.33 ± 5.99) and KSS (86.33 ± 7.09) (P<0.001). Mean NRS decreased from 7.33 ± 0.58 in the preoperative period to 0.67 ± 0.58 at the most recent followup (P<0.001). One patient had heterotrophic ossification following THA. There were no revisions. Conclusions: Bilateral lower limb arthroplasty of the hip and knee is a good treatment option to restore function and mobility in MED patients with advanced degenerative arthritis. Careful preoperative planning, meticulous surgical techniques, patient focussed postoperative rehabilitation with multidisciplinary team approach are vital to ensure good functional outcomes and implant survivorship.
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Case Series
Open Access May 20, 2022

Prevailing Injuries among Senior High Students-Athletes in the Akuapem Municipality

Abstract Sports injuries among student-athletes in high schools have become prevalent in most developing countries such as Ghana. In identifying the prevailing injuries among senior high student-athletes in the Akuapem municipality, a descriptive cross-sectional survey design was used. A total of 610 student-athletes were purposely selected for the study to respond to the DEMASS inventory questionnaire [...] Read more.
Sports injuries among student-athletes in high schools have become prevalent in most developing countries such as Ghana. In identifying the prevailing injuries among senior high student-athletes in the Akuapem municipality, a descriptive cross-sectional survey design was used. A total of 610 student-athletes were purposely selected for the study to respond to the DEMASS inventory questionnaire regarding their opinion on the prevailing sports injuries. The results indicated that wounds (67.8%), knee injury (65.1%), muscle cramps (56.1%), and thigh injury (55.1%) were prevailing in S.H.S tournament than sprain (37.8%), strain (32.0%), dislocation (30.0%), fracture (31.3%), nose bleeding (31.3%) and groin injuries (23.1%). Participants who played more games professed that the number of games played contributed to sustaining sprain, strain, dislocation, and nose bleeding. Further studies should be carried out at other places and districts to uncover more about injuries sustained during high school sports competitions to minimize their occurrence.
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