scholarly journals 93 The Effects of Kinesiophobia on Outcome following Total Knee Replacement: A Systematic Review

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
O Brown ◽  
L Hu ◽  
C Demetriou ◽  
T Smith ◽  
C Hing
Keyword(s):  
Systematic Review ◽  
Total Knee Replacement ◽  
Range Of Motion ◽  
Knee Replacement ◽  
Functional Outcomes ◽  
English Language ◽  
Psychological Treatment ◽  
Functional Score ◽  
Case Control Studies ◽  
Total Knee

Abstract Aim Kinesiophobia, the fear of physical movement and activity related to injury vulnerability, has been linked to sub-optimal outcomes following total knee replacement (TKR). This systematic review has two aims: to define the relationship between kinesiophobia and functional outcomes, pain and range of motion following TKR, and to evaluate published treatments for kinesiophobia following TKR. Method A primary search was performed in March 2020. English-language studies recruiting adult primary TKR patients, using the Tampa Scale of Kinesiophobia (TSK) were included. Study quality was assessed using the Newcastle Ottawa Scale for cohort or case control studies, and the Cochrane Collaboration Risk of Bias tool for randomised controlled trials. Results All thirteen included papers (82 identified) showed adequately low risk of methodological bias. TSK1 (activity avoidance) correlated with WOMAC functional score at 12 months in three studies (r = 0.20 p < 0.05, R = 0.317 p = 0.001, and correlation coefficient 0.197 p = 0.005). TSK score significantly correlated with mean active range of motion (ROM) at six months (105.33 (SD = 12.34) vs 85.53 (SD = 14.77) p = 0.000) post-operation. Three post-operative interventions improved TSK score vs control following TKR: a home-based functional exercise programme (TSK -14.30 (SD = 0.80) vs -2.10 (SD = 0.80) p < 0.001)), an outpatient CBT programme (TSK 27.76 (SD = 4.56) vs 36.54 (SD = 3.58), and video-based psychological treatment (TSK 24 (SD = 5) vs 29 (SD = 5) p < 0.01). Conclusions Kinesiophobia negatively affects functional outcomes up until one year post-operatively, while active ROM is reduced up to six months post procedure. Post-operative functional and psychological interventions can improve kinesiophobia following TKR.

scholarly journals The Effect of Infrapatellar Fat Pad Resection in Total Knee Replacement on Patella Tendon Length and Functional Outcomes after Five Years

2019 ◽  
Vol 3 (4) ◽  
pp. 1-7
Author(s):  
Sheldon M
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Functional Outcomes ◽  
Statistical Significance ◽  
Infrapatellar Fat Pad ◽  
Functional Score ◽  
Fat Pad ◽  
Patella Tendon ◽  
Total Knee ◽  
One Year

Background : It remains unclear whether infrapatellar fat pad (IPFP) excision leads to patella tendon shortening. Shortening of the tendon alters the biomechanics of the knee and can be problematic however current literature is divided regarding the effect of IPFP resect ion on patella length and functional outcomes following total knee replacement. Methods : Our aim was to identify any functional and radiographic differences incurred with IPFP resection. We conducted a retrospective study comparing resection and preservation of the infrapatellar fat pad between 2007 - 2009 using the Stryker Triathlon or Duracon implants between two independent consultant surgeons. 168 consecutive patients were recruited. Baseline demographics were similar between resection and preservation groups with a mean age of 68.5 (70 vs 67, p=0.17), BMI 31.71 (31.02 vs 32.4, p=0.84) and pa tella resurfacing 23.5 (24 vs 23, p=0.29). Results : Comparisons between the resection and preservation groups for the Insall - Salvati, Modified Insall - Salvati, Caton - deschamps and Blackburne - peel ratios preoperatively, at one year and five years postoperat ively did not demonstrate any statistically significant differences. Knee society scores (KSS) preoperatively (45.36 vs 40.5, p=0.31) and at five years postoperatively (90.49 vs 85.31, p=0.2) were not statistically different. Similarly anterior knee pain s cores (AKPS) demonstrated no statistical significance between groups preoperatively (50.6 vs 42.8, p=0.3) and at five years post operatively (69.4 vs 62.0, p=0.88). Conclusion : There is no statistical difference in radiological measures or functional score s (AKPS &KSS) at one or five years post - operatively between resection or preservation of the infrapatellar fat pad following total knee arthroplasty for primary osteoarthritis.

scholarly journals A home visit program versus a non-home visit program in total knee replacement patients: a randomized controlled trial

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Bura Sindhupakorn ◽  
Piya-on Numpaisal ◽  
Suwittaya Thienpratharn ◽  
Darawan Jomkoh
Keyword(s):  
Total Knee Replacement ◽  
Range Of Motion ◽  
Knee Replacement ◽  
Home Visit ◽  
Controlled Trial ◽  
Satisfaction Score ◽  
Functional Score ◽  
Patient’S Satisfaction ◽  
Functional Scores ◽  
Total Knee

