Thigh and Knee Circumference, Knee‐Extension Strength, and Functional Performance After Fast‐Track Total Hip Arthroplasty

Holm, Bente; Kristensen, Morten Tange; Husted, Henrik; Kehlet, Henrik; Bandholm, Thomas

doi:10.1016/j.pmrj.2010.10.019

Cited by 26 publications

(24 citation statements)

References 49 publications

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“…We included only a small number of participants from a single medical center, so our observations must be interpreted with caution. The present study investigated only the early postoperative period; these findings should be considered preliminary for TKA and THA, although other studies have considered physical function in the early period after TKA and THA[12,18,24]. Scores on the preoperative PCS in the present study were higher than those reported in previous TKA studies[9-11].…”

Section: Discussioncontrasting

confidence: 60%

“…The strength-testing position of the knee extensors was confirmed using a goniometer at a hip angle of 90° and knee flexed to 60°. If necessary, the feet were supported by a small bench[18-22]. A strap was attached between the examination couch and a point on the participant’s ankle, 5 cm above the lateral malleolus.…”

Section: Methodsmentioning

confidence: 99%

“…The variables of percent changes between pre- and post-operation were quantified. It was calculated dividing post-operation score by pre-operation score[18]. Their resultant data were analyzed by paired t -test.…”

Section: Methodsmentioning

confidence: 99%

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Associations among pain catastrophizing, muscle strength, and physical performance after total knee and hip arthroplasty

Hayashi¹,

Kako²,

Suzuki³

et al. 2017

WJO

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AIMTo investigate whether reductions in pain catastrophizing associated with physical performance in the early period after total knee arthroplasty (TKA) or total hip arthroplasty (THA).METHODSThe study group of 46 participants underwent TKA or THA. The participants were evaluated within 7 d before the operation and at 14 d afterwards. Physical performance was measured by the Timed Up and Go (TUG) test, and 10-m gait time was measured at comfortable and maximum speeds. They rated their knee or hip pain using a visual analog scale (VAS) for daily life activities. Psychological characteristics were measured by the Pain Catastrophizing Scale (PCS). Physical characteristics were measured by isometric muscle strength of knee extensors and hip abductors on the operated side. The variables of percent changes between pre- and post-operation were calculated by dividing post-operation score by pre-operation score.RESULTSPostoperative VAS and PCS were better than preoperative for both TKA and THA. Postoperative physical performance and muscle strength were poorer than preoperative for both TKA and THA. The percent change in physical performance showed no correlation with preoperative variables. In TKA patients, the percent change of PCS showed correlation with percent change of TUG (P = 0.016), 10-m gait time at comfortable speeds (P = 0.003), and 10-m gait time at maximum speeds (P = 0.042). The percent change of muscle strength showed partial correlation with physical performances. The percent change of VAS showed no correlation with physical performances. On the other hand, in THA patients, the percent change of hip abductor strength showed correlation with percent change of TUG (P = 0.047), 10-m gait time at comfortable speeds (P = 0.001), and 10-m gait time at maximum speeds (P = 0.021). The percent change of knee extensor strength showed partial correlation with physical performances. The percent change of VAS and PCS showed no correlation with physical performances.CONCLUSIONChanges in pain catastrophizing significantly associated with changes in physical performance in the early period after TKA. It contributes to future postoperative rehabilitation of arthroplasty.

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Section: Discussioncontrasting

confidence: 60%

Section: Methodsmentioning

confidence: 99%

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Associations among pain catastrophizing, muscle strength, and physical performance after total knee and hip arthroplasty

Hayashi¹,

Kako²,

Suzuki³

et al. 2017

WJO

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“…As muscle weakness also appears to be a problem in the early postoperative period, the reduced quadriceps muscle function amounting to about 60–80% reduction after TKA (Mizner et al 2005, Holm et al 2010) and to about 30–40% after THA (Holm et al 2011), may call for early physiotherapy including strengthening exercises and/or reduction of inhibitory neural reflexes that may contribute to impaired muscle function (Mizner et al 2005). …”

Section: Discussionmentioning

confidence: 99%

Why still in hospital after fast-track hip and knee arthroplasty?

