{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T07:51:17Z","timestamp":1772092277380,"version":"3.50.1"},"reference-count":44,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2012,5,25]],"date-time":"2012-05-25T00:00:00Z","timestamp":1337904000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arthritis Care &amp;amp; Research"],"published-print":{"date-parts":[[2012,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine whether symptomatic (painful\/problematic) joints pre\u2013total knee replacement (TKR) surgery influence 1) pre\u2010 and 12\u2010month post\u2010TKR patient\u2010reported outcomes (pain, physical function, and mood [fatigue, anxiety, and depression]) and 2) postsurgical pain and function mediated through mood.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 494 participants completed the patient\u2010reported outcome measures pre\u2010 and 12\u2010months post\u2010TKR. Symptomatic (painful\/problematic) joints affected by arthritis were indicated on a homunculus presurgery. Covariate data included age, sex, educational attainment, body mass index, and comorbidity. Pre\u2010 and postsurgical outcome scores were regressed on symptomatic joint sites and covariates using linear regression analyses; postsurgical scores additionally were regressed on presurgery scores. Path analyses examined whether the effects of symptomatic joint sites on postsurgical pain and function were mediated through mood.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The age range was 35\u201388 years (mean 65 years) and 65% were women. Forty\u2010six percent reported \u22654 symptomatic joints (other than the surgical knee). Pre\u2010 and postsurgery, worse outcome scores were observed with increasing joint count. Adjusted for covariates, individuals reporting symptomatic ankles\/feet\/toes, neck, and spine\/lower back had worse presurgery fatigue and anxiety. Adjusted for covariates and presurgery status, worse fatigue for the neck and spine\/lower back and worse depression, pain, and function for the ankles\/feet\/toes and neck were observed postsurgery. The influence of symptomatic ankles\/feet\/toes on postsurgical pain and function was in part direct and partially mediated through depression. Full mediation was found for the neck through fatigue, anxiety, and depression, and for the spine\/lower back through fatigue.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Findings suggest that a comprehensive approach to osteoarthritis management\/care is warranted, and identify important associations between symptomatic joints and mood that negatively impact post\u2010TKR pain and physical function.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.21629","type":"journal-article","created":{"date-parts":[[2012,5,8]],"date-time":"2012-05-08T15:40:36Z","timestamp":1336491636000},"page":"838-846","source":"Crossref","is-referenced-by-count":66,"title":["Multiple joint involvement in total knee replacement for osteoarthritis: Effects on patient\u2010reported outcomes"],"prefix":"10.1002","volume":"64","author":[{"given":"A. V.","family":"Perruccio","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. 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