Robotic device-assisted knee extension training during the early postoperative period after opening wedge high tibial osteotomy: a case report

Abstract

BackgroundMaintenance or restoration of a good range of motion of the knee is one of the most important outcomes following knee surgery. According to previous studies, opening wedge high tibial osteotomy enables better recovery of range of motion in knee flexion than that achievable after total knee arthroplasty or unicompartmental knee arthroplasty. However, few reports provide a detailed description of the postoperative recovery of knee extension range of motion after opening wedge high tibial osteotomy. We describe our experience with a knee extension training program using a single-joint hybrid assistive limb device (HAL-SJ; Cyberdyne Inc., Tsukuba, Japan) during the acute recovery phase after opening wedge high tibial osteotomy. The HAL-SJ is a wearable robotic device that facilitates voluntary control of knee joint motion.Case presentationA 67-year-old Japanese woman who underwent opening wedge high tibial osteotomy for spontaneous osteonecrosis of the left medial femoral condyle received HAL-SJ-based knee extension training postoperatively. Our experience with this patient revealed that knee extension training with the HAL-SJ during the acute phase following opening wedge high tibial osteotomy is feasible. Furthermore, the patient’s knee extension range of motion improved to values similar to those seen during the preoperative stage, and her flexion range of motion was improved at 3 months after the surgery.ConclusionsHAL-SJ-based knee extension training could be used as a novel post-opening wedge high tibial osteotomy rehabilitation modality. Further exploration of individualized optimal settings of the HAL-SJ is required to improve its safety and efficacy.

Effects of Robot-Assisted Gait Training in Patients with Burn Injury on Lower Extremity: A Single-Blind, Randomized Controlled Trial

“…Moreover, the use of robot-assisted training significantly decreased the pain level during active movement and improved performance compared with conventional therapy [ 10 ]. The robot-assisted training improved the neuromuscular functions of the quadriceps, which allowed the knee to extend fully and did not increase the level of knee pain immediately after surgery [ 23 ]. Improvements in isometric strengths after RAGT in the hip, knee, and ankle were similar to the measurements after conventional strengthening program [ 24 ].…”

Rehabilitation training using a single-joint type hybrid assistive limb for the knee after anterior cruciate ligament reconstruction: an initial case report indicating safety and feasibility

“…2A, B). The patient was then instructed to perform knee extension and flexion thereby contracting his quadriceps and hamstring muscles 5) . Generally, several anatomical problems occur following ACLR: slightly lax graft tension, partial graft tear, poor synovial coverage, and cyclops-like lesion 7) .…”

“… ). The patient was then instructed to perform knee extension and flexion thereby contracting his quadriceps and hamstring muscles 5 ) .…”

“…The movement of the robot is triggered by bioelectric signals (muscle action potentials) from the muscles. Although previous studies have reported that the knee HAL-SJ is effective in functional recovery following total knee arthroplasty (TKA) and opening wedge high tibial osteotomy 5 , 6 ) , this has not been done after ACLR.…”

Hybrid assistive limb (HAL) treatment for patients with severe thoracic myelopathy due to ossification of the posterior longitudinal ligament (OPLL) in the postoperative acute/subacute phase: A clinical trial

“…Previous studies have reported on the feasibility and efficacy of HAL training in the rehabilitation of patients with impaired walking due to chronic multifactorial conditions 6 and to various underlying conditions, including musculoskeletal ambulation disorder, 7 spinal cord injury, [8][9][10][11][12][13][14] stroke, [15][16][17][18][19][20][21][22] knee joint disease, [23][24][25][26] and brachial plexus injury. 27,28 However, the applicability of HAL training in patients with OPLL has only been evaluated in a few case reports to date.…”