Preoperative characteristics and intraoperative factors do not correlate with accomplishments of active straight-leg raising, standing up, and walking after primary total knee arthroplasty

Abstract

Background The correlations between patient characteristics and early postoperative functional performances after total knee arthroplasty have not been adequately studied. The purpose of this study was to clarify the effects of preoperative characteristics (sex, age, body mass index, American Society of Anesthesiologists grade, hospital for special surgery score) and intraoperative factors (duration of surgery and tourniquet use) on the time required to accomplish active straight-leg-raising, standing up, and walking as the objective performances for the initiation of early postoperative rehabilitation. Methods This cross-sectional retrospective study included 307 patients (384 primary total knee arthroplasties). Postoperative times required until each activity was accomplished were measured. Various preoperative characteristics and intraoperative factors that might affect three objective performances were evaluated. Results The postoperative times required before each activity was accomplished were 1.5 ± 0.5 days for active straight-leg-raising, 1.2 ± 0.5 days for standing up, and 1.4 ± 0.7 days for walking. There were no significant correlations between any factor (age, body mass index, hospital for special surgery score, duration of surgery, and tourniquet use) and the three objective performances using Spearman’s correlation coefficient. There were no differences in sex or American Society of Anesthesiologists grade for three objective functional assessments by Wilcoxon rank sum test. Conclusions Differences in patient preoperative characteristics and intraoperative factors are unlikely to affect three objective functional performances in the early postoperative period. Therefore, there is no need to consider differences between patients when initiating early postoperative rehabilitation.

Clinical Application of Perioperative Anaesthesia Management Based on Enhanced Recovery after Surgery Concept to Elderly Patients Undergoing Total Knee Replacement

“…Patients with hypertension and diabetes must receive blood pressure and glucose control before operation, and can drink some water to improve circulation stability and reduce postoperative insulin resistance, thus accelerating the recovery of gastrointestinal function [ 20 ]. Ishii Yoshinori et al showed that insulin resistance could be reduced if patients undergoing TKR were to eat and drink water moderately before surgery, and their hospital stay could be shortened to (8.54 ± 0.54) d [ 21 ], which was consistent with the results obtained herein. Not only that, the combination of preoperative analgesia and postoperative multi-mode analgesia can enhance the analgesic effect and alleviate central sensitization in patients.…”

Risk Factors for Postoperative Knee Stiffness in Patients with Anteromedial Knee Osteoarthritis Undergoing Unicompartmental Knee Arthroplasty with Cemented Prostheses: A Short-Term, Retrospective, Case-Control Study

“…Pre-operatively, these defects commonly present themselves and amplify the limitation of knee motion during the surgical procedure and subsequent hospitalization [ 50 ]. Skeletal muscle health plays a crucial role in the success of postoperative treatment [ 51 ]. Moreover, when painful stimuli are present and isometric muscle contractions are performed, pain processing is suppressed, and analgesic effects are elicited by working memory tasks [ 52 ].…”