scholarly journals Which osteoarthritic gait features recover following Total Knee Replacement surgery?

2018 ◽  
Author(s):  
Paul Robert Biggs ◽  
Gemma Marie Whatling ◽  
Chris Wilson ◽  
Andrew John Metcalfe ◽  
Cathy Avril Holt
Keyword(s):  
Total Knee Replacement ◽  
Gait Analysis ◽  
Knee Replacement ◽  
Ground Reaction Force ◽  
Reaction Force ◽  
Principal Component ◽  
Gait Velocity ◽  
Control Group ◽  
Clinical Indicators ◽  
Total Knee

AbstractBackgroundGait analysis can be used to measure variations in joint function in patients with knee osteoarthritis (OA), and is useful when observing longitudinal biomechanical changes following Total Knee Replacement (TKR) surgery. The Cardiff Classifier is an objective classification tool applied previously to examine the extent of biomechanical recovery following TKR. In this study, it is further developed to reveal the salient features that contribute to recovery towards healthy function.MethodsGait analysis was performed on 30 patients before and after TKR surgery, and 30 healthy controls. Median TKR follow-up time was 13 months. The combined application of principal component analysis (PCA) and the Cardiff Classifier defined 18 biomechanical features that discriminated OA from healthy gait. Statistical analysis tested whether these features were affected by TKR surgery and, if so, whether they recovered to values found for the controls.ResultsThe Cardiff Classifier successfully discriminated between OA and healthy gait in all 60 cases. Of the 18 discriminatory features, only six (33%) were significantly affected by surgery, including features in all three planes of the ground reaction force (p<0.001), ankle dorsiflexion moment (p<0.001), hip adduction moment (p=0.003), and transverse hip angle (p=0.007). All but two (89%) of these features remained significantly different to those of the control group after surgery.ConclusionsThis approach was able to discriminate gait biomechanics associated with knee OA. The ground reaction force provided the strongest discriminatory features. Despite increased gait velocity and improvements in self-reported pain and function, which would normally be clinical indicators of recovery, the majority of features were not affected by TKR surgery. This TKR cohort retained pre-operative gait patterns; reduced sagittal hip and knee moments, decreased knee flexion, increased hip flexion, and reduced hip adduction. The changes that were associated with surgery were predominantly found at the ankle and hip, rather than at the knee.

scholarly journals Gait analysis of patients with an off-the-shelf total knee replacement versus customized bi-compartmental knee replacement

2017 ◽  
Vol 42 (4) ◽  
pp. 805-810 ◽  
Author(s):  
Henry Wang ◽  
Jonathan Foster ◽  
Natasha Franksen ◽  
Jill Estes ◽  
Lindsey Rolston
Keyword(s):  
Total Knee Replacement ◽  
Gait Analysis ◽  
Knee Replacement ◽  
Total Knee

Effect of Counseling on Quality of Life and Self-Care Agency for Patients Who are Scheduled for Total Knee Replacement

2021 ◽  
pp. 105477382110589
Author(s):  
Çiğdem Kaya ◽  
Özlem Bilik
Keyword(s):  
Quality Of Life ◽  
Total Knee Replacement ◽  
Knee Replacement ◽  
Intervention Group ◽  
Self Care ◽  
Control Group ◽  
Face To Face ◽  
Total Knee ◽  
Care Agency

This study aims to determine the effect of counseling on quality of life and self-care agency for patients who are scheduled for total knee replacement (TKR). The study has a quantitative and quasi-experimental design with a control group. The patients in the control group ( n = 40) received routine care. Face-to-face and telephone counseling was offered to individuals in the intervention group ( n = 39). The data was collected at face-to-face interviews by using a patient characteristics form, Quality of Life Scale, and Self-Care Agency Scale. The scores for quality of life and self-care agency in the 6th to 8th and 14th to 16th weeks after surgery were very significantly higher in the intervention group than in the control group ( p < .001). This study shows that counseling given by the nurse increases the quality of life and self-care agency of patients undergoing TKR.

scholarly journals Weight Loss Intervention Before Total Knee Replacement: A 12-Month Randomized Controlled Trial

2019 ◽  
pp. 145749691988381 ◽  
Author(s):  
A. Liljensøe ◽  
J. O. Laursen ◽  
H. Bliddal ◽  
K. Søballe ◽  
I. Mechlenburg
Keyword(s):  
Quality Of Life ◽  
Weight Loss ◽  
Body Composition ◽  
Total Knee Replacement ◽  
Knee Replacement ◽  
Diet Group ◽  
Control Group ◽  
Weight Loss Intervention ◽  
Total Knee

