No difference between wound closure in extension or flexion for range of motion following total knee arthroplasty: a randomized clinical trial

Motififard, Mehdi; Heidari, Mohsen; Nemati, Amin

doi:10.1007/s00167-014-3317-6

Cited by 12 publications

(15 citation statements)

References 20 publications

(33 reference statements)

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“…Furthermore, they are the cause of invalidity mainly among older people, about 75 % people over 65 years old. Nowadays, there are no precautionary measures or early interventions that would prevent it from happening, more precisely slow down the progression of knee arthritis (9)(10)(11)(12)(13)(14). Where conservative treatment fails, surgical intervention takes place -a total knee arthroplasty.…”

Section: Discussionmentioning

confidence: 99%

Does standard post-operative rehabilitation have its place after total knee replacement?

Vavro¹,

Žiaková²,

Gazdíková³

et al. 2017

BLL

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OBJECTIVE: The pilot study objective was to evaluate the effect of comprehensive post-operative physiotherapeutic treatment on the selected physiotherapeutic parameters as well as patients' quality of life after a total knee joint replacement surgery. RESULTS: Thirty patients after total knee joint arthroplasty were enrolled into the pilot study. After completing the physiotherapeutic processes, we have observed among the patients who underwent a total knee replacement surgery, a signifi cant increase in muscle strength as with the fl exors as well as the extensors (p = 0.001), improvement in their range of motion in knee joint fl exion, in comparison to its range before treatment (p = 0.001), knee pain reduction (p = 0.001) and post-operative swelling (p <0.001), respectively. After undergoing the physiotherapeutic procedures, we recorded a statistically signifi cant improvement in the monitored physical components: dressing (p = 0.008) and toilet use (p = 0.001), transfer from bed to chair (p = 0.008), walking on fl at surface (p = 0.001), climbing stairs (p = 0.001). Passing the physiotherapy signifi cantly reduced the degree of dependence of operated patients (p = 0.001). CONCLUSION: Early post-operative physiotherapy treatment positively affects patients' general condition. In addition, it improves muscle strength, range of motion of the operated joint, eliminates post-operative pain and reduces swelling that improves patients' self-suffi ciency. Standard physiotherapy nowadays and in the next few years will take a unique place in patients' management after total knee joint replacement (Tab. 5, Ref. 26). Text in PDF www.elis.sk.

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Section: Discussionmentioning

confidence: 99%

Does standard post-operative rehabilitation have its place after total knee replacement?

Vavro¹,

Žiaková²,

Gazdíková³

et al. 2017

BLL

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“…A total of seven studies were included in this review (►Table 1). [17][18][19][20][21][22][23] Two of these studies reported the outcomes of the same series of patients. 22,23 The total number of patients included was 516 patients (259 patients in the flexion group and 257 patients in the full extension group).…”

Section: Methodsmentioning

confidence: 99%

“…The difference was not statistically significant between the groups (p > 0.05). Motififard et al, 18 Wang et al, 19 Kömürcü et al, 20 and Emerson et al 22,23 reported no wound dehiscence or infection that required second surgery in both groups.…”

Section: Wound-related Complicationsmentioning

confidence: 95%

“…ROM was not significantly different between the two groups at 6 months postoperatively (p ¼ 0.72). In a similar study, Motififard et al 18 prospectively enrolled and randomly assigned 91 patients in two groups. Skin closure was performed in 90 degrees flexion (n ¼ 45) and in full extension position (n ¼ 46).…”

Section: Range-of-motion Recoverymentioning

confidence: 99%

“…Although they reported no numbers to corroborate their findings, they found that KSS and KSS-F were not significantly different between the two groups. In the study by Motififard et al, 18 mentioned earlier, KSS was evaluated preoperatively and after 12 months. They reported no significant difference between the two study groups.…”

Section: Knee Society Scorementioning

confidence: 99%

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Knee Position during Surgical Wound Closure in Total Knee Arthroplasty: A Review

et al. 2017

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Study areas concerning maximizing knee range of motion (ROM) following total knee arthroplasty (TKA) have come under focus by surgeons. Among the perioperative factors that were identified to affect ROM after TKAs is knee position during surgical wound closure. Therefore, the aim of this study was to review the impact of knee position during TKA wound closure on: (1) postoperative ROM, (2) wound-related complications, (3) Knee Society Score (KSS), (4) postoperative pain, and (5) muscle strength and home functional recovery. A literature search was performed using PubMed, Ovid, and Google Scholar using various combinations of the following search terms: "wound closure," "knee position," "surgical closure," and "knee arthroplasty." The studies were evaluated for outcomes after TKA and stratified based on the knee position at surgical closure. After application of inclusion and exclusion criteria, seven studies were analyzed. The total number of patients included was 516 patients (259 patients in the flexion group and 257 patients in the full extension group). Based on the reviewed literature, wound closure in flexion was associated with significant improvement in ROM recovery at earlier follow-ups after TKA (four positive and three neutral studies), better early postoperative pain scores (two positive and one neutral study), and faster physical recovery (two positive studies) (better muscle strength and early achievement of physical therapy milestones) compared with wound closure in extension. No difference was found between wound closure in flexion compared with closure in extension in terms of long-term ROM recovery, long-term postoperative pain scores, wound-related complications (seven neutral studies), knee function measured by KSS (five neutral studies), or patient satisfactions after TKA. Although the current review is limited by the number of studies that are available in the literature, it demonstrates that overall, compared with extension, surgical wound closure in flexion may provide better ROM, faster recovery, comparable patient satisfaction, and no risk of higher wound complications.

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The role of wound closure in total knee arthroplasty: a systematic review on knee position

Cerciello

Morris

Lustig

et al. 2016

Knee Surg Sports Traumatol Arthrosc

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The findings of the present review did not show any statistically significant differences in terms of post-operative flexion ROM, functional scores, or complications related to the position of the knee at the time of joint and wound closure during TKA. There is no clear advantage to either closure method based on the currently available evidence, and therefore, this choice should be based on surgeon preference.

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No difference between wound closure in extension or flexion for range of motion following total knee arthroplasty: a randomized clinical trial

Abstract: I.

Cited by 12 publications

References 20 publications

Does standard post-operative rehabilitation have its place after total knee replacement?

Does standard post-operative rehabilitation have its place after total knee replacement?

Knee Position during Surgical Wound Closure in Total Knee Arthroplasty: A Review

The role of wound closure in total knee arthroplasty: a systematic review on knee position

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