Postoperative Changes in Knee Joint Function of Total Knee Arthroplasty Patients

Abstract

Abstract.[Purpose] We investigated postoperative improvements in the knee joint function of 121 patients (17 males, 104 females) who received total knee arthroplasty (TKA). [Subjects and Methods] The evaluation criteria were: knee joint flexion range of motion, knee joint extension strength and flexion strength, pain in the knee joint, score on The Japanese Orthopedic Association knee criteria of "pain" and "ability to ascend and descend stairs", and 6-minute walking distance. The time points for the evaluations were: prior to surgery, at the time of discharge, 3 months postoperative, 6 months postoperative, and 1 year postoperative. In addition, the level of satisfaction 1 year after the operation was also assessed.[Results] In the results, 6-minute walking distance and ability to ascend and descend stairs were significantly better at 3 months postoperative than before surgery. Knee joint range of motion at 3 months postoperative had improved to its preoperative status, and was significantly improved at 1 year postoperative. Knee joint extension strength at 3 months postoperative had recovered to its preoperative status, and was significantly improved at 6 months postoperative. Knee joint pain was significantly ameliorated at the time of discharge compared to before surgery. Knee joint pain had completely disappeared in approximately 30% of patients by 1 year after surgery, and 90% of patients were satisfied with the results of their surgery. Nevertheless, many of the patients still complained of knee discomfort from TKA.[Conclusion] The results of this study show that knee joint pain was reduced at the time of discharge, and that 6-minute walking distance and ability to ascend and descend stairs were significantly improved at 3 months postoperative. Moreover, these results suggest that there are improvements in knee joint extension strength after 6 months, and in knee joint range of motion at 1 year postoperative. The results show that knee joint function after TKA improves over the year after surgery.

Efficacy and safety of knee flexion enhanced standardized home exercise program comparing supervised physiotherapy to improve mobility and quality of life after Total knee arthroplasty

“…Standard supervised physiotherapy treatment usually includes warm heat application, ROM exercises, strength recovery and other applications to avoid postoperative conditions such as loss of motion of the joint, muscle atrophy, tissue edema, functional limitations etc [32,33]. It is recommended that patients should receive physiotherapy training two or three times weekly to achieving these goals [34]. An American study demonstrated that medicare reimbursements for physical therapy would over 1000 dollar for 12 sessions, and home rehabilitation can much lower the economic burden on patients [11].…”

Knee joint function, walking ability and quality of life within 6 weeks after total knee arthroplasty: A prospective cohort study

“…While the average number of inpatient days decreased from 9.4 to 4.2 days, the percentage of discharged patients transferring to rehabilitation wards increased from 10% to 38% (Vincent, Vincent, Lee, & Alfano, ). According to the literature, previous studies found that patients’ joint and body functions are able to sufficiently recover by 3–6 months after TKA, resulting in high patient satisfaction levels (Cher et al, ; Kennedy, Stratford, Hanna, Wessel, & Gollish, ; Lin, Chang, & Chuang, ; Maruyama et al, ; Naal et al, ). Cher et al () followed 209 TKA patients for 2 years and found that patients reached the largest improvement during the first 6 months.…”

“…Because increasing joint activity and lower‐extremity muscle strength are priorities after this operation, medical staff working with patients who have undergone TKA should provide assistance in conducting rehabilitation exercises as soon as possible to hasten their recovery (Lee, ). The functional recovery of patients after TKA surgery is of concern to scholars (Kennedy et al, ; Lin et al, ; Maruyama et al, ). Kennedy et al () noted that 85%–90% of patients who underwent TKA experienced relief from joint pain, and 70%–80% exhibited improved activity after their operation.…”

Mid Term Outcome of Home-Based Exercises vs. Sophisticated Physiotherapy Protocol After Total Knee Arthroplasty

“…The manda-tory outpatient physiotherapy sessions are often substituted with completing a limited number of clinic visits. Home-based programs can replace physical therapy as well (12)(13)(14).…”

“…Efficiency decrease in one of the serious concerns of home-based exercise rehabilitation; however, this approach is crucial for patients not attending physiotherapy sessions, as they are more likely to have poorer functional health. Uptake optimization and adherence to interventions are essential in rehabilitation procedures (7,(12)(13)(14).…”