Background and Aims: Obesity is an increasing problem in patients after total knee replacement. The aim of this study was to investigate whether a weight loss intervention before primary total knee replacement would improve quality of life, knee function, mobility, and body composition 1 year after surgery. Material and Methods: Patients scheduled for total knee replacement due to osteoarthritis of the knee and obesity were randomized to a control group receiving standard care or to an intervention group receiving 8-week low-energy diet before total knee replacement. Patient-reported quality of life, 6-Min Walk Test, and body composition by dual-energy X-ray absorptiometry were assessed before intervention for the diet group, and within 1 week preoperatively for both groups, and the changes in outcome from baseline to 1 year after total knee replacement were compared between groups. The number of participants was lower than planned, which might introduce a type-2 error and underestimate the trend for a better outcome after weight loss. Results: The analyses are based on a total of 76 patients, 38 in each group. This study showed major improvement in both study groups in quality of life and knee function, though no statistically significant differences between the groups were observed 1 year after total knee replacement. The average weight loss after 8-week preoperative intervention was 10.7 kg and consisted of a 6.7 kg reduction in fat mass. One year after total knee replacement, the participants in the diet group managed to maintain the weight reduction, whereas there was no change in the control group. Conclusion: The results suggest that it is feasible and safe to implement an intensive weight loss program shortly before total knee replacement. The preoperative intervention resulted in a 10% body weight loss, improved body composition, lower cardiovascular risk factors, and sustained s-leptin.

Gait analysis: Comparative evaluation of conventional total knee replacement and modular distal femoral megaprosthesis

The Knee ◽  
2020 ◽  
Vol 27 (5) ◽  
pp. 1567-1576
Author(s):  
Pietro Pellegrino ◽  
Andrea Conti ◽  
Andrea Pautasso ◽  
Michele Boffano ◽  
Nicola Ratto ◽  
...  
Keyword(s):  
Total Knee Replacement ◽  
Gait Analysis ◽  
Knee Replacement ◽  
Comparative Evaluation ◽  
Total Knee

scholarly journals EFFECTS OF FULL IMMERSION VIRTUAL REALITY TRAINING ON BALANCE AND KNEE FUNCTION IN TOTAL KNEE REPLACEMENT PATIENTS: A RANDOMIZED CONTROLLED STUDY

2020 ◽  
Vol 20 (09) ◽  
pp. 2040007
Author(s):  
SAMWON YOON ◽  
HOHEE SON
Keyword(s):  
Virtual Reality ◽  
Total Knee Replacement ◽  
Knee Replacement ◽  
Knee Function ◽  
Continuous Passive Motion ◽  
Control Group ◽  
Vr Training ◽  
Total Knee ◽  
Full Immersion ◽  
Experimental Group

Background: Recently, new methods have emerged that encourage voluntary participation by allowing patients to perform tasks, including exercises or treatments, in a virtual reality (VR) environment. Aim: This study aimed to examine the effects of full immersion virtual reality training on balance and knee function in patients who had undergone total knee replacement. Design: Single blind randomized controlled trial. Setting: Department of Physical Therapy in a rehabilitation center. Population: A total of 30 elderly patients ([Formula: see text]65 years old) who had undergone total knee replacement. Methods: Participants were randomly allocated to an experimental group ([Formula: see text]) and a control group ([Formula: see text]). The experimental group received with a continuous passive motion machine, exercise therapy, and a full immersion VR training program; the control group received only with a continuous passive motion machine and exercise therapy. Biorescue was used to test static and dynamic balance ability, and the Timed Up and Go and Western Ontario and McMaster Universities tests were used to assess knee function. Paired [Formula: see text]-tests were used to examine differences by time in each group, and independent [Formula: see text]-tests were used to examine differences between the groups. Results: In terms of within-group differences by time, both the experimental group and the control group showed significant changes in the anterior, and posterior limits of stability in both sides; static balance; and knee function. In the between-groups comparison, among static balance tests, there was a significant difference in center of mass path length in the standing position with eyes open ([Formula: see text]); among dynamic balance tests, there were significant differences in left, right, anterior, and posterior limits of stability ([Formula: see text]). Conclusions: VR training produced better early balance ability and knee function than what was seen in the control group. We believe that VR training in initial post-operative rehabilitation of total knee replacement patients may increase the rate of recovery. Clinical Rehabilitation Impact: VR exercise programs are effective in early rehabilitation after total knee replacement, and have clinical value as inexpensive methods that can promote active participation.

scholarly journals Effects of Elastic Resistance Exercise on Postoperative Outcomes Linked to the ICF Core Sets for Osteoarthritis after Total Knee Replacement in Overweight and Obese Older Women with Sarcopenia Risk: A Randomized Controlled Trial

