{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T21:24:18Z","timestamp":1792013058738,"version":"4.4.0"},"reference-count":45,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T00:00:00Z","timestamp":1763596800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,3,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Although total knee arthroplasty (TKA) is known to improve patient-reported outcome measure (PROM) scores in the short term to midterm, the long-term trajectories of both disease-specific and generic PROM scores remain unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We retrospectively analyzed the prospectively collected registry data of 1,264 patients (mean age, 68.5 years; 93.7% female) who underwent primary TKA for osteoarthritis between 2005 and 2013 and completed PROM assessments at baseline and 10 years postoperatively. Disease-specific PROMs were assessed using the Knee Society Knee Score (KSKS), Knee Society Function Score (KSFS), and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Generic PROMs were assessed using the Short Form-36 Health Survey (SF-36). Assessments were performed preoperatively and at 6 months and 1, 2, 5, 10, and 15 years postoperatively. Generalized linear models and linear mixed-effects models were used to evaluate temporal changes and subgroup differences by age and sex.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>All PROM scores improved significantly within 6 months after TKA. Thereafter, disease-specific PROMs showed modest changes up to 1 year, with relative stability until 5 years, whereas generic PROMs demonstrated heterogeneous patterns across different domains. Between 5 and 10 years postoperatively, WOMAC pain and stiffness scores did not show significant changes, the KSKS decreased but not significantly so, and WOMAC physical function scores exhibited small but significant deterioration that was not clinically meaningful. SF-36 domains demonstrated varied trajectories: physical and mental component scores declined by more than the minimal clinically important difference after 5 years, whereas the social functioning score showed continuous improvement, although not all changes were significant. Octogenarians demonstrated lower physical functioning scores but higher social functioning scores in the long term compared with younger patients, and female patients demonstrated inferior functional and vitality scores compared with male patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Both disease-specific and generic PROM scores after TKA improved significantly and remained superior to baseline scores over a 15-year period, although physical function scores tended to decline in the long term. In this large, predominantly female Korean cohort, the distinct age- and sex-specific trajectories highlight the importance of implementing individualized, time-adapted long-term management strategies to optimize patient outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Therapeutic\n                      <jats:underline>Level III<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.25.00770","type":"journal-article","created":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T21:00:47Z","timestamp":1767646847000},"page":"355-362","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":5,"title":["Long-Term Trajectories of Patient-Reported Outcomes Following Total Knee Arthroplasty"],"prefix":"10.2106","volume":"108","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4492-4358","authenticated-orcid":false,"given":"Byung Sun","family":"Choi","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6199-908X","authenticated-orcid":false,"given":"Du Hyun","family":"Ro","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, South Korea"},{"name":"Connecteve Co., Ltd., Seoul, South Korea"},{"name":"Innovative Medical Technology Research Institute, Seoul National University Hospital, Seoul, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1229-8863","authenticated-orcid":false,"given":"Hyuk-Soo","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,11,20]]},"reference":[{"issue":"3","key":"bib1-20260304","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1016\/j.cger.2010.03.001","article-title":"Epidemiology of osteoarthritis","volume":"26","author":"Zhang","year":"2010","journal-title":"Clin Geriatr Med."},{"issue":"3","key":"bib2-20260304","doi-asserted-by":"crossref","first-page":"e0230613","DOI":"10.1371\/journal.pone.0230613","article-title":"The prevalence of and demographic factors associated with radiographic knee osteoarthritis in Korean adults aged \u2265 50 years: The 2010-2013 Korea National Health and Nutrition Examination Survey","volume":"15","author":"Hong","year":"2020","journal-title":"PLoS One."},{"key":"bib3-20260304","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1016\/j.jor.2020.10.003","article-title":"Modelling the cost-effectiveness of total knee arthroplasty: A systematic review","volume":"22","author":"Kamaraj","year":"2020","journal-title":"J Orthop."},{"issue":"1","key":"bib4-20260304","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1007\/s11999-011-2123-4","article-title":"Pain relief and functional improvement remain 20 years after knee arthroplasty","volume":"470","author":"Meding","year":"2012","journal-title":"Clin Orthop Relat Res."},{"issue":"1","key":"bib5-20260304","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1080\/17453670902805007","article-title":"Knee arthroplasty: are patients\u2019 expectations fulfilled? A prospective study of pain and function in 102 patients with 5-year follow-up","volume":"80","author":"Nilsdotter","year":"2009","journal-title":"Acta Orthop."},{"issue":"8","key":"bib6-20260304","doi-asserted-by":"crossref","first-page":"1062","DOI":"10.1002\/art.24644","article-title":"Total knee replacement and health-related quality of life: factors influencing long-term outcomes","volume":"61","author":"N\u00fa\u00f1ez","year":"2009","journal-title":"Arthritis Rheum."},{"issue":"3","key":"bib7-20260304","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1016\/j.cger.2012.06.001","article-title":"Health-related quality of life after total joint arthroplasty: a scoping review","volume":"28","author":"Jones","year":"2012","journal-title":"Clin Geriatr Med."},{"issue":"1S","key":"bib8-20260304","doi-asserted-by":"crossref","first-page":"S41","DOI":"10.1016\/j.otsr.2017.04.017","article-title":"Quality of life after total knee arthroplasty","volume":"104","author":"Canovas","year":"2018","journal-title":"Orthop Traumatol Surg Res."},{"issue":"4","key":"bib9-20260304","doi-asserted-by":"crossref","first-page":"e058044","DOI":"10.1136\/bmjopen-2021-058044","article-title":"Progression of chronic pain and associated health-related quality of life and healthcare resource use over 5 years after total knee replacement: evidence from a cohort study","volume":"12","author":"Cole","year":"2022","journal-title":"BMJ Open."},{"issue":"2","key":"bib10-20260304","doi-asserted-by":"crossref","first-page":"156","DOI":"10.2106\/JBJS.M.00372","article-title":"Intermediate and long-term quality of life after total knee replacement: a systematic review and meta-analysis","volume":"97","author":"Shan","year":"2015","journal-title":"J Bone Joint Surg Am."},{"issue":"7","key":"bib11-20260304","doi-asserted-by":"crossref","first-page":"S169","DOI":"10.1016\/j.arth.2023.04.005","article-title":"Age-Related Differences in Pain, Function, and Quality of Life Following Primary Total Knee Arthroplasty: Results From a FORCE-TJR (Function and Outcomes Research for Comparative Effectiveness in Total Joint Replacement) Cohort","volume":"38","author":"Ayers","year":"2023","journal-title":"J Arthroplasty."},{"issue":"8S1","key":"bib12-20260304","doi-asserted-by":"crossref","first-page":"S100","DOI":"10.1016\/j.arth.2024.04.031","article-title":"Gender Differences in Pain, Function, and Quality of Life Five Years Following Primary Total Knee Arthroplasty","volume":"39","author":"Ayers","year":"2024","journal-title":"J Arthroplasty."},{"key":"bib13-20260304","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1097\/00003086-198911000-00004","article-title":"Rationale of the Knee Society clinical rating system","volume":"248","author":"Insall","year":"1989","journal-title":"Clin Orthop Relat Res."},{"issue":"12","key":"bib14-20260304","first-page":"1833","article-title":"Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee","volume":"15","author":"Bellamy","year":"1988","journal-title":"J Rheumatol."},{"issue":"6","key":"bib15-20260304","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1097\/00005650-199206000-00002","article-title":"The MOS 36-item short-form health survey (SF-36). 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