scholarly journals Preoperative methylprednisolone does not reduce loss of knee-extension strength after total knee arthroplasty

2017 ◽  
Vol 88 (5) ◽  
pp. 543-549 ◽  
Author(s):  
Viktoria Lindberg-Larsen ◽  
Thomas Q Bandholm ◽  
Camilla K Zilmer ◽  
Jens Bagger ◽  
Mette Hornsleth ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Knee Extension ◽  
Knee Extension Strength ◽  
Total Knee

Effect of knee joint icing on knee extension strength and knee pain early after total knee arthroplasty: a randomized cross-over study

2012 ◽  
Vol 26 (8) ◽  
pp. 716-723 ◽  
Author(s):  
Bente Holm ◽  
Henrik Husted ◽  
Henrik Kehlet ◽  
Thomas Bandholm
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Joint ◽  
Knee Pain ◽  
Knee Arthroplasty ◽  
Acute Effect ◽  
Knee Extension ◽  
Control Treatment ◽  
Knee Extension Strength ◽  
Total Knee ◽  
Pain At Rest

Objective: To investigate the acute effect of knee joint icing on knee extension strength and knee pain in patients shortly after total knee arthroplasty. Design: A prospective, single-blinded, randomized, cross-over study. Setting: A fast-track orthopaedic arthroplasty unit at a university hospital. Participants: Twenty patients (mean age 66 years; 10 women) scheduled for primary unilateral total knee arthroplasty. Interventions: The patients were treated on two days (day 7 and day 10) postoperatively. On one day they received 30 minutes of knee icing (active treatment) and on the other day they received 30 minutes of elbow icing (control treatment). The order of treatments was randomized. Main outcome measures: Maximal knee extension strength (primary outcome), knee pain at rest and knee pain during the maximal knee extensions were measured 2–5 minutes before and 2–5 minutes after both treatments by an assessor blinded for active or control treatment. Results: The change in knee extension strength associated with knee icing was not significantly different from that of elbow icing (knee icing change (mean (1 SD)) –0.01 (0.07) Nm/kg, elbow icing change –0.02 (0.07) Nm/kg, P = 0.493). Likewise, the changes in knee pain at rest ( P = 0.475), or knee pain during the knee extension strength measurements ( P = 0.422) were not different between treatments. Conclusions: In contrast to observations in experimental knee effusion models and inflamed knee joints, knee joint icing for 30 minutes shortly after total knee arthroplasty had no acute effect on knee extension strength or knee pain.

Loss of Knee-Extension Strength Is Related to Knee Swelling After Total Knee Arthroplasty

2010 ◽  
Vol 91 (11) ◽  
pp. 1770-1776 ◽  
Author(s):  
Bente Holm ◽  
Morten T. Kristensen ◽  
Jesper Bencke ◽  
Henrik Husted ◽  
Henrik Kehlet ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Knee Extension ◽  
Knee Extension Strength ◽  
Total Knee

Decreasing Posterior Femoral Condyle Offset Improves Intraoperative Correction of Flexion Contracture in Total Knee Arthroplasty

2020 ◽  
Author(s):  
Murilo Anderson Leie ◽  
Antonio Klasan ◽  
Wei Wang Yeo ◽  
Dylan Misso ◽  
Myles Coolican
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Femoral Condyle ◽  
Knee Extension ◽  
Flexion Contracture ◽  
Level Of Evidence ◽  
Full Extension ◽  
Time Of Surgery ◽  
Posterior Femoral Condyle ◽  
Total Knee

AbstractMultiple intraoperative strategies are described to achieve full extension in total knee arthroplasty, but only a few studies have assessed the effect of the flexion gap on intraoperative improvement in flexion contracture. The aim of this study was to determine whether posterior condylar offset, in isolation, independently affects extension at the time of total knee arthroplasty.Two hundred and seventy-eight patients who underwent total knee arthroplasty for knee osteoarthritis and flexion contracture ≥ 5 degrees between January 2008 and July 2018 were included in this study. Patients with other factors that could affect knee extension at the time of surgery were excluded. We recorded the thickness of posterior femoral condyle bone resected as well as the thickness of the posterior femoral component chosen for each patient. Patients' knee extension was recorded under anesthetic, prior to resection and intraoperatively after total knee replacement.Average thickness of bone resection for the posteromedial femur was 12.64  ± 1.65 mm and for the posterolateral femur was 10.38  ± 1.52 mm. Using a linear regression model, we found that changes in posterior offset and implant downsizing influenced correction of fixed flexion deformity at the time of surgery. When patients had a combined posteromedial and posterolateral offset 2 mm thinner than the thickness of bone resected, there was an average correction of 3.5 degrees of flexion contracture.Our study demonstrated that posterior femoral condyle offset is an independent variable affecting correction of flexion contracture at the time of surgery in a gap balanced cruciate-retaining total knee arthroplasty. Level of evidence Level IV evidence

Modified Intervastus Approach to the Knee

2017 ◽  
Vol 31 (05) ◽  
pp. 422-424
Author(s):  
James Kohlman ◽  
Craig Valle ◽  
Muthana Sartawi
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Knee Extension ◽  
Extensor Mechanism ◽  
Vastus Medialis ◽  
Medial Parapatellar Approach ◽  
Total Knee ◽  
Anterior Knee ◽  
Medial Parapatellar

AbstractThe modified intervastus approach to the anterior knee is an approach that may be used in the majority of patients undergoing total knee arthroplasty. This article presents the first description of this approach. The advantages of this approach include its extensile nature, similar to a medial parapatellar approach, and preservation of the extensor mechanism and the vastus medialis, leading to a more rapid return to active knee extension than is traditionally observed. The approach is also simple to perform, easy to close, and is compatible with more extensile approaches such as a quadriceps snip if required in revision scenarios.

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