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

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.

2021 ◽  
pp. 105477382110589
Author(s):  
Çiğdem Kaya ◽  
Özlem Bilik

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.


Author(s):  
Abdulhamit Misir ◽  
Turan Bilge Kizkapan ◽  
Suleyman Kasim Tas ◽  
Kadir Ilker Yildiz ◽  
Erdal Uzun ◽  
...  

AbstractDissatisfaction is still an important problem in a small but important group of patients who undergo total knee arthroplasty. This study was designed to evaluate the effectiveness of showing patients the change in their standing posture, before and after total knee replacement, using standing photographs (anterior, posterior, and lateral view), on improving self-reported quality of life and satisfaction. Full-length lower extremity radiographs and standing photographs were obtained prior to total knee replacement and 6 months after surgery in the study group. In the control group, radiographs and photographs were not obtained. The hip–knee–ankle angle and mechanical axis deviation were compared between the two limbs and two groups. The changes in the following outcome measures were evaluated from baseline to 6 months after surgery: Short Form-36 Survey, Knee Injury and Osteoarthritis Outcome Score, Western Ontario and McMaster Universities Osteoarthritis Index, Oxford Knee Score, and Knee Society score. Postoperative measures were also compared before and after showing patients their standing photographs, and between two groups. The study and control groups included 71 and 44 patients, respectively, with unilateral or bilateral knee osteoarthritis (Kellgren–Lawrence Grade 3 or 4), with a mean age of 66 years. All patients had a varus malalignment, with significant improvement in postoperative limb alignment (p < 0.001). All self-reported outcome measures improved after surgery (p < 0.05), with the exception of mental health in the Short Form-36. Self-reported scores further improved after patients seeing their standing photographs (p < 0.05), with the exception of mental health and social role functioning. There were also significantly improved scores in the study group than control group after showing photographs (p < 0.05). Showing patients the pre-to-postoperative change in their standing posture might be an easy-to-administer method to improve patient satisfaction with the outcome of total knee replacement and self-reported quality of life. The Level of Evidence for this study is four.


2020 ◽  
Vol 9 (1) ◽  
pp. 29-39
Author(s):  
Erna Setiawati ◽  
Juwita Kusumadewi ◽  
Robby Tjandra

ABSTRACT Introduction: An exercise program like prehabilitation exercise is expected to contribute in improving outcomes in Osteoarthritis (OA) postoperatively such as Total Knee Replacement (TKR). Elastic resistance products in prehabilitation exercise programs have been widely used in rehabilitation and are an effective method. Resistance band is one of elastic resistance products that have several advantages. The purpose of this study was to determine the effect of prehabilitation exercise intervention with a resistance band on the quality of life of patients under going TKR using the SF-36 questionnaire. Methods: This study was a randomized controlled trial pre-test and post-test control group design knowing the effects of prehabilitation exercise in patients underwent TKR. 16 subjects were allocated to treatment group (n = 8) which received additional prehabilitation exercise using resistance band and control group (n = 8) with conventional therapy (ergocycle and Transcutaneous Electrical Nerve Stimulation (TENS)) preoperatively. Quality of life assessment using SF-36 score was carried out 4 weeks preoperatively and 8 weeks postoperatively. Results: The mean baseline value of SF-36 in the treatment group is 41.18 ± 9.40 and control group with mean 43.78 ± 5.66, did not differ significantly with p > 0.05. Both groups experienced a significantincrease in their SF-36 post-test scores for the control group (p <0.05) and the treatment group (p <0.05). Comparison between groups showed a significant difference (p <0.05) between the pretest and posttestSF-36 scores where the control group (6.32±3.21) and treatment group (23.95±9.75). Discussion: The SF-36 pre-test score between groups showed no significant d ifference. While the posttest results had significantly increased in SF-36 mean score in both groups. This might be caused byalthough the exercises performed by the two groups were different, they still did exercises that had an effect on joints. Despite of that, treatment group post-test results still had significantly betterimprovement than those of the control group. Conclusion: Prehabilitation exercise intervention using resistance bands improving the quality of life of patients undergoing TKR. The quality of life improving more in those who do prehabilitation exercisethan those who do conventional therapy.Keywords: Prehabilitation exercise, quality of life, total knee replacement.


2019 ◽  
Vol 8 (3) ◽  
pp. 170-174
Author(s):  
Soo-Hyun Leem ◽  
Byounghee Lee ◽  
EunJung Chung ◽  
Jiyeon Lee ◽  
Jung-Hee Kim

2010 ◽  
Vol 30 (S 01) ◽  
pp. S104-S106
Author(s):  
W. Miesbach ◽  
L. M. Sahner ◽  
A. Kurth ◽  
B. Habermann

Summary Purpose Purpose of this retrospective study was to evaluate our own results after total knee replacement in patients with haemophilia. Patients, material, method: 30 patients with haemophilia who underwent total knee replacement between 1987 and 2005 were included. We used the clinical and radiological Knee Society Score. Furthermore, the Petterson and the Arnold and Hilgartner score were applied. Results: The mean age at the time of surgery was 43.2 (27–66). At the time of follow- up examination the mean age was 51.6 (30–82) years. The mean follow-up was 7.1 (2–20) years. Preoperative, he mean Arnold and Hilgartner score was 4.17 (± 0.59) and the mean Petterson-Score was 9 ± 2.29. Compared to the preoperative deficiency in knee function (KSS-Score 88.17 ± 33.58) an improvement with 166.67 (± 22.73) points was seen. 1 patient showed an aseptic loosening after 11 years. Discussion: Total knee replacement in patients with haemophilia improves knee function and quality of life. The results of our study represent results in earlier published studies. Compared to a non-haemo-philic normal population the rate of perioper-ative complications was not increased.


2017 ◽  
Vol 29 (6) ◽  
pp. 974-977 ◽  
Author(s):  
Jiyeon Lee ◽  
Jung-hee Kim ◽  
Eun-jung Jung ◽  
Byoung-Hee Lee

2004 ◽  
Vol 12 (2) ◽  
pp. 140-143 ◽  
Author(s):  
Susanne Fuchs ◽  
Christian Sandmann ◽  
Georg Gerdemann ◽  
Adrian Skwara ◽  
Carsten O. Tibesku ◽  
...  

2020 ◽  
Vol 9 (5) ◽  
pp. 1298
Author(s):  
Stephan Heisinger ◽  
Wolfgang Hitzl ◽  
Gerhard M. Hobusch ◽  
Reinhard Windhager ◽  
Sebastian Cotofana

The aim of the study was to longitudinally investigate symptomatic and structural factors prior to total knee replacement (TKR) surgery in order to identify influential factors that can predict a patient’s need for TKR surgery. In total, 165 participants (60% females; 64.5 ± 8.4 years; 29.7 ± 4.7 kg/m2) receiving a TKR in any of both knees within a four-year period were analyzed. Radiographic change, knee pain, knee function and quality of life were annually assessed prior to the TKR procedure. Self-learning artificial neural networks were applied to identify driving factors for the surgical procedure. Significant worsening of radiographic structural change was observed prior to TKR (p ≤ 0.0046), whereas knee symptoms (pain, function, quality of life) worsened significantly only in the year prior to the TKR procedure. By using our prediction model, we were able to predict correctly 80% of the classified individuals to undergo TKR surgery with a positive predictive value of 84% and a negative predictive value of 73%. Our prediction model offers the opportunity to assess a patient’s need for TKR surgery two years in advance based on easily available patient data and could therefore be used in a primary care setting.


Sign in / Sign up

Export Citation Format

Share Document