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.

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.

The Impact of Intraoperative Gap Difference Between Extension and Flexion on Perception of Joint Function After Total Knee Arthroplasty: a Comparative Retrospective Study

2021 ◽  
Author(s):  
Tomohiro Okayoshi ◽  
Yoshinori Okamoto ◽  
Hitoshi Wakama ◽  
Shuhei Otsuki ◽  
Masashi Neo
Keyword(s):  
Total Knee Arthroplasty ◽  
Retrospective Study ◽  
Soft Tissue ◽  
Knee Joint ◽  
Predictive Factors ◽  
Knee Arthroplasty ◽  
Difference Threshold ◽  
Joint Function ◽  
Flexion Gap ◽  
Total Knee

Abstract Background: The argument presupposes that intra-operative soft tissue balance is associated with patient-reported outcome measures after total knee arthroplasty (TKA). Our aim was to assess the association between the extension-to-flexion gap and patients’ reported perception of knee joint function.Methods: This was a retrospective study of 60 cases of primary cruciate-retaining TKAs performed for the treatment of medial-compartment knee osteoarthritis, at a mean follow-up of 2.6 (range, 2.0–5.2) years. Knee perception was evaluated by asking patients whether they considered their knee joint as “natural” (grade I) or “artificial”, with or without restrictions (grades II–V). The following factors were compared between the two groups: age, sex, and the extension-to-flexion gap difference. A multiple logistic regression analysis was used to identify predictive factors of an artificial knee joint perception. A receiver operating characteristic curve analysis was used to identify cut-off values of predictive factors. Result: Compared to a natural knee joint perception (26 knees, 43%), an artificial perception (34 knees, 57%) was associated with a smaller gap difference at the distraction force of 20 lbf (p < .001), 30 lbf (p = .022), and 40 lbf (p = .038), a lower EuroQol 5-Dimension score (p = .029), and self-reported joint health (Knee injury and Osteoarthritis Outcome Score-Joint Replacement [KOOS-JR], p = .032). A gap difference <1.0 mm was a predictive of an artificial perception (odds ratio, 1.63; 95% confidence interval, 1.33–4.54; p < .001). A cut-off gap difference of 0.99 mm at 20 lbf predicted an artificial perception with a sensitivity of 81.5% and a specificity of 87.9%. Post-operative satisfaction (p < .001), KOOS-JR (p < .001), patient’s joint perception (p = .006), pain (p = .015), and EuroQol 5-Dimension (p = .032) differed between the two groups when the gap difference threshold was set to 1.0 mm.Conclusion: Careful balancing of soft tissue during TKA to achieve an extension-to-flexion gap ≥ 1.0 mm can improve patients’ perception of knee joint function and quality of life.

scholarly journals Postoperative Changes in Knee Joint Function of Total Knee Arthroplasty Patients

2011 ◽  
Vol 23 (5) ◽  
pp. 719-724 ◽  
Author(s):  
Takaki Maruyama ◽  
Yutaka Sawada ◽  
Seiji Kubo ◽  
Keisuke Kinoshita ◽  
Masahiro Kurosaka ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Joint ◽  
Knee Arthroplasty ◽  
Joint Function ◽  
Postoperative Changes ◽  
Total Knee

scholarly journals Influence of Patella thickness on Patellofemoral pressure in total knee Arthroplasty

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Hidenori Tanikawa ◽  
Mitsunori Tada ◽  
Ryo Ogawa ◽  
Kengo Harato ◽  
Yasuo Niki ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Joint ◽  
Knee Arthroplasty ◽  
Knee Flexion ◽  
Patellofemoral Joint ◽  
Joint Function ◽  
Custom Made ◽  
Total Knee ◽  
Patellar Thickness ◽  
Patellofemoral Pressure

Abstract Background Patellofemoral complications are one of the major issues after total knee arthroplasty (TKA). Excessive patellofemoral joint pressure is associated with complications after TKA surgery, and the amount of patellar osteotomy has a direct effect on patellofemoral joint pressure. The purpose of this study was to evaluate the influence of patella thickness on patellofemoral pressure in TKA. Methods Five freshly frozen cadavers were operated with a custom-made Stryker posterior stabilizing type knee joint prosthesis. Patellofemoral joint pressure was measured using a pressure sensor, with the knee joint flexed from 90 to 110 degrees, and with patellar thickness of − 2 mm to + 4 mm. Results Increasing or decreasing patellar thickness significantly increased or decreased patellofemoral pressure. Regarding knee flexion angle, patellofemoral pressure increased with increasing patellar thickness at all flexion angles, but the pressure increase was greatest at 90 degrees of knee flexion and smallest at 110 degrees. Conclusions The amount of patellar osteotomy influences the patellofemoral pressure. Surgeons should avoid increasing patella thickness, since the resulting increased patellofemoral pressure may reduce knee joint function.

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.

scholarly journals ASSESSMENT OF KNEE JOINT FUNCTION IN PATIENTS AFTER TOTAL KNEE ARTHROPLASTY USING THE KOOS SCALE

2018 ◽  
Vol 16 (6) ◽  
pp. 666-672
Author(s):  
O. M. Abelevich ◽  
◽  
A. I. Abelevich ◽  
A. V. Marochkov ◽  
◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Joint ◽  
Knee Arthroplasty ◽  
Joint Function ◽  
Total Knee
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