scholarly journals Comparative Outcomes of Total Knee Arthroplasty on Physically Active and Passive Patients

2011 ◽  
Vol 54 (2) ◽  
pp. 69-72
Author(s):  
Daniel Waciakowski ◽  
Karel Urban
Keyword(s):  
Physical Activity ◽  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Sedentary Lifestyle ◽  
Active Group ◽  
Functional Score ◽  
Knee Score ◽  
Physically Active ◽  
Significant Difference ◽  
Total Knee

The physical activity of the population is decreasing due to an increase in sedentary lifestyles. The aim of the study was to analyze midterm results of total knee arthroplasty according to the lifelong physical activity of the patients. We evaluated 37 patients (23 women, 14 men), with age average 70.0 years (range 53–87). We divided the patients according to lifelong physical activity. The active group included 11 patients with any history of physical activity and the passive included 26 patients with a sedentary lifestyle. No intergroup differences existed in age, gender or preoperative Knee Score. The active group had a higher postoperative Knee Score 90,5 (±5,0) compared to the passive 87,4 (±5,0). Pain after arthroplasty was experienced significantly more in the active group. Between the active 87,3 (±9,3) and passive 67,5 (±16,7) groups we measured a statistically significant difference in the improvement of Functional Score – ability to walk and climb stairs. Sedentary lifestyle affects the clinical outcomes of total knee arthroplasty. This data is demonstrating that physical activity ameliorate functional postoperative results.

Role of telerehabilitation in patients following total knee arthroplasty: Evidence from a systematic literature review and meta-analysis

2016 ◽  
Vol 23 (2) ◽  
pp. 339-346 ◽  
Author(s):  
H Shukla ◽  
SR Nair ◽  
D Thakker
Keyword(s):  
Physical Activity ◽  
Total Knee Arthroplasty ◽  
Literature Review ◽  
Systematic Literature Review ◽  
Knee Arthroplasty ◽  
Knee Extension ◽  
Control Group ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Total Knee

Introduction Increased physical activity and functional ability are the goals of total knee replacement surgery. Therefore, adequate rehabilitation is required for the recovery of patients after discharge from hospital following total knee arthroplasty (TKA). This systematic literature review aimed to evaluate the effectiveness of home telerehabilitation in patients who underwent TKA. Methods Studies published in the English language between 2000 and 2014 were retrieved from Embase, PubMed, and Cochrane databases using relevant search strategies. Two researchers independently reviewed the studies as per the Cochrane methodology for systematic literature review. We considered telerehabilitation sessions as those that were conducted by experienced physiotherapists, using videoconferencing to patients’ homes via an internet connection. The outcomes assessed included: knee movement (knee extension and flexion); quadriceps muscle strength; functional assessment (the timed up-and-go test); and assessment of pain, stiffness, and functional capacity using the Western Ontario and McMaster Universities Osteoarthritis Index and visual analogue scale for pain. Results In total, 160 potentially relevant studies were screened. Following the screening of studies as abstracts and full-text publications, six primary publications (four randomized controlled trials, one non-randomized controlled trial, and one single-arm trial) were included in the review. Patients experienced high levels of satisfaction with the use of telerehabilitation alone. There was no significant difference in change in active knee extension and flexion in the home telerehabilitation group as compared to the control group (mean difference (MD) −0.52, 95% CI −1.39 to 0.35, p = 0.24 and MD 1.14, 95% CI −0.61 to 2.89, p = 0.20, respectively). The patients in the home telerehabilitation group showed improvement in physical activity and functional status similar to patients in the conventional therapy group. Discussion The evidence from this systematic literature review demonstrated that telerehabilitation is a practical alternative to conventional face-to-face rehabilitation therapy in patients who underwent TKA.

scholarly journals Effect of Enhanced Exercise Program on Pain and Physical Activity for Patients after Total Knee Arthroplasty

