Osteoarthritis of the knee joint. Etiology, treatment, rehabilitation (analytical review of the literature)

According to epidemiological studies, osteoarthritis accounts for 10–12 % of all cases of musculoskeletal diseases. In the general structure of knee pathology, degenerative diseases make up 57.8 %. The urgency of the problems of gonarthrosis is due to not only its widespread prevalence, but also the high risk of developing knee dysfunction, accompanied by a significant reduction in the quality of life of patients and often leading to partial or permanent disability of patients. Gonarthrosis has significant gender features. Women account for about 70 % of the number of patients, while men had this disease almost 2 times less often, but other data indicate that the incidence of gonarthrosis in men under 60 years of age is higher, and in women it begins to increase after 65 years. Knee replacement is a leading method in the treatment of knee osteoarthritis stages III–IV. The tendency towards an increase in the total number of surgeries leads to an increase in the frequency of complications and unsatisfactory results: according to some authors, from 3.3 to 13.2 % of patients complain of knee replacement outcomes. Studies of long-term complaints after arthroplasty have shown that in addition to pain reduction, some patients had an increase in varus angle when bending the knee while walking but they didn’t mark an improvement in gait parameters compared to preoperative examination. After unilateral total knee arthroplasty, the load patterns of the frontal plane in the operated knee remain pathological in the long run. After knee arthroplasty, there is muscle weakness, and studies have shown changes in all muscles of the lower extremity. Weakening of some muscles led to compensatory strengthening of others. Studies of the effect of preoperative rehabilitation on the outcome of knee arthroplasty have shown its low efficiency. Many studies have studied motor activity of patients after total knee arthroplasty in recent years. Not only gait features, but also movements of the pelvis, trunk and upper extremities are studied. Modern methods of diagnosing spatial oscillations of the body when walking have shown that disorders of body movements — excessive hand movements, pelvic loosening, asymmetrical flexion of the knee joints, etc., after arthroplasty are preserved in patients and restore slowly, and some disorders remain forever. Conclusions. Knee arthroplasty relieves pain, improves quality of life, but according to many authors, patients complain of incomplete restoration of the functionality of the prosthetic limb. According to the researchers, the main cause for incomplete reco-very of gait parameters is the difference in the frontal angles of the knee joint flexion and the difference in the length of the steps. Special training exercises can reduce the asymmetry of the steps, but it is difficult to completely restore the symmetry of the steps within 2 years. Studies of the effect of preoperative rehabilitation on the outcome of knee arthroplasty have shown its low effectiveness.

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Knee joint function, walking ability and quality of life within 6 weeks after total knee arthroplasty: A prospective cohort study

Journal of Clinical Nursing ◽

10.1111/jocn.14888 ◽

2019 ◽

Vol 28 (17-18) ◽

pp. 3222-3232 ◽

Cited By ~ 2

Author(s):

Su‐Yu Chang ◽

Li‐Hwa Lin ◽

Pi‐Chu Lin

Keyword(s):

Quality Of Life ◽

Total Knee Arthroplasty ◽

Cohort Study ◽

Knee Joint ◽

Knee Arthroplasty ◽

Prospective Cohort ◽

Walking Ability ◽

Joint Function ◽

Total Knee

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Safety of Total Knee Arthroplasty in the Treatment of Knee Osteoarthritis and Its Effect on Postoperative Pain and Quality of Life of Patients

Contrast Media & Molecular Imaging ◽

10.1155/2021/6951578 ◽

2021 ◽

Vol 2021 ◽

pp. 1-6

Author(s):

Yunfeng Zhang ◽

Hua Liu

Keyword(s):

Quality Of Life ◽

Total Knee Arthroplasty ◽

Postoperative Pain ◽

Knee Joint ◽

Knee Osteoarthritis ◽

Knee Arthroplasty ◽

Number Of Patients ◽

Total Knee ◽

Preoperative Score

Objective. To explore the safety of total knee arthroplasty (TKA) in the treatment of knee osteoarthritis (KOA) and its impact on patients’ postoperative pain and quality of life. Methods. A total of 60 KOA patients admitted to our hospital from January 2019 to January 2020 were selected as the research objects. The knee joint scores (HSS) before and after TKA were compared, and the patients’ quality of life was evaluated using the Osteoarthritis Index of Western Ontario and McMaster University (WOMAC). At the same time, the number of patients with complications was recorded, and the efficacy of TKA was comprehensively analyzed. Results. The postoperative HSS score was significantly higher than the preoperative score ( P < 0.05 ), the postoperative pain score increased with time, and the pain gradually decreased. The postoperative WOMAC score was significantly lower than the preoperative score ( P < 0.001 ), and the score at 6 months after surgery was significantly lower than that at 3 months after surgery ( P < 0.001 ). There were no complications such as severe prosthesis fracture, secondary sepsis, and patellar tendon rupture, and the total incidence of complications was 11.7%. The effective rate of treatment at 6 months after operation was 98.3%, which was significantly higher than that at 3 months after operation ( P < 0.05 ). Conclusion. Total knee arthroplasty can improve the knee joint function of patients with knee osteoarthritis, with low postoperative pain, low complication rate, and good quality of life for patients. It is worthy of promotion and application.

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Will Total Knee Replacement Ever Provide Normal Knee Function?

Journal of Interdisciplinary Medicine ◽

10.1515/jim-2017-0040 ◽

2017 ◽

Vol 2 (s3) ◽

pp. 22-26

Author(s):

István Gergely ◽

Tudor Sorin Pop ◽

Tiberiu Bățagă ◽

Andrei-Marian Feier ◽

Sándor-György Zuh ◽

...

Keyword(s):

Quality Of Life ◽

Total Knee Arthroplasty ◽

Total Knee Replacement ◽

Knee Replacement ◽

Current Literature ◽

Knee Arthroplasty ◽

Knee Function ◽

Normal Knee ◽

Total Knee

AbstractKnee osteoarthritis or gonarthrosis is considered the most common joint disease, affecting more than 70% of subjects aged over 65 years. Its occurrence is increasing with age and is more problematic with the current rise in the incidence of obesity. In severe and advanced cases, total knee arthroplasty is recommended as a gold standard therapy for pain relief, restoration of normal knee function, and quality of life improvement. There are numerous controversies whether total knee arthroplasty is able to reach and provide end-point outcomes and restore previous function of the knee joint. Studies suggest that the surgeons’ experience, type of prosthesis used, associated pathology, underlying pathologies, risk factors, continuous passive movement, and patient expectations about the surgery may influence the outcomes to a great extent. “Normal knee function” is a statement that is hardly defined in the current literature, as authors usually refer to subjective results when analyzing outcomes. Objective results may be more straightforward, but they do not always symbolize the actual state that the patient is reporting or the actual quality of life. Our objective was to analyze and present summaries of the current literature regarding normal knee function restoration after total knee replacement surgery. Our literature review results confirm the hypothesis that subjective and objective results are difficult to interpret and unravel. Complex future trials may bring supplementary and clearer conclusions regarding knee function and kinematics, clinical improvement, patient satisfaction, and quality of life.

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Recognition of Factors of Postoperative Complications of Knee Osteoarthritis Patients and Comprehensive Nursing Intervention

Computational and Mathematical Methods in Medicine