Treatment of Pain in Total Knee Arthroplasty Favoring Post-op Physical Activity

2015 ◽  
pp. 2533-2539
Author(s):  
Francesco Benazzo ◽  
Matteo Ghiara ◽  
Stefano Marco Paolo Rossi
2017 ◽  
Vol 4 (3) ◽  
pp. 1-8 ◽  
Author(s):  
Gustavo J Almeida ◽  
Lauren Terhorst ◽  
James J ◽  
Irrgan g ◽  
G. Kelley Fitzgerald ◽  
...  

Author(s):  
Sara Birch ◽  
Torben Bæk Hansen ◽  
Maiken Stilling ◽  
Inger Mechlenburg

Background: Pain catastrophizing is associated with pain both before and after a total knee arthroplasty (TKA). However, it remains uncertain whether pain catastrophizing affects physical activity (PA). The aim was to examine the influence of pain catastrophizing on the PA profile, knee function, and muscle mass before and after a TKA. Methods: The authors included 58 patients with knee osteoarthritis scheduled for TKA. Twenty-nine patients had a score >22 on the Pain Catastrophizing Scale (PCS), and 29 patients had a score <11. PA was measured with a triaxial accelerometer preoperative, 3 months, and 12 months after TKA. Other outcome measures consisted of the Knee Osteoarthritis Outcome Score and dual-energy X-ray absorptiometry scans. Results: The authors found no difference in PA between patients with a better/low or a worse/high score on the PCS, and none of the groups increased their mean number of steps/day from preoperative to 12 months postoperative. Patients with better/low PCS scores had higher/better preoperative scores on the Knee Osteoarthritis Outcome Score subscales (symptoms, pain, and activity of daily living), and they walked longer in the 6-min walk test. Further, they had lower body mass index, lower percent fat mass, and higher percent muscle mass than patients with worse/high PCS scores both before and after a TKA. Conclusion: Preoperative pain catastrophizing did not influence PA before or after a TKA. Although the patients improved substantially in self-reported knee function, their PA did not increase. This may be important to consider when the clinicians are informing the patients about the expected benefits from the operation.


Author(s):  
T. H. Hylkema ◽  
S. Brouwer ◽  
C. M. Kooijman ◽  
A. J. De Vries ◽  
F. Breukelman ◽  
...  

Abstract Purpose Objective measurements of sedentary and physical activity (PA) behavior are scarce among working-age patients who undergo total knee arthroplasty (TKA). Aim was to assess sedentary and PA behaviors using accelerometers and to identify compensation effects between occupational and leisure time of sedentary and PA behavior. Methods One year post-TKA, 51 patients wore an ActiGraph(GT3x) accelerometer for 7 days. Sedentary time, prolonged sedentary bouts (≥ 30 min) and PA (light-intensity and moderate-to-vigorous PA) were examined. Compliance with the guideline of > 150 min moderate-to-vigorous PA per week was calculated. Compensation effects were analyzed using multilevel models, splitting effects into routine and within-day compensation, stratifying by physical and non-physical jobs. The routine compensation effects are the ones of interest, representing habitual compensation during a week. Results Participants spent 60% of time in sedentary bouts and 17% in prolonged sedentary bouts, with 37% of PA spent in light-intensity and 3% in moderate-to-vigorous activity. About 70% of patients met the PA guideline. Routine compensation effects were found for workers in physical jobs, who compensated for their occupational light-intensity PA with less light-intensity PA during leisure time. Workers in non-physical jobs did not compensate for their occupational prolonged sedentary bouts, as these continued during leisure time. Conclusion This study showed that working TKA patients are highly sedentary 1 year after surgery, but most met the PA guideline. Especially those with non-physical jobs do not compensate for their occupational prolonged sedentary bouts. This stresses the need to stimulate PA among TKA patients not complying with the guidelines and those with non-physical jobs.


2016 ◽  
Vol 23 (2) ◽  
pp. 339-346 ◽  
Author(s):  
H Shukla ◽  
SR Nair ◽  
D Thakker

Introduction Increased physical activity and functional ability are the goals of total knee replacement surgery. Therefore, adequate rehabilitation is required for the recovery of patients after discharge from hospital following total knee arthroplasty (TKA). This systematic literature review aimed to evaluate the effectiveness of home telerehabilitation in patients who underwent TKA. Methods Studies published in the English language between 2000 and 2014 were retrieved from Embase, PubMed, and Cochrane databases using relevant search strategies. Two researchers independently reviewed the studies as per the Cochrane methodology for systematic literature review. We considered telerehabilitation sessions as those that were conducted by experienced physiotherapists, using videoconferencing to patients’ homes via an internet connection. The outcomes assessed included: knee movement (knee extension and flexion); quadriceps muscle strength; functional assessment (the timed up-and-go test); and assessment of pain, stiffness, and functional capacity using the Western Ontario and McMaster Universities Osteoarthritis Index and visual analogue scale for pain. Results In total, 160 potentially relevant studies were screened. Following the screening of studies as abstracts and full-text publications, six primary publications (four randomized controlled trials, one non-randomized controlled trial, and one single-arm trial) were included in the review. Patients experienced high levels of satisfaction with the use of telerehabilitation alone. There was no significant difference in change in active knee extension and flexion in the home telerehabilitation group as compared to the control group (mean difference (MD) −0.52, 95% CI −1.39 to 0.35, p = 0.24 and MD 1.14, 95% CI −0.61 to 2.89, p = 0.20, respectively). The patients in the home telerehabilitation group showed improvement in physical activity and functional status similar to patients in the conventional therapy group. Discussion The evidence from this systematic literature review demonstrated that telerehabilitation is a practical alternative to conventional face-to-face rehabilitation therapy in patients who underwent TKA.


2014 ◽  
Vol 46 ◽  
pp. 496
Author(s):  
Roger J. Paxton ◽  
Stephanie D. Glick ◽  
Jennifer E. Stevens-Lapsley ◽  
Edward L. Melanson ◽  
Cory L. Christiansen

2018 ◽  
Vol 33 (4) ◽  
pp. 1094-1100 ◽  
Author(s):  
Alexander Hoorntje ◽  
Claudia S. Leichtenberg ◽  
Koen L.M. Koenraadt ◽  
Rutger C.I. van Geenen ◽  
Gino M.M.J. Kerkhoffs ◽  
...  

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