2021 ◽  
Vol 3 (3) ◽  
pp. 14
Author(s):  
Safaa M. Hamed ◽  
Rasha F. M. Gaballah
Keyword(s):  
Physical Activity ◽  
Total Knee Arthroplasty ◽  
Pain Score ◽  
Knee Arthroplasty ◽  
Rating Scale ◽  
Treatment Plan ◽  
Exercise Program ◽  
Orthopedic Procedure ◽  
Significant Difference ◽  
Total Knee

Context: Total knee arthroplasty (TKA) is considered the most effective orthopedic procedure for treating knee osteoarthritis. The need for knee replacement is predicted to increase six-fold between 2005 and 2030 to reflect an increasingly yet functionally demanding population. Aim: This study aimed to evaluate the effect of an enhanced exercise program on pain and physical activity after total knee arthroplasty. Methods: Quasi-experimental (pre/posttest) design was utilized in this study. The study was carried out in the orthopedic department, Benha University Hospital, and followed the patients through the orthopedic outpatient clinic from the beginning of May 2020 till the beginning of May 2021. A purposive sample of 64 patients was recruited to achieve the aim of this study. Four tools were used to collect the study data. These are the structured interview questionnaire to assess patients' knowledge regarding total knee arthroplasty, Barthel ADL index scale, Lysholm knee scoring scale, and Numeric Pain Rating Scale to assess the effect of the enhanced exercise program. Results: Showed that nearly two-thirds of the study sample was ≤60 years old, females, and married. The study also showed a statistically significant difference between pre-and post- enhanced exercise program in terms of total knowledge mean score among the study sample, as well as an increase in the total mean score in Barthel ADL index, decrease Lysholm knee scoring, and pain score after one month and after three months of enhanced program exercise implementation. Conclusion: Implementing an enhanced exercise program for patients with total knee arthroplasty effectively improved knowledge, increased physical activity (Barthel ADL index), decreased Lysholm knee scoring, and pain score. The present study recommended including an enhanced exercise program in the treatment plan for patients with total knee arthroplasty to improve patient's knowledge and practices. Also, repeating the study on a larger probability sample to achieve generalization of the findings.            

Periprosthetic Infection: Major Cause of Early Failure of Primary and Revision Total Knee Arthroplasty

2018 ◽  
Vol 32 (10) ◽  
pp. 941-946 ◽  
Author(s):  
Dimitrios S. Evangelopoulos ◽  
Sufian S. Ahmad ◽  
Anna M. Krismer ◽  
Christoph E. Albers ◽  
Sven Hoppe ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Revision Total Knee Arthroplasty ◽  
Functional Score ◽  
Extension Deficit ◽  
Primary Tkas ◽  
Significant Difference ◽  
Flexion Extension ◽  
Cause Of Failure ◽  
Total Knee

AbstractRevision total knee arthroplasty (RTKA) represents an effective treatment for failed TKA, but with less favorable outcomes. Considering the technical complexity and economic burden of RTKA procedures, it is mandatory to investigate current mechanisms and predictors for RTKA failure. The objective of this study is to evaluate the survivorship and determine the predominant causes of failure of RTKA. A total of 146 patients undergoing RTKA between 2003 and 2013 were identified from the institutional database. Revision was defined as surgery in which the whole prostheses (inlay and both femoral and tibial components) required exchange. Median follow-up was 6.3 ± 2.7 years (range: 2.2–10). Patient demographics, year of primary implantation, reasons for revision surgery, implant type, pain, knee mobility, systemic or local postoperative complications, and treatment of the complications were recorded and evaluated. Infection was a major cause of failure followed by aseptic loosening, instability, pain, malalignment, and inlay wear. Following RTKA, Knee Society Score (KSS) (knee score and functional score) demonstrated a significant improvement (p < 0.05). No significant difference in flexion, extension deficit, and KSS was detected between aseptic and septic primary TKAs preoperatively and following first RTKA. Reinfection rate of the septic primary TKAs was 5%. Infection was the major cause of a second revision, reaching as high as 50% in all cases. The results of this study support that septic failure of a primary TKA is likely to occur within the first 2 years following implantation. Septic failure of primary TKA does not influence survival of the revision prosthesis.

