Do lifestyle factors affect patient reported clinical outcomes after total knee replacement surgery? A feasibility cohort study (PRO-Knee)

Stephens, Gareth, Liloglou, Triantafyllos ORCID: 0000-0003-0460-1404, Moffatt, Maria ORCID: 0000-0002-8385-7418 and Littlewood, Chris (2025) Do lifestyle factors affect patient reported clinical outcomes after total knee replacement surgery? A feasibility cohort study (PRO-Knee) PLOS ONE, 20 (10). e0332953-e0332953. ISSN 1932-6203, 1932-6203

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Abstract

Aims To evaluate the feasibility of a substantive cohort study to determine whether modifiable lifestyle factors, including smoking, physical inactivity, alcohol consumption and being overweight, affect patient-reported clinical outcomes after total knee replacement surgery. Methods Adults awaiting total knee replacement surgery were recruited pre-operatively and completed self-reported questionnaires at baseline and 3- and 6-months post-surgery. Feasibility outcomes, including recruitment, retention and response rate of the primary outcome questionnaire were analysed descriptively. Results 40 participants were recruited from 183 eligible patients (22%). 87.5% (35/40) participants returned questionnaires at 6-months. 85% (34/40) of participants were overweight (BMI>24.9), 25% (10/40) drank alcohol (AUDIT-C>4), 5% (2/40) smoked tobacco and 67.5% (27/40) were physically inactive (GPPAQ classification of ‘moderately inactive’, or ‘inactive’). Conclusion Modifiable lifestyle factors including smoking, alcohol use, physical inactivity and being overweight are highly prevalent in patients waiting for total knee replacement. Based on this study, a future substantive cohort study investigating the effect of lifestyle factors on clinical outcomes post total knee replacement in the UK NHS is feasible.

Item Type:	Article
Uncontrolled Keywords:	Humans, Treatment Outcome, Arthroplasty, Replacement, Knee, Cohort Studies, Feasibility Studies, Alcohol Drinking, Smoking, Life Style, Aged, Middle Aged, Female, Male, Overweight, Surveys and Questionnaires, Patient Reported Outcome Measures
Depositing User:	Symplectic Admin
Date Deposited:	10 Sep 2026 11:21
Last Modified:	10 Sep 2026 12:25
DOI:	10.1371/journal.pone.0332953
Related Websites:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3202624
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