scholarly journals 512 THE PROPER REHABILITATION EXERCISE IN PATIENITS WITH DEGENERATIVE ARTHRITIS OF THE TOTAL KNEE ARTHROPLASTY

2008 ◽  
Vol 16 ◽  
pp. S219
Author(s):  
J-Y. Kim ◽  
D-G. Jung ◽  
H-S. Kyung ◽  
T-G. Kim ◽  
O-S. Shin ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Degenerative Arthritis ◽  
Total Knee ◽  
Rehabilitation Exercise

scholarly journals Establishment of a Qualified Integrated Care System After Total Knee Arthroplasty as a Role of Regional Rheumatoid and Degenerative Arthritis Centers

2021 ◽  
Author(s):  
Eun Young Han ◽  
Sang Rim Kim ◽  
Sang Hee
Keyword(s):  
Total Knee Arthroplasty ◽  
Integrated Care ◽  
Knee Arthroplasty ◽  
Policy Support ◽  
Degenerative Arthritis ◽  
Geriatric Population ◽  
Socioeconomic Characteristics ◽  
Total Knee ◽  
Intensive Rehabilitation ◽  
Care System

Abstract Background: The geriatric population and advanced knee osteoarthritis are rapidly increasing in Korea, and the socioeconomic burden of total knee arthroplasty (TKA) is increasing. This study aimed to analyze the demographic, clinical and socioeconomic characteristics of patients who underwent TKA and to differentiate the factors affecting participation in inpatient-intensive rehabilitation programs after TKA in oo regional rheumatoid and degenerative arthritis centers established by the government.Methods: This retrospective cohort study included 845 patients (735 females; 72.0±5.8 years) diagnosed with primary osteoarthritis (OA) of the knee who underwent elective unilateral primary TKA between January 2013 and June 2016. Demographic, clinical and socioeconomic characteristics, including age, body mass index, obesity, length of stay, OA severity, underlying disease, education level, occupation, and location of residence, were reviewed. Patients were allocated to the TKA-only group (home discharge) and to the TKA+ rehab group (participation in post-TKA rehabilitation). The variables were analyzed and compared before and after the establishment of the center and according to participation in intensive rehabilitation.Results: They showed a predominance of females and geriatrics and a high prevalence of comorbidities and obesity. Additionally, the only factor differentiating participation in intensive rehabilitation was the location of residence.Conclusion: The regional rheumatoid and degenerative arthritis center was appropriate to meet the high need for participating in intensive rehabilitation after TKA and for the qualified integrated post-TKA care system. Policy support should ensure early rehabilitation and a qualified integrated care system and prepare for the increased burden of revision, and future longitudinal studies should be conducted to assess the long-term effect of the integrated post-TKA rehabilitation program on functional outcomes and patient survivorship free from revision.

scholarly journals Establishment of Qualified Integrated Care System after Total Knee Arthroplasty as a Role of Regional Rheumatoid and Degenerative Arthritis Center

2021 ◽  
Author(s):  
Eun Young Han ◽  
Sang Rim Kim ◽  
Sang Hee Im
Keyword(s):  
Total Knee Arthroplasty ◽  
Integrated Care ◽  
Knee Arthroplasty ◽  
Rehabilitation Program ◽  
Policy Support ◽  
Degenerative Arthritis ◽  
Socioeconomic Characteristics ◽  
Total Knee ◽  
Intensive Rehabilitation ◽  
Care System

Abstract Elderly population and advanced knee osteoarthritis are rapidly increasing in Korea and the socioeconomic burden of total knee arthroplasty (TKA). This study aimed to analyze the demographic, clinical and socioeconomic characteristics in patients who underwent TKA and to differentiate the factors affecting participation in inpatient- intensive rehabilitation program after TKA in oo regional rheumatoid and degenerative arthritis center established by government. This retrospective cohort study included 845 patients (735 females; 72.0 ± 5.8 years) diagnosed with primary osteoarthritis (OA) of the knee and who performed an elective unilateral primary TKA between January 2013 and June 2016. Demographic, clinical and socioeconomic characteristics including age, body mass index, obesity, length of stay, OA severity, underlying disease, education level, occupation, location of residence) were reviewed and Patients were allocated to TKA only group (home discharge) and to TKA + rehab group (participation in post-TKA rehabilitation). The variables were analyzed and compared before and after establishment of center and according to participation in intensive rehabilitation. They showed predominance of female and elderly and high prevalence of comorbidities and obesity. Also, the only factor differentiating participation in intensive rehabilitation was the location of residence. Therefore, the regional rheumatoid & degenerative arthritis center was appropriate to meet the high need for participating in intensive rehabilitation after TKA and for the qualified integrated post-TKA care system. The policy support should ensure early rehabilitation and qualified integrated care system and prepare for the increased burden of revision and the future longitudinal study should be conducted for long-term effect of the integrated post-TKA rehabilitation program on functional outcome and patients’ survivorship free from revision.