scholarly journals Improved levels of physical activity in patients over 75 years following total knee arthroplasty

2019 ◽  
Vol 27 (3) ◽  
pp. 230949901987336
Author(s):  
Yuriko Matsunaga-Myoji ◽  
Kimie Fujita ◽  
Shuya Ide ◽  
Yasuko Tabuchi ◽  
Masaaki Mawatari
Keyword(s):  
Physical Activity ◽  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Older Patients ◽  
Oxford Knee Score ◽  
Knee Score ◽  
Metabolic Equivalents ◽  
Before And After ◽  
Total Knee ◽  
Healthy Participants

Purpose: There is insufficient evidence regarding the precise levels of physical activity (PA) in older patients following total knee arthroplasty (TKA). The aims of this study were (1) to describe the changes in the amount and intensity of PA before and after TKA with an accelerometer in older patients, compared with age- and sex-matched healthy participants and (2) to assess the effect of TKA on PA depending on age. Methods: Sixty-six primary TKA patients aged 60 years or over (mean age, 73.3 years) wore an accelerometer (Lifecorder EX) for 10 consecutive days and completed the Oxford Knee Score (OKS) before and at 6 months after TKA. PA was evaluated by mean step count and time spent (min) engaged in PA per day. PA intensity was classified as light (1.5–3 metabolic equivalents (METs)), moderate to vigorous (≥3 METs), and total (≥1.5 METs). Sixty-four healthy participants completed a single assessment of PA. Results: Each of the PA measures and OKS increased significantly after TKA. Compared with healthy controls, light and total PA improved to 100% at 6 months after TKA in patients 75 years or older. By contrast, moderate-to-vigorous PA was 32% of that of the controls and rose to 78% after TKA. PA intensity in patients aged 60–74 years was 31–74% of the controls but did not reach the same level after TKA. Conclusion: TKA in older patients increases the amount of PA, with light and total PA suitable parameters for assessing PA.

scholarly journals Early Outcomes of Cemented versus Cementless Total Knee Arthroplasty

2019 ◽  
Vol 9 (4) ◽  
pp. 93-98
Author(s):  
Jeffrey Shepherd ◽  
Alexander C.M. Chong ◽  
Robert P. Cusick
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Functional Outcomes ◽  
Clinical Score ◽  
Functional Score ◽  
Patient Demographics ◽  
Included Patient ◽  
Significant Difference ◽  
Measured Time ◽  
Total Knee

Introduction. Total knee arthroplasty (TKA) has been provento be very effective for long-term pain relief in the degenerativeknee. Few studies have investigated short-term clinicaland functional outcomes between the cemented and cementlessTKA. The specific aim of this study was to assess the potentialdifference of functional outcomes in the early postoperativeperiod between these two surgical options usingthe Knee Society Score (KSS) and range of motion (ROM). Methods. A total of 164 knees that had undergone TKA by a singlesurgeon at a single institution between 2007 and 2010 were reviewed.Three different TKA prosthetic designs (cruciate retaining(CR), posterior stabilized (PS) and cruciate substituting (CS))were included. Data collection included patient demographics,pre- and post-operative ROM, and pre- and post-operative KSSat each visit (1.5 months, 3 months, and 12 months). Two separateKSS scores were assigned: functional score and clinical score. Results. Sixty-seven knees underwent cemented TKA and 97knees underwent cementless TKA. No significant differencewas recognized in either age or body mass index for thesetwo TKA groups. The cementless group showed a significantearly ROM improvement after 1.5 months post-operative (p <0.05), while the cemented group showed ROM improvementonly after three months post-operative. No significant differencewas detected in terms of KSS between the cemented andcementless TKA groups at each measured time period. Bothgroups showed marked KSS improvement (cemented: 135%,cementless: 125%) after 1.5 months post-operative and theKSS seemed to be stabilized after three months post-operativefor both groups (cemented: p = 0.36; cementless: p = 0.07). Conclusions. There was a significant early ROM improvementfor the cementless TKA group compared to the cementedTKA group, but no statistical significant difference was notedin KSS in the early post-operative period when comparing cementedand cementless TKA groups. The findings provide evidencethat cementless TKA patients can undergo an identicalpost-operative protocol to cemented TKA, without concernsabout implant stability or function. KS J Med 2016;9(4):93-98.

