scholarly journals Knee-Extension Training with a Single-Joint Hybrid Assistive Limb during the Early Postoperative Period after Total Knee Arthroplasty in a Patient with Osteoarthritis

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Tomokazu Yoshioka ◽  
Hisashi Sugaya ◽  
Shigeki Kubota ◽  
Mio Onishi ◽  
Akihiro Kanamori ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Range Of Motion ◽  
Knee Arthroplasty ◽  
Knee Extensor ◽  
Recovery Phase ◽  
Knee Extension ◽  
Early Postoperative Period ◽  
Wearable Robot ◽  
Total Knee ◽  
Hybrid Assistive Limb

The knee range of motion is an important outcome of total knee arthroplasty (TKA). According to previous studies, the knee range of motion temporarily decreases for approximately 1 month after TKA due to postoperative pain and quadriceps dysfunction following surgical invasion into the knee extensor mechanism. We describe our experience with a knee-extension training program based on a single-joint hybrid assistive limb (HAL-SJ, Cyberdyne Inc., Tsukuba, Japan) during the acute recovery phase after TKA. HAL-SJ is a wearable robot suit that facilitates the voluntary control of knee joint motion. A 76-year-old man underwent HAL-SJ-based knee-extension training, which enabled him to perform knee function training during the acute phase after TKA without causing increased pain. Thus, he regained the ability to fully extend his knee postoperatively. HAL-SJ-based knee-extension training can be used as a novel post-TKA rehabilitation modality.

scholarly journals Rehabilitation during early postoperative period following total knee arthroplasty using single-joint hybrid assistive limb as new therapy device: a randomized, controlled clinical pilot study

2021 ◽  
Author(s):  
Silvia J. Mrotzek ◽  
Shahir Ahmadi ◽  
Alexander von Glinski ◽  
Alexis Brinkemper ◽  
Mirko Aach ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Range Of Motion ◽  
Knee Arthroplasty ◽  
Postoperative Period ◽  
Early Postoperative Period ◽  
Continuous Passive Motion ◽  
Control Group ◽  
New Therapy ◽  
Total Knee ◽  
Hybrid Assistive Limb

Abstract Introduction The first weeks after total knee arthroplasty (TKA) are crucial for the functional outcome. To improve knee mobility, a continuous passive motion (CPM) motor rail is commonly used during in-hospital rehabilitation. The single-joint hybrid assistive limb (HAL-SJ) is a new therapy device. The aim of the study was to improve patients’ range of motion (ROM), mobility, and satisfaction using the active-assistive support of the HAL-SJ. Materials and methods Between 09/2017 and 10/2020, 34 patients, who underwent TKA and matched the inclusion criteria, were randomized into study (HAL-SJ) and control (CPM) group. Treatment began after drain removal and was carried out until discharge. Primary outcome parameters were raised pre- and postoperatively and included the Oxford knee score (OKS), visual analog scale (VAS), and acquired range of motion. Furthermore complications caused by the device were recorded. Results OKS increased in both groups postoperatively, but only significantly in the HAL-SJ group. Postoperative pain improved in both groups without significant differences. Flexion improvement was significant in both groups between days 3/7 and 8 weeks postoperatively. We did not encounter any complications related to HAL-SJ. Conclusions In conclusion, use of the HAL-SJ during rehabilitation in the early postoperative period after TKA was safe without disadvantages compared to the control group and seems to have advantages in terms of daily life impairment.

scholarly journals The Training Effect of Early Intervention with a Hybrid Assistive Limb after Total Knee Arthroplasty

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Takashi Fukaya ◽  
Hirotaka Mutsuzaki ◽  
Kenichi Yoshikawa ◽  
Ayumu Sano ◽  
Masafumi Mizukami ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Joint ◽  
Knee Arthroplasty ◽  
Knee Extensor ◽  
Knee Extension ◽  
Walking Ability ◽  
Joint Function ◽  
Timed Up And Go ◽  
Total Knee ◽  
Hybrid Assistive Limb

After total knee arthroplasty (TKA), it is important for patients to show early improvements in knee joint function and walking to regain independence in performing the activities of daily life. We conducted for 4 weeks an intervention one week after TKA using a hybrid assistive limb (HAL: unilateral leg type) as an exoskeleton robotic device to facilitate knee joint function and walking. The intervention improved the range of knee extension movement safely and without pain compared to preoperation. In addition, we found that training with the HAL improved walking ability, speed, and rate, as well as the time taken to perform the timed up and go (TUG) test compared to preoperation. The strength of the quadriceps muscle did not improve with training; however, the patient was able to induce a knee extensor moment during the initial stance phase, as measured by kinetics and kinematics, and these actions could be performed without pain. HAL training soon after TKA improved knee joint function in a 76-year-old patient who presented with OA of the knee. The improvements in knee extension lag and knee extensor moment allowed the patient to walk without pain and regain ADL in comparison with preoperation.

