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World J Orthop. Mar 18, 2026; 17(3): 115537
Published online Mar 18, 2026. doi: 10.5312/wjo.v17.i3.115537
Published online Mar 18, 2026. doi: 10.5312/wjo.v17.i3.115537
Significant quality of life improvement following total knee replacement for end-stage osteoarthritis: Retrospective cohort study
Mohammed H Abushal, Department of Orthopedic Surgery, University of Tabuk, Tabuk 71491, Saudi Arabia
Osama M Embaby, Department of Orthopedic Surgery, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham B66 2QT, United Kingdom
Mahmoud Mersal, Department of Orthopedic Surgery, University Hospital of Birmingham Foundation Trust, Birmingham B9 5SS, United Kingdom
Emran Badghish, Department of Surgery, College of Medicine, University of Bisha, Bisha 67714, Saudi Arabia
Mohamed Elalfy, Department of Orthopedic Surgery, Mansoura University, Mansoura 35516, Egypt
Co-first authors: Mohammed H Abushal and Osama M Embaby.
Author contributions: Abushal MH and Embaby OM designed the study concept and methodology, they contributed equally to this article, they are the co-first authors of this manuscript; Abushal MH, Embaby OM, and Mersal M conducted the clinical investigation and data collection; Embaby OM and Mersal M performed data curation, prepared original manuscript draft; Abushal MH, Embaby OM, Mersal M, Badghish E, and Elalfy M subsequently reviewed and edited; Abushal MH and Elalfy M provided supervision; and all authors have read and approved the final version of the manuscript.
Institutional review board statement: This study was approved by the University of Tabuk, Saudi Arabia, approval No. 704.
Informed consent statement: Informed consent was waived due to the retrospective nature of the study and the use of de-identified patient data.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: Data supporting the findings of this study are available from the corresponding author upon reasonable request.
Corresponding author: Mohammed H Abushal, Assistant Professor, Department of Orthopedic Surgery, University of Tabuk, Duba Road, University City, Tabuk 71491, Saudi Arabia.
Received: October 20, 2025
Revised: November 4, 2025
Accepted: December 17, 2025
Published online: March 18, 2026
Processing time: 148 Days and 10 Hours
Revised: November 4, 2025
Accepted: December 17, 2025
Published online: March 18, 2026
Processing time: 148 Days and 10 Hours
Core Tip
Core Tip: Total knee replacement is a highly effective procedure for improving the quality of life in patients with severe knee osteoarthritis. This retrospective cohort study from a major Saudi Arabian orthopedic center provides strong evidence that surgical intervention offers substantial and clinically meaningful benefits over conservative management, as measured by the EuroQol five-dimension, five-level questionnaire patient-reported outcome measure. These findings support prioritizing timely surgical referrals for eligible candidates to maximize improvements in health-related quality of life.