Abstract Background The goals in total knee replacement (TKR) are pain relief, restore functions, and improve quality of life. Surgical outcomes were not related to patients’ satisfaction. Low 1-year WOMAC especially in the first 6 weeks and painful TKR related to patient dissatisfied. To improve satisfaction, we created the home visit program (TKR-H) after hospital discharge. INHOMESSS was the rationale for home visit activities. Methods We recruited 52 TKRs. Four TKRs were excluded. We used simple randomization for 24 patients as a home visit (TKR-H) and 24 patients as a non-home visit (TKR). Patients were evaluated by general demographics, pain intensity scores (VAS), range of motion (ROM), WOMAC, knee scores, and functional scores as a primary objective. A duration for gait aid independent and patient’s satisfaction score as secondary objective. The study was 6 weeks after surgery. Results TKR-H and TKR had significant differences in the mean of WOMAC score (88.29 ± 10.66 vs. 68.00 ± 12.47, respectively, P <  0.001), pain score (VAS) (6.25 ± 10.13 vs. 35.67 ± 22.05, respectively, P <  0.001), knee score (81.67 ± 10.08 vs. 68.38 ± 6.45, respectively, P <  0.001), functional score (77.83 ± 4.22 vs. 73.70 ± 7.48, respectively, P = 0.037), and range of motion (107.71 ± 8.47 vs. 98.17 ± 9.57, respectively, P = 0.001). The patient’s satisfaction score in TKR-H group (4.71 ± 0.46) was significantly higher than the TKR group (4.13 ± 0.45) (P <  0.001) and time to gait aid independent (2.75 ± 0.99 vs. 3.71 ± 1.23, respectively, P = 0.005). Conclusion Our TKR-H showed better clinical outcomes and satisfaction than non-home visit. The rationale in TKR-H improves satisfaction after total knee replacement. Trial registration TCTR20190514001.

scholarly journals Patient Satisfaction After Total Knee Replacement: A Systematic Review

2018 ◽  
Vol 14 (2) ◽  
pp. 192-201 ◽  
Author(s):  
Cynthia A. Kahlenberg ◽  
Benedict U. Nwachukwu ◽  
Alexander S. McLawhorn ◽  
Michael B. Cross ◽  
Charles N. Cornell ◽  
...  
Keyword(s):  
Systematic Review ◽  
Patient Satisfaction ◽  
Total Knee Replacement ◽  
Knee Replacement ◽  
Total Knee

scholarly journals Characteristics of Usual Physical Therapy Post‐Total Knee Replacement and Their Associations With Functional Outcomes

2019 ◽  
Vol 71 (9) ◽  
pp. 1171-1177 ◽  
Author(s):  
Carol A. Oatis ◽  
Joshua K. Johnson ◽  
Traci DeWan ◽  
Kelly Donahue ◽  
Wenjun Li ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Total Knee Replacement ◽  
Knee Replacement ◽  
Functional Outcomes ◽  
Total Knee

scholarly journals Adductor canal block to manage flexion contracture deformity (FCD) of knee before total knee replacement (TKR) ‐ a case report

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Jadon Ashok ◽  
Sudarshan Pavan ◽  
Sinha Neelam ◽  
Chakraborty Swastika
Keyword(s):  
Pain Relief ◽  
Total Knee Replacement ◽  
Range Of Motion ◽  
Continuous Infusion ◽  
Knee Replacement ◽  
Flexion Contracture ◽  
Lower Limbs ◽  
Adductor Canal Block ◽  
Adductor Canal ◽  
Total Knee

Abstract Background The fixed contracture deformity (FCD) which is often present in patients awaiting total knee replacement (TKR) affects the surgical outcome. Therefore, it is necessary to reduce the severity of the FCD before the TKR surgery. Physiotherapy, including active stretching and exercise to increase range of motion are commonly practiced techniques. However, due to the presence of pain, patients are often unable to cooperate and perform exercise up-to the desired levels. We used continuous adductor canal block (CACB) in two patients with severe FCD scheduled for TKR surgery to decrease their pain during physiotherapy and to help them in increasing their range of motion to achieve early fitness for surgery. This approach is not documented and published earlier in the medical literature. Case presentation Two female patients aged 58 and 68 years were scheduled for TKR surgery with severe flexion contracture deformity of both limbs (70°–90°). Due to severe contracture deformity surgeon suggested improvement in ROM before surgery. Ultrasound-guided adductor canal block was given, and catheters were inserted in the adductor canal. Continuous infusion of local anesthetic and bolus injection before active stretching was given. Both patients had good pain relief in existing arthritic pain and pain during active stretching. The flexion deformity was reduced in both the patients up to 30°. The technique of adductor can block with continuous infusion also provided excellent postoperative analgesia and helped in early mobilization without affecting the muscle strength of lower limbs. Conclusion In two patients of severe flexion contracture deformity, the continuous adductor canal block helped to reduce the degree of deformity before the total knee replacement surgery. It also provided excellent pain relief in postoperative pain and helped in early postoperative mobilization without muscle weakness.

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