A Simple Goniometer for Use Intra-Operatively in Total Knee Arthroplasty

2010 ◽  
Author(s):  
Kate D. Liddle ◽  
Jennifer Peter ◽  
Jovauna M. Currey ◽  
Jenni M. Buckley ◽  
William A. McGann
Keyword(s):  
Total Knee Arthroplasty ◽  
Range Of Motion ◽  
Knee Arthroplasty ◽  
Computer Assisted Surgery ◽  
Cost Effective ◽  
Knee Extension ◽  
Computer Assisted ◽  
Navigation Systems ◽  
Important Indicator ◽  
Total Knee

Intra-operative range of motion (ROM) assessment can be challenging during total knee arthroplasty (TKA) surgery. Measurement accuracy is often compromised by patient draping and anatomy, particularly when assessing knee extension. Accurate ROM assessment is important, as ROM after total knee arthroplasty is an important indicator of clinical outcome. Computer assisted surgery has been shown to accurately determine intra-operative range of motion; however, navigation systems are costly and not readily available to many surgeons. We have developed a simple, cost-effective intraoperative device to precisely measure knee flexion and extension that is efficient and easy to use.

scholarly journals Range of Motion Comparison Following Total Knee Arthroplasty with and without Patella Resurfacing

2021 ◽  
Vol 11 ◽  
Author(s):  
Melissa Jackels ◽  
Samantha Andrews ◽  
Maya Matsumoto ◽  
Kristin Mathews ◽  
Cass Nakasone
Keyword(s):  
Total Knee Arthroplasty ◽  
Range Of Motion ◽  
Knee Arthroplasty ◽  
Knee Flexion ◽  
Knee Extension ◽  
Implant Design ◽  
Tourniquet Time ◽  
Full Extension ◽  
Total Knee ◽  
Low Incidence

Background: Despite significant evaluation, no consensus has been reach for best clinical practice for resurfacing the patella during total knee arthroplasty. Further complicating the ability to reach a conclusion is the inclusion of several different implant types used in previous research. Questions/Purpose: The purpose of this study was to compare post-TKA outcomes between two cruciate retaining implants with or without patella resurfacing. Methods: This retrospective review included 289 patients (380 knees) with a minimum six-month follow-up. All patients received a CR implant, with either a symmetric or an asymmetric tibial baseplate. Post-TKA knee flexion was categorized as <120° and ≥120° and knee extension classified as 0° or >0° and required knee manipulations were noted. Descriptive, nonparametric statistics were performed and a multivariate logistic regression was performed to determine risk of poor range of motion and manipulations. Results: Age was significantly lower in the resurfaced group (p=0.001) and the resurfaced group had longer tourniquet time (p=0.003). The symmetric-resurfaced group had ≥120° of flexion and full extension in 72% and 98.7% of patients, respectively. Compared to symmetric-resurfaced, all other groups had a significantly greater risk of not reaching 120° of knee flexion (p<0.05). There were no significant differences in the risk of requiring a MUA between groups (p>0.06). Conclusions: The effect of resurfacing the patella on post-TKA outcomes may be influenced by tibial implant design. Compared to all other combinations, a symmetric tibial baseplate and resurfaced patella resulted in the highest percentage of patients reaching ≥120°, with a low incidence of manipulations.

scholarly journals Home physiotherapy with vs. without supervision of physiotherapist for assessing manipulation under anaesthesia after total knee arthroplasty

Arthroplasty ◽  
2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Sanjay Bhalchandra Londhe ◽  
Ravi Vinod Shah ◽  
Amit Pankaj Doshi ◽  
Shubhankar Sanjay Londhe ◽  
Kavita Subhedar ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Range Of Motion ◽  
Knee Arthroplasty ◽  
Forgotten Joint Score ◽  
Group A ◽  
Manipulation Under Anaesthesia ◽  
Total Knee ◽  
The Mean ◽  
Group B ◽  
Discharge From Hospital

