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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 December 28, 2025

Acute Right Ovarian Torsion with Six Twists: Successful Ovarian Preservation Following Detorsion

Abstract Introduction: Ovarian torsion is a rare gynecological emergency that can result in permanent ovarian loss if not promptly recognized and managed. Cases involving multiple rotations of the ovary are highly unusual and pose a significant risk for ovarian viability. Clinical Description: A 33-year-old P2 woman presented with sudden severe lower abdominal pain. Imaging showed a complex [...] Read more.
Introduction: Ovarian torsion is a rare gynecological emergency that can result in permanent ovarian loss if not promptly recognized and managed. Cases involving multiple rotations of the ovary are highly unusual and pose a significant risk for ovarian viability. Clinical Description: A 33-year-old P2 woman presented with sudden severe lower abdominal pain. Imaging showed a complex midline adnexal mass, more towards left and mild free fluid with suspected torsion. Emergency laparotomy showed a sixfold torsion of the right ovary with a dermoid cyst. Detorsion and cystectomy were performed with preservation of the ovary. Postoperative recovery was uneventful and histopathology further confirmed a benign dermoid cyst. Discussion: Ovarian torsion with multiple rotations is extremely rare so early recognition and timely surgical intervention enable ovarian salvage even in severe cases. Moreover, Dermoid cysts are the most common predisposing factor. Conclusion: This case highlights the importance of prompt diagnosis and immediate management of ovarian torsion to prevent complications, preserve ovarian integrity and fertility.
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Keyword:  Postoperative Recovery

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