Residual Mild Varus Alignment and Neutral Mechanical Alignment Have Similar Outcome after Total Knee Arthroplasty for Varus Osteoarthritis in Five-Year Follow-Up

2019 ◽  
Vol 33 (02) ◽  
pp. 200-205 ◽  
Author(s):  
Zhiqi Zhang ◽  
Can Liu ◽  
Zhiwen Li ◽  
Peihui Wu ◽  
Shu Hu ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Weight Bearing ◽  
Primary Total Knee Arthroplasty ◽  
Functional Score ◽  
Mechanical Alignment ◽  
Knee Score ◽  
Neutral Group ◽  
Total Knee

AbstractThe effect of residual varus on survival rate and function in patients with varus knee osteoarthritis (OA) was considered an important issue for successful primary total knee arthroplasty (TKA). In this study, we compared the midterm clinical and functional outcomes in patients with different residual varus. A retrospective review of 175 patients (219 knees) with varus OA was > 3° for the hip-knee-ankle (HKA) who underwent primary TKA after exclusions and loss to follow-up from 237 patients (281 knees). The mean follow-up period was 5.2 ( ±  1.1) years. Patients were divided into four groups according to the first postoperative HKA angle from weight-bearing full-leg radiographs: “valgus” group (HKA angle > 0°, n = 44), “neutral” group (–3° ≤ HKA angle < 0°, n = 86), “mild varus” group (–6° ≤ HKA angle < –3°, n = 62), and “severe varus” group (HKA angle < –6°, n = 27). Survival analysis, Knee Society Score (KSS, including knee score and functional score), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were compared among the four groups. No knee required revision surgery during follow-up. For the KSS knee score and functional score at the last follow-up, the neutral and mild varus groups were better compared with the valgus and severe varus groups (p < 0.05), and there were no significant differences between the neutral and mild varus groups (p > 0.05). WOMAC scores of the neutral and mild varus groups were also better compared with the valgus and severe varus groups (p < 0.05), and there were no significant differences between the neutral and mild varus groups at the last follow-up. The postoperative HKA angle was significantly changed in valgus group between first and at the last follow-up when compared with the other three groups (p < 0.05). Leaving an HKA angle at < 6° varus had the same excellent functional outcome as neutral mechanical alignment after TKA for varus-type OA in the 5-year follow-up, using mechanically aligned technique. Caution is advised when leaving valgus or leaving severe varus after TKA.

scholarly journals Outcomes of total knee arthroplasty in arthritis using functional knee score

2018 ◽  
Vol 4 (5) ◽  
pp. 778
Author(s):  
Arvind B. Goregaonkar ◽  
Hitesh A. Shukla ◽  
Amit Singh ◽  
Santosh Bindumadhavan ◽  
Rajesh S.
Keyword(s):  
Total Knee Arthroplasty ◽  
Standard Deviation ◽  
Pain Relief ◽  
Knee Arthroplasty ◽  
Weight Bearing ◽  
Functional Score ◽  
Knee Score ◽  
True Outcome ◽  
Total Knee ◽  
Surgical Modality