Abstract The aim of this retrospective cohort study was to compare home physiotherapy with or without supervision of physiotherapist for assessing manipulation under anaesthesia after total knee arthroplasty. Methods A total of 900 patients (including 810 females and 90 males) who had undergone total knee arthroplasty were divided into group A (n = 300) and group B (n = 600). Patients in group A had home physiotherapy on their own after discharge from hospital. The physiotherapist did not visit them at home. Patients in group B received home physiotherapy under supervision of physiotherapist for 6 weeks after discharge from hospital. Patients’ age, range of motion of the knee, and forgotten joint score-12 were assessed. A p < 0.05 was considered statistically significant. Results In group A, the mean age was 69.1 ± 14.3 years (range: 58 to 82 years); in group B, the mean age was 66.5 ± 15.7 years (range: 56 to 83 years) (p > 0.05). Preoperatively, the mean range of motion of the knee in group A and B was 95.8° ± 18.1° and 95.4° ± 17.8°, respectively (p > 0.05). The mean forgotten joint score-12 of group A and B were 11.90 ± 11.3 and 11.72 ± 12.1 (p > 0.05), respectively. Six weeks after total knee arthroplasty, the mean ROM of the knee in group A and B was 109.7° ± 22.3° and 121° ± 21.5°, respectively (p < 0.05). The mean postoperative forgotten joint score-12 of the group A and B was 24.5 ± 16.4 and 25.6 ± 17.4, respectively (p > 0.05). The rate of manipulation under anaesthesia was 3% in group A and 0.2% in group B (p < 0.05). Conclusion After total knee arthroplasty, frequent physiotherapist’s instruction helps the patients improve knee exercises and therefore decrease the risk of revision surgery. The home physiotherapy under supervision of physiotherapist lowers the rate of manipulation under anaesthesia. Level of evidence Therapeutic study, Level IIa.

scholarly journals Effect of Posterior Tibial Slope Change on Postoperative Range of Motion and Clinical Outcomes after Posterior Cruciate-Substituting Total Knee Arthroplasty

2021 ◽  
Author(s):  
O-Sung Lee ◽  
Jangyun Lee ◽  
Myung Chul Lee ◽  
Hyuk-Soo Han
Keyword(s):  
Total Knee Arthroplasty ◽  
Range Of Motion ◽  
Correlation Coefficient ◽  
Knee Arthroplasty ◽  
Tibial Slope ◽  
Posterior Tibial Slope ◽  
Posterior Tibial ◽  
Clinical Scores ◽  
Total Knee ◽  
The Mean

AbstractThe posterior tibial slope (PTS) is usually adjusted by less than 5 degrees, without considering its individual difference, during posterior cruciate-substituting (PS) total knee arthroplasty (TKA). The effect of these individual changes of PTS would be important because clinical results depending on postoperative PTS were reported conflictingly. We investigated the effect of the change in PTS on the postoperative range of motion (ROM) and clinical scores after PS TKA. We retrospectively reviewed 164 knees from 107 patients who underwent PS TKA with a 2-year follow-up. We analyzed the preoperative and postoperative PTS, ROM, visual analog scale pain scale, Western Ontario and McMaster University Index (WOMAC), Hospital for Special Surgery Knee Score, Knee Society Score, and Forgotten Joint Score (FJS). The association of the absolute change in PTS with ROM and clinical scores was analyzed using correlation analysis and multiple regression analysis. As a result, the mean PTS and mean ROM changed from 9.6 ±  3.4 and 120.1 ±  15.4 degrees preoperatively to 2.0 ±  1.3 and 128.4 ±  9.3 degrees postoperatively, and the mean PTS change was 7.6 ±  3.5 degrees. The PTS change had no statistically significant association with the postoperative ROM and clinical scoring systems, although it did have a weak positive correlation with WOMAC function, No 10 (difficulty in rising from sitting) (correlation coefficient = 0.342, p = 0.041), and moderate positive correlation with the FJS, No. 6 (awareness when climbing stairs) (correlation coefficient = 0.470, p = 0.001). The authors concluded that the amount of change in PTS did not affect the postoperative ROM and clinical scores, although proximal tibial resection with a constant target of PTS resulted in individually different changes in the PTS after PS TKA,

Effect of Body Mass Index on Range of Motion and Manipulation After Total Knee Arthroplasty

2011 ◽  
Vol 26 (8) ◽  
pp. 1194-1197 ◽  
Author(s):  
Naomi E. Gadinsky ◽  
Jessica K. Ehrhardt ◽  
Christopher Urband ◽  
Geoffrey H. Westrich
Keyword(s):  
Body Mass Index ◽  
Total Knee Arthroplasty ◽  
Range Of Motion ◽  
Body Mass ◽  
Knee Arthroplasty ◽  
Total Knee
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