Trends in Periprosthetic Knee Infection and Associated Costs: A Population-Based Study Using National Data

2020 ◽  
Author(s):  
Robert Brochin ◽  
Jashvant Poeran ◽  
Khushdeep S. Vig ◽  
Aakash Keswani ◽  
Nicole Zubizarreta ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Length Of Stay ◽  
Knee Arthroplasty ◽  
Trend Test ◽  
Strong Impact ◽  
Hospitalization Costs ◽  
Teaching Status ◽  
Increasing Trend ◽  
Total Knee ◽  
Increasing Trends

AbstractGiven increasing demand for primary knee arthroplasties, revision surgery is also expected to increase, with periprosthetic joint infection (PJI) a main driver of costs. Recent data on national trends is lacking. We aimed to assess trends in PJI in total knee arthroplasty revisions and hospitalization costs. From the National Inpatient Sample (2003–2016), we extracted data on total knee arthroplasty revisions (n = 782,449). We assessed trends in PJI prevalence and (inflation-adjusted) hospitalization costs (total as well as per-day costs) for all revisions and stratified by hospital teaching status (rural/urban by teaching status), hospital bed size (≤299, 300–499, and ≥500 beds), and hospital region (Northeast, Midwest, South, and West). The Cochran–Armitage trend test (PJI prevalence) and linear regression determined significance of trends. PJI prevalence overall was 25.5% (n = 199,818) with a minor increasing trend: 25.3% (n = 7,828) in 2003 to 28.9% (n = 19,275) in 2016; p < 0.0001. Median total hospitalization costs for PJI decreased slightly ($23,247 in 2003–$20,273 in 2016; p < 0.0001) while median per-day costs slightly increased ($3,452 in 2003–$3,727 in 2016; p < 0.0001), likely as a function of decreasing length of stay. With small differences between hospitals, the lowest and highest PJI prevalences were seen in small (≤299 beds; 22.9%) and urban teaching hospitals (27.3%), respectively. In stratification analyses, an increasing trend in PJI prevalence was particularly seen in larger (≥500 beds) hospitals (24.4% in 2003–30.7% in 2016; p < 0.0001), while a decreasing trend was seen in small-sized hospitals. Overall, PJI in knee arthroplasty revisions appears to be slightly increasing. Moreover, increasing trends in large hospitals and decreasing trends in small-sized hospitals suggest a shift in patients from small to large volume hospitals. Decreasing trends in total costs, alongside increasing trends in per-day costs, suggest a strong impact of length of stay trends and a more efficient approach to PJI over the years (in terms of shorter length of stay).

Effect of Manipulation under Anesthesia of the First Knee in Staged Bilateral Total Knee Arthroplasty on Clinical Outcome and Satisfaction

2020 ◽  
Author(s):  
Jung-Won Lim ◽  
Yong-Beom Park ◽  
Dong-Hoon Lee ◽  
Han-Jun Lee
Keyword(s):  
Total Knee Arthroplasty ◽  
Patient Satisfaction ◽  
Clinical Outcome ◽  
Clinical Outcomes ◽  
Knee Arthroplasty ◽  
Knee Flexion ◽  
Functional Score ◽  
Manipulation Under Anesthesia ◽  
Total Knee

AbstractThis study aimed to evaluate whether manipulation under anesthesia (MUA) affect clinical outcome including range of motion (ROM) and patient satisfaction after total knee arthroplasty (TKA). It is hypothesized that MUA improves clinical outcomes and patient satisfaction after primary TKA. This retrospective study analyzed 97 patients who underwent staged bilateral primary TKA. MUA of knee flexion more than 120 degrees was performed a week after index surgery just before operation of the opposite site. The first knees with MUA were classified as the MUA group and the second knees without MUA as the control group. ROM, Knee Society Knee Score, Knee Society Functional Score, Western Ontario and McMaster Universities (WOMAC) score, and patient satisfaction were assessed. Postoperative flexion was significantly greater in the MUA group during 6 months follow-up (6 weeks: 111.6 vs. 99.8 degrees, p < 0.001; 3 months: 115.9 vs. 110.2 degrees, p = 0.001; 6 months: 120.2 vs. 117.0 degrees, p = 0.019). Clinical outcomes also showed similar results with knee flexion during 2 years follow-up. Patient satisfaction was significantly high in the MUA group during 12 months (3 months: 80.2 vs. 71.5, p < 0.001; 6 months: 85.8 vs. 79.8, p < 0.001; 12 months: 86.1 vs. 83.9, p < 0.001; 24 months: 86.6 vs. 85.5, p = 0.013). MUA yielded improvement of clinical outcomes including ROM, and patient satisfaction, especially in the early period after TKA. MUA in the first knee could be taken into account to obtain early recovery and to improve patient satisfaction in staged bilateral TKA.

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