Muscular function and bone mass after knee arthroplasty

Anchuela, J.; Gomez-Pellico, L; Ferrer-Blanco, M.; Slocker, M.; Rodríguez, Roberto Puente

doi:10.1007/s002640100234

Cited by 12 publications

(9 citation statements)

References 21 publications

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“…Analogous changes for MVC force:BM ratio were noted. Several authors reported weakness of the QF muscle on the operated limb in comparison with the contralateral side in patients with unilateral TKA [1, 4, 5, 21]. Lorentzen et al [21] found that isometric MVC force deficit of the QF muscle in the operated leg 6 months after TKA was 29% when compared with the non‐operated leg at 75° of knee flexion.…”

Section: Discussionmentioning

confidence: 99%

Quadriceps femoris muscle voluntary isometric force production and relaxation characteristics before and 6 months after unilateral total knee arthroplasty in women

Gapeyeva

Buht

Peterson

et al. 2006

Knee Surg Sports Traumatol Arthrosc

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The purpose of the present prospective intervention study was to evaluate voluntary isometric force production, relaxation and activation capacity of the quadriceps femoris (QF) muscle before and 6 months after unilateral total knee arthroplasty (TKA). TKA was performed in ten women with primary knee osteoarthritis (OA) using the condylar endoprostheses. Isometric maximal voluntary contraction (MVC) force, rate of force development at 50% of MVC (RFD50) and their ratio to body mass, half-relaxation time (HRT) and voluntary activation (VA) of the QF muscle were recorded in patients for operated and non-operated leg before and 6 months after TKA. Established characteristics were compared with data on the dominant leg of ten age- and gender-matched controls. The clinical examination was performed using the Knee Society System (KSS) scores and pain intensity was assessed by visual analogue scale. MVC force in operated leg was lower (P < 0.05) before and 6 months after TKA as compared with the non-operated leg (31 and 32%, respectively) and controls (48 and 44%, respectively). Patients had lower (P < 0.05) VA of the QF muscle in operated leg 6 months after TKA as compared to controls. Significant increase (P < 0.05) of KSS clinical scores and the tendency for the increasing of explosive force production of QF muscle in the operated leg were observed 6 months after TKA (RFD50 was 60% lower before TKA and 40% lower 6 months after surgery as compared to controls). When compared with the preoperative value, HRT prolongation (P < 0.05) was noted 6 months after TKA in QF muscle of both legs in patients. Therefore, the present study confirmed that patients with knee OA had reduced force generation ability of QF muscle before TKA and the improvement of explosive force was noted 6 months after surgery.

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Section: Discussionmentioning

confidence: 99%

Quadriceps femoris muscle voluntary isometric force production and relaxation characteristics before and 6 months after unilateral total knee arthroplasty in women

Gapeyeva

Buht

Peterson

et al. 2006

Knee Surg Sports Traumatol Arthrosc

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show abstract

“…12,15 On the other hand, Berth et al, 18 in a study with patients assessed three years after TKA, have demonstrated that voluntary muscle activation improved over time, but did not reach the levels of healthy individuals. Anchuela et al 26 and Lorentzen et al 27 have also reported similar results, with greater capacity of strength production after surgery.…”

Section: Discussionmentioning

confidence: 66%

“…Several researchers have investigated the alterations in the muscle strength of individuals with OA and TKA by assessing torque. 3,13,15,18,26,27 Because peak torque represents performance at a single point of the range of motion, it might not be a good indicator of total functional capacity. Thus, muscle strength over the entire range of motion (work) and strength per unit of time (power) would be more clinically relevant.…”

Section: Discussionmentioning

confidence: 99%

“…22,23,25 Even authors who have reported an improvement in quadriceps muscle strength in individuals after TKA have not observed total recovery as compared with healthy individuals in the same age group. 18,26,27 The infl ammatory manifestations, defi cit in voluntary muscle activation, and hypotrophy of patients with knee OA and those undergoing TKA are believed to lower total muscle work, 28,29 leading to a reduction in torque, muscle power 30 and resistance. This generates important functional capacity loss, predisposing such individuals to fatigue.…”

Section: Introductionmentioning

confidence: 99%

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Trabalho e potência dos músculos extensores e flexores do joelho de pacientes com osteoartrite e com artroplastia total de joelho

Bastiani¹,

Ritzel²,

Bortoluzzi³

et al. 2012

Rev. Bras. Reumatol.

