Buterin A, Vuckovic M, Spanja Prpic S, Zaharija V, Nonkovic M, Prpic T. Comparison of functional recovery of the knee following total knee arthroplasty in patients with and without ankle symptoms. World J Orthop 2025; 16(5): 106004 [PMID: 40496260 DOI: 10.5312/wjo.v16.i5.106004]
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May 19, 2025, 09:35
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Reader Comments:
The studied groups were not homogeneous by age and gender proportion. Research does not achieve the objectives of the experiment.
The results are unreliable and cannot be considered to be a meaningful contribution to research progress in this field.
Furthermore, the comorbidity was not reported: this represents a further limit that could affect the results.
Reply from the Editorial Office:
Thank you very much for your comments.
Reader's ID:
05431296
Submitted on:
May 18, 2025, 06:11
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Reader Comment Standards for Published Articles:
1 Title
Does the title reflect the main subject/hypothesis of the manuscript?
2 Abstract
Does the abstract summarize and reflect the work described in the manuscript?
3 Key Words
Do the key words reflect the focus of the manuscript?
4 Background
Does the manuscript adequately describe the background, present status and significance of the study?
5 Methods
Does the manuscript describe methods (e.g., experiments, data analysis, surveys, and clinical trials, etc.) in adequate detail?
6 Results
Are the research objectives achieved by the experiments used in this study?
Has the study made meaningful contributions towards research progress in this field?
7 Discussion
Does the manuscript interpret the findings adequately and appropriately, highlighting the key points concisely, clearly and logically?
Are the findings and their applicability/relevance to the literature stated in a clear and definite manner?
Is the Discussion accurate and does it discuss the paper’s scientific significance and/or relevance to clinical practice sufficiently?
8 Illustrations and Tables
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Does the author self-cite, omit, incorrectly cite and/or over-cite references?
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Are the style, language and grammar accurate and appropriate?
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For all manuscripts involving human studies and/or animal experiments, author(s) must submit the related formal ethics documents that were reviewed and approved by their local ethical review committee. Did the manuscript meet the requirements of ethics?
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Reader Comments:
This prospective study rightly identifies a significant problem i.e.,preoperative ankle pain might effect the early functional outcome in patients undergoing total knee arthroplasty for primary Osteoarthritis knee.It is often overlooked but the deformity at the level of knee definitely impacts the biomechanics alignment of the entire lower limb and also at the ankle. The key finding was patients exhibited significantly lower KOOS scores and extension recovery at 3 months postoperatively, even after adjusting for demographic confounders. This reiterates the necessity for a complete lower limb assessment and managing preoperatively any hip/ankle symptoms preoperatively to optimize TKA outcomes. The methodology, protocol, grouping of patients was all good.
The authors could have given a detailed radiographic alignment of the patient's lowerliimbs that were operated to substantiate the preoperative status and the results postoperatively. Even though AOFAS score, is an appropriate tool for assessing the ankle symptoms and pathologies, a detailed radiographic assessment of the ankle including ankle hind foot assessment, weight bearing alignment could have been added/ mentioned. Incorporating pre- and postoperative radiographs would have allowed the authors to better delineate whether the observed differences in KOOS and knee extension were attributable to underlying mechanical misalignment or simply symptomatic variation.
A gait analysis of the patients can also be included to add objective assessment to the data. That would tell us whether the results are an outcome of any malalignment or just symptomatic variation.
A longer followup would also suggest us whether the symptoms are resolving over time or still persisting.
Reply from the Editorial Office:
First, thank you very much for your professional comments on the article published in World Journal of Orthopedics.
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