Natural history of changes in knee skin temperature following total knee arthroplasty: a systematic review and meta-analysis

Lilach Gavish*, Leonid Kandel, Gurion Rivkin, S. David Gertz, Oshrit Hoffer

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Patients undergoing total-knee arthroplasty (TKA) have transient increases in anterior knee skin temperature (ST) that subside as recovery progresses–except in cases of systemic or local prosthetic joint infections (PJI). This meta-analysis was designed to quantify the changes in knee ST following TKA in patients with uncomplicated recovery as a prerequisite for assessing the usefulness of thermal imaging for diagnosis of PJI. This meta-analysis (PROSPERO-CRD42021269864) was performed according to PRISMA guidelines. PUBMED and EMBASE were searched for studies reporting knee ST of patients that underwent unilateral TKA with uncomplicated recovery. The primary outcome was the weighted means of the differences in ST between the operated and the non-operated knees (ΔST) for each time point (before TKA, and 1 day; 1,2, and 6 weeks; and 3,6, and 12-months post-TKA). For this analysis, 318 patients were included from 10 studies. The elevation in ST was greatest during the first 2-weeks (ΔST = 2.8 °C) and remained higher than pre-surgery levels at 4–6 weeks. At 3-months, ΔST was 1.4 °C. It decreased to 0.9 °C and 0.6 °C at 6 and 12-months respectively. Establishing the baseline profile of knee ST following TKA provides the necessary first step for evaluating the usefulness of thermography for the diagnosis of post-procedural PJI.

Original languageAmerican English
Article number6810
JournalScientific Reports
Issue number1
StatePublished - Dec 2023

Bibliographical note

Funding Information:
We thank Tomer Ben-Shushan, Reference Librarian, The Muriel and Philip Berman Medical Library, The Hebrew University of Jerusalem. These studies were supported in part by The Stuart Roden Family Research Fund, London, UK; The Saul and Joyce Brandman Fund for Cardiovascular Research, The Alexander Grass Family Research Fund, The Dr. Bruce and Baila Waldholtz Research Fund, and The Dr. Martin and Grace Rosman Research Fund, Faculty of Medicine, The Hebrew University of Jerusalem, Israel. This study was chosen for the EFORT Jacques Duparc poster award at the 23rd annual EFORT congress, June 22-24, 2022, Lisbon, Portugal.

Publisher Copyright:
© 2023, The Author(s).


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