<p class="abstract"><strong>Background:</strong> Knee being a major weight bearing joint, arthritis of the knee is a common problem. Over time various conservative measures have been used to alleviate the arthritic pain, but complete pain relief has rarely been achieved. Total Knee Arthroplasty has an established place in the treatment of knee arthritis and is an effective surgical modality that provides immediate pain relief and enhances quality of life. Though most patients were satisfied by the immediate outcome of the surgery, further detailed interrogation revealed concern and inability to perform activities they previously used to do, thus arising the need for an objective method to measure the true outcome.</p><p class="abstract"><strong>Methods:</strong> There are very few established objective scoring methods to evaluate the outcome following a Total Knee Arthroplasty. In our study, we have used the ‘Functional Knee Score’ for the 30 patients with arthritis who underwent TKA using the midvastus approach under tourniquet cover.<strong></strong></p><p class="abstract"><strong>Results:</strong> The majority of the patients were from the age group of 61-70 years which accounts for 36.7% of patients in our study. The mean functional new knee society score preoperatively was 39.90 standard deviation of 3.055 which improved to 80.77 with standard deviation of 6.263 postoperatively, p&lt;0.001.</p><p class="abstract"><strong>Conclusions:</strong> Using knee society functional score, 10 patients had excellent results, 16 had a good result, 4 patients a had fair result.</p>

Effect of Manipulation under Anesthesia of the First Knee in Staged Bilateral Total Knee Arthroplasty on Clinical Outcome and Satisfaction

2020 ◽  
Author(s):  
Jung-Won Lim ◽  
Yong-Beom Park ◽  
Dong-Hoon Lee ◽  
Han-Jun Lee
Keyword(s):  
Total Knee Arthroplasty ◽  
Patient Satisfaction ◽  
Clinical Outcome ◽  
Clinical Outcomes ◽  
Knee Arthroplasty ◽  
Knee Flexion ◽  
Functional Score ◽  
Manipulation Under Anesthesia ◽  
Total Knee

AbstractThis study aimed to evaluate whether manipulation under anesthesia (MUA) affect clinical outcome including range of motion (ROM) and patient satisfaction after total knee arthroplasty (TKA). It is hypothesized that MUA improves clinical outcomes and patient satisfaction after primary TKA. This retrospective study analyzed 97 patients who underwent staged bilateral primary TKA. MUA of knee flexion more than 120 degrees was performed a week after index surgery just before operation of the opposite site. The first knees with MUA were classified as the MUA group and the second knees without MUA as the control group. ROM, Knee Society Knee Score, Knee Society Functional Score, Western Ontario and McMaster Universities (WOMAC) score, and patient satisfaction were assessed. Postoperative flexion was significantly greater in the MUA group during 6 months follow-up (6 weeks: 111.6 vs. 99.8 degrees, p < 0.001; 3 months: 115.9 vs. 110.2 degrees, p = 0.001; 6 months: 120.2 vs. 117.0 degrees, p = 0.019). Clinical outcomes also showed similar results with knee flexion during 2 years follow-up. Patient satisfaction was significantly high in the MUA group during 12 months (3 months: 80.2 vs. 71.5, p < 0.001; 6 months: 85.8 vs. 79.8, p < 0.001; 12 months: 86.1 vs. 83.9, p < 0.001; 24 months: 86.6 vs. 85.5, p = 0.013). MUA yielded improvement of clinical outcomes including ROM, and patient satisfaction, especially in the early period after TKA. MUA in the first knee could be taken into account to obtain early recovery and to improve patient satisfaction in staged bilateral TKA.

scholarly journals The Effect of Femoral Nerve Block and Adductor Canal Block Methods on Patient Satisfaction in Unilateral Knee Arthroplasty: Randomized Non-Inferiority Trial

2021 ◽  
Vol 12 ◽  
pp. 215145932199663
Author(s):  
Mustafa Kaçmaz ◽  
Zeynep Yüksel Turhan
Keyword(s):  
Total Knee Arthroplasty ◽  
Patient Satisfaction ◽  
Nerve Block ◽  
Knee Arthroplasty ◽  
Femoral Nerve Block ◽  
Femoral Nerve ◽  
Adductor Canal Block ◽  
Adductor Canal ◽  
Significant Difference ◽  
Total Knee