Husted¹,

Lunn²,

Troelsen³

et al. 2011

Acta Orthopaedica

Self Cite

347

246

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Background and purpose Length of stay (LOS) following total hip and knee arthroplasty (THA and TKA) has been reduced to about 3 days in fast-track setups with functional discharge criteria. Earlier studies have identified patient characteristics predicting LOS, but little is known about specific reasons for being hospitalized following fast-track THA and TKA.Patients and methods To determine clinical and logistical factors that keep patients in hospital for the first postoperative 24–72 hours, we performed a cohort study of consecutive, unselected patients undergoing unilateral primary THA (n = 98) or TKA (n = 109). Median length of stay was 2 days. Patients were operated with spinal anesthesia and received multimodal analgesia with paracetamol, a COX-2 inhibitor, and gabapentin—with opioid only on request. Fulfillment of functional discharge criteria was assessed twice daily and specified reasons for not allowing discharge were registered.Results Pain, dizziness, and general weakness were the main clinical reasons for being hospitalized at 24 and 48 hours postoperatively while nausea, vomiting, confusion, and sedation delayed discharge to a minimal extent. Waiting for blood transfusion (when needed), for start of physiotherapy, and for postoperative radiographic examination delayed discharge in one fifth of the patients.Interpretation Future efforts to enhance recovery and reduce length of stay after THA and TKA should focus on analgesia, prevention of orthostatism, and rapid recovery of muscle function.

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“…Однако функциональная активность оперирован-ного сустава уменьшается вследствие боли, оберега-ния сустава от движения и мышечной слабости [5].…”

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Multimodal Analgesia After Total Hip Arthroplasty

Мукуца¹,

Царенко²,

Лядов³

2012

Traumatology and Orthopedics of Russia

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ФГБУ «Лечебно-реабилитационный центр» Минздрава России, директор -член-корр. РАМН д.м.н., профессор К.В. Лядов Москва Цель исследования -оценить влияние мультимодального обезболивания на раннюю реабилитацию пациентов после эндопротезирования тазобедренного сустава.Материал и методы. Проведено проспективное одноцентровое рандомизированное исследование, в которое вошли 32 пациента. Пациенты первой группы получали парацетамол, кеторолак и трамадол, второй группы -кеторолак вну-тривенно, третьей группы -эторикоксиб и габапентин. Больным второй и третьей групп проводили эпидуральную анал-гезию ропивакаином. Мультимодальное обезболивание проводилось в течение 48 часов после операции.Оценку интенсивности боли проводили при помощи ВАШ, нейропатического компонента боли -по опроснику DN4. Регистрировали время первой и второй вертикализации пациентов -ходьбы с опорой на ходунки и фиксированием пройденного расстояния за 2 минуты.Результаты. Интенсивность боли более 50 мм по ВАШ при движении хотя бы один раз за 48 часов после операции отмечалась у 9% пациентов первой группы, у 22% больных второй и у 8% пациентов третьей группы. Количество боль-ных с нейропатическим компонентом болевого синдрома уменьшилось с 25% до 3% (р0,05).Первую вертикализацию проводили через 10±8 часов после операции, вторую -через 21±8 часов. Отмечено более частое развитие нежелательных явлений у пациентов первой группы по сравнению с больными второй и третьей групп при первой (91%, 33% и 25%, р0,05) и второй вертикализации (70%, 25% и 17%, р0,05).Выводы. Мультимодальная аналгезия позволяет проводить успешную активизацию пациентов после эндопротези-рования тазобедренного сустава в первые сутки после операции. У пациентов третьей группы отмечается тенденция к оптимальной комбинации эффективности и безопасности аналгетической терапии.Ключевые слова: эндопротезирование тазобедренного сустава, болевой синдром, мультимодальное обезболивание. MULTIMODAL ANALGESIA AFTER TOTAL HIP ARTHROPLASTYI.G. Mukutsa, S.V. Tsarenko, K.V. Lyadov, E.S. Koneva, A.G. Voloshin Medical and Rehabilitation Center MoscowPurpose -to assess the effect of multimodal analgesia in the early rehabilitation of patients after hip replacement. Materials and methods. A prospective single-centre randomized research, which included 32 patients. Patients of the 1st group received paracetamol, ketorolac and tramadol, the 2nd group of patients -ketorolac intravenously and the 3rd group of patients -etoricoxib and gabapentin. Patients of the 2nd and the 3rd groups underwent epidural analgesia with ropivacaine. Multimodal analgesia was carried out for 48 hours after the surgery.Assessment of pain intensity was performed by the VAS (visual analogue scale), a neuropathic pain component -on the DN4 questionnaire . Time was recorded during the first and second verticalization of patients, using the distance walkers and by fixing the distance covered with in 2 minutes.Results. The intensity of pain for more than 50 mm on VAS at movement at least once every 48 hours after the surgery was occurre...

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Thigh and Knee Circumference, Knee‐Extension Strength, and Functional Performance After Fast‐Track Total Hip Arthroplasty

Cited by 26 publications

References 49 publications

Associations among pain catastrophizing, muscle strength, and physical performance after total knee and hip arthroplasty

Associations among pain catastrophizing, muscle strength, and physical performance after total knee and hip arthroplasty

Why still in hospital after fast-track hip and knee arthroplasty?

Multimodal Analgesia After Total Hip Arthroplasty

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