THE IMPACT: Education Level Has a Relativity for The Recovery of Total Knee Arthroplasty: a meta-analysis of randomized controlled trials

Abstract Objective: This study aimed to observe the relationship between education level and outcomes after total knee arthroplasty (TKA).Methods: 1264 patients after TKA in our hospital from April 2016 to April 2020 were reviewed. These patients were divided into 4 groups (A who are illiterate, B who had elementary school degree, C who had junior high school degree, D who had senior high school degree or higher) by the educational level, which was blinded to the observers. The postoperative outcomes of KSS score, pain, joint extension and flexion function were observed 1 month, 6 months and 1 year after discharged from hospital.Results: Among 1253 patients met the inclusion criteria, the average age was 68.63 years, the average weight was 57.73 kg. There are no distinctions among 4 groups one day after the surgery. However, the outcomes of the follow up were that, the KSS score was: 77.84 ± 10.635; 80.70 ± 8.956; 87.92 ± 8.123;91.27 ± 8.262, with significant differences (P < 0.05). The mean VAS scores were: 1.97 ± 1.60; 2.07 ± 1.66; 1.197 ± 1.5265, 1.044 ± 1.4662. Patients in Group C and D had significantly less pain than that in Group A and B (P < 0.05). The knee flexion range of motion (ROM) was: 91.21 ± 11.69 °; 91.77 ± 11.95 °; 102.12 ± 11.38 °; 109.96 ± 10.64 °, Group D performed best, with significant differences (P < 0.05). The knee extension ROM were: – 2.41 ± 4.49 °; – 0.91 ± 2.82 °; – 0.83 ± 2.87 °; – 0.35 ± 1.60 °, with significant difference between Group D and the others (P < 0.05).Conclusion: Education level is an important factor affecting the outcomes after total knee arthroplasty. The patients with higher education level would likely have better outcomes.