2020 ◽  
Vol 9 (7) ◽  
pp. 2194
Author(s):  
Chun-De Liao ◽  
Yen-Shuo Chiu ◽  
Jan-Wen Ku ◽  
Shih-Wei Huang ◽  
Tsan-Hon Liou
Keyword(s):  
Total Knee Replacement ◽  
Resistance Exercise ◽  
Older Women ◽  
Outcome Measures ◽  
Knee Replacement ◽  
Postoperative Outcomes ◽  
Secondary Outcome ◽  
Control Group ◽  
Elastic Resistance ◽  
Total Knee

(1) Background: Knee osteoarthritis (KOA) and aging are associated with high sarcopenia risk; sarcopenia may further affect outcomes after total knee replacement (TKR). Elastic resistance exercise training (RET) limits muscle attenuation in older adults. We aimed to identify the effects of post-TKR elastic RET on lean mass (LM) and functional outcomes in overweight and obese older women with KOA by using the brief International Classification of Functioning, Disability and Health Core Set for osteoarthritis (Brief-ICF-OA). (2) Methods: Eligible women aged ≥60 years who had received unilateral primary TKR were randomly divided into an experimental group (EG), which received postoperative RET twice weekly for 12 weeks, and a control group (CG), which received standard care. The primary and secondary outcome measures were LM and physical capacity, respectively, and were linked to the Brief-ICF-OA. The assessment time points were 2 weeks prior to surgery (T0) and postoperative at 1 month (T1; before RET) and 4 months (T2; upon completion of RET) of follow-up. An independent t test with an intention-to-treat analysis was conducted to determine the between-group differences in changes of outcome measures at T1 and T2 from T0. (3) Results: Forty patients (age: 70.9 ± 7.3 years) were randomly assigned to the EG (n = 20) or CG (n = 20). At T2, the EG exhibited significantly greater improvements in leg LM (mean difference (MD) = 0.86 kg, p = 0.004) and gait speed (MD = 0.26 m/s, p = 0.005) compared with the CG. Furthermore, the EG generally obtained significantly higher odds ratios than the CG for treatment success for most Brief-ICF-OA categories (all p < 0.001). Conclusions: Early intervention of elastic RET after TKR yielded positive postoperative outcomes based on the Brief-ICF-OA. The findings of this study may facilitate clinical decision-making regarding the optimal post-TKR rehabilitation strategy for older women with KOA.

Potential role of electrostimulation in augmentation of venous blood flow after total knee replacement: A pilot study

2015 ◽  
Vol 31 (4) ◽  
pp. 251-256 ◽  
Author(s):  
Seyhan Yilmaz ◽  
Murat Calbiyik ◽  
Behice Kaniye Yilmaz ◽  
Eray Aksoy
Keyword(s):  
Blood Flow ◽  
Total Knee Replacement ◽  
Knee Replacement ◽  
Femoral Vein ◽  
Venous Blood ◽  
Control Group ◽  
Venous Blood Flow ◽  
Female Ratio ◽  
Total Knee ◽  
Peak Blood

Aim To investigate the potential role of a novel electrostimulation device in augmenting the femoral vein venous blood flow following total knee replacement surgery. Material and methods A total of 30 consecutive patients undergoing total knee replacement were allocated to receive either peroneal nerve electrostimulation plus low molecular weight heparin and below-knee compression stockings (Group 1, electrostimulation group, n = 15, mean age: 63.40 ± 5.91 years, male: female ratio 9:6) or low molecular weight heparin and below-knee compression stockings alone (Group 2, control group, n = 15, mean age: 63.86 ± 7.47 years, male: female ratio 8:7). Electrostimulation was performed for 1 h in every 4 h after the operation. Peak blood velocity in the femoral vein was evaluated with Duplex ultrasonongraphy in supine position. Presence of leg edema and calf diameter was also taken into consideration as outcome measures, which were recorded both before surgery and at the time of discharge from hospital. Results Postoperative peak blood flow velocity in the femoral vein was significantly higher in electrostimulation group compared to control group (17.46 ± 2.86 cm/s vs. 13.84 ± 3.58 cm/s, p < 0.02). Electrostimulation group achieved a significant increase in peak blood flow velocity in the femoral vein after the operation (mean increase 67.48 ± 17.38%, p < 0.001). Conclusion Electrostimulation of the common peroneal nerve enhanced venous flow in the lower limb and may potentially be of use as a supplementary technique in deep venous prophylaxis following lower limb orthopedic operations.

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