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Introduction: The infl ammatory manifestations of knee osteoarthritis (OA) lead to muscle inhibition and hypotrophy, resulting in a reduction in total muscle work and muscle power. Total knee arthroplasty (TKA) is the most adequate surgery for the treatment of advanced OA. However, its effects on muscle functional behavior have not been well understood. Objective: To compare the total work and power of the knee fl exor and extensor muscles in patients with OA (20) and in patients post-TKA (12) at two angular velocities (60°/sec and 240°/sec). Methods: An isokinetic Biodex dynamometer was used to assess muscle power and total work during isokinetic contractions. Two-way ANOVA for repeated measures was used to compare total muscle work and muscle power between the groups (SPSS software, version 13.0; signifi cance level, P < 0.05). Results: There was no difference between the OA and TKA groups for the total work of both knee extensors and fl exors at the two angular velocities (P ≥ 0.05). In addition, no difference was observed in the muscle power of the knee extensors and fl exors (P ≥ 0.05). Conclusion: Total work and power were similar in the OA and TKA groups, suggesting that TKA did not improve functional capacity, which was similar in both groups.

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“…Among other causes, stress-shielding-related bone loss in the immediate proximity of a knee prosthesis may lead to loosening of the prosthesis [1]. In addition, bone loss has been observed more peripherally both in the tibial and femoral diaphyses in association with total knee replacement operations [2][3][4][5][6]. Bone loss in the operated leg is most marked during the first post-operative year [1], while the functional performance of the operated leg remains weaker than that of the non-operated leg during the same time span [7].…”

Section: Introductionmentioning

confidence: 99%

Maximal voluntary isokinetic knee flexion torque is associated with femoral shaft bone strength indices in knee replacement patients

et al. 2012

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It is currently unknown whether knee replacement-associated bone loss is modified by rehabilitation programs. Thus, a sample of 45 (18 men and 25 women) persons with unilateral knee replacement were recruited; age 66 years (sd 6), height 169 cm (sd 8), body mass 83 kg (sd 15), time since operation 10 months (sd 4) to explore the associations between maximal torque/power in knee extension/flexion and femoral mid-shaft bone traits (Cortical cross-sectional area (CoA, mm(2)), cortical volumetric bone mineral density (CoD, mg/mm(3)) and bone bending strength index (SSI, mm(3))). Bone traits were calculated from a single computed tomography slice from the femoral mid-shaft. Pain in the operated knee was assessed with the WOMAC questionnaire. Stepwise regression models were built for the operated leg bone traits, with knee extension and flexion torque and power, age, height, body mass, pain score and time since operation as independent variables. CoA was 2.3% (P=0.015), CoD 1.2% (P<0.001) and SSI 1.6% (P=0.235) lower in the operated compared to non-operated leg. The overall proportions of the variation explained by the regression models were 50%, 29% and 55% for CoA, CoD and SSI, respectively. Body mass explained 12% of Coa, 11% of CoD and 11% of SSI (P≤0.003). Maximal knee flexion torque explained 38% of Coa, 7% of CoD and 44% of SSI (p≤0.047). For CoD time since operation also became a significant predictor (11%, P=0.045). Knee flexion torque of the operated leg was positively associated with bone strength in the operated leg. Thus, successful rehabilitation may diminish bone loss in the operated leg.

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Muscular function and bone mass after knee arthroplasty

Cited by 12 publications

References 21 publications

Quadriceps femoris muscle voluntary isometric force production and relaxation characteristics before and 6 months after unilateral total knee arthroplasty in women

Quadriceps femoris muscle voluntary isometric force production and relaxation characteristics before and 6 months after unilateral total knee arthroplasty in women

Trabalho e potência dos músculos extensores e flexores do joelho de pacientes com osteoartrite e com artroplastia total de joelho

Maximal voluntary isokinetic knee flexion torque is associated with femoral shaft bone strength indices in knee replacement patients

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