Introduction: Femoral Nerve Block (FNB) and Adductor Canal Block (ACB) methods, which are regional analgesic techniques, are successfully used in postoperative pain control after total knee arthroplasty. This study aimed to compare adductor canal block method that was preoperatively used and femoral nerve block method in total knee arthroplasty (TKA) patients who underwent spinal anesthesia in terms of factors effecting patient satisfaction and determine whether these methods were equally effective or not. Methods: A total of 80 patients between the ages of 60 and 75 who were in the American Society of Anesthesia (ASA) physical status of I-III were prospectively included in this randomized study. Patients (n = 40) who received FNB were called Group FNB and patients (n = 40) who received Adductor Canal Block were called Group ACB. Results: Although mean postoperative VAS values were lower in FNB group only in the first hour (p = 0.02) there was no significant difference between the groups in the third, fifth, seventh, ninth, 12th and 24th hours (p≥0.05). Although Bromage scores were lower in FNB group in the first, second, third, fourth and fifth hours there was no statistically significant difference between the groups (p≥0.05). When mobilization time, patient satisfaction level, time of first analgesia, intraoperative sedation need, and recovery time of sensorial block were compared no statistically significant difference was found (p≥0.05). Discussion: When ACB and FNB that are used for postoperative analgesia in patients who undergo total knee arthroplasty are compared in terms of factors affecting patient satisfaction it is observed that they result in the same level (non-inferiority) of patient satisfaction. Conclusion: We recommend the routine use of ACB method with FNB in total knee arthroplasty. More studies focusing especially on measuring patient satisfaction are needed.

Accelerometer-Based Portable Navigation System Is Useful for Tibial Bone Cutting in Modified Kinematically Aligned Total Knee Arthroplasty

2019 ◽  
Author(s):  
Masanori Tsubosaka ◽  
Tomoyuki Kamenaga ◽  
Yuichi Kuroda ◽  
Koji Takayama ◽  
Shingo Hashimoto ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Clinical Outcomes ◽  
Knee Arthroplasty ◽  
Navigation System ◽  
Slope Angle ◽  
Posterior Slope ◽  
Tibial Bone ◽  
Significant Difference ◽  
Portable Navigation ◽  
Total Knee

AbstractSeveral studies have reported better clinical outcomes following kinematically aligned total knee arthroplasty (KA-TKA) than mechanically aligned TKA. Consistent reproduction of a KA-TKA is aided by accurate tibial bone resections using computer navigation systems. This study compares an accelerometer-based portable navigation system with a conventional navigation system on tibial bone resection and clinical outcomes in KA-TKA. This study included 60 knees of patients who underwent primary KA-TKA between May 2015 and September 2017. They were randomly assigned to the OrthoPilot and iASSIST groups. A tibial bone cut was performed with 3 degree varus and 7 degree posterior slope in relation to the mechanical axis in all cases. The tibial component angle (TCA) and posterior slope angle (PSA) were evaluated by postoperative radiography, and those that deviated more than 2 degree were set as outliers. The clinical outcomes were the knee range of motion (ROM) and 2011 Knee Society Score (KSS) evaluated at 1 year postoperation. The groups were compared in terms of the TCA, PSA, number of outliers, ROM, and 2011 KSS (p < 0.05). No significant difference was observed between the groups in terms of the mean TCA, PSA, number of outliers, ROM, and categories of the 2011 KSS (objective knee indicators, symptoms, satisfaction, expectations, and functional activities). Although tibial bone cuts were performed with 3 degree varus and 7 degree posterior slope, no significant difference was observed between the OrthoPilot and iASSIST groups in terms of the accuracy of cuts or postoperative clinical result. The iASSIST was found to be a simple and useful navigation system for KA-TKA.

Sign in / Sign up

Export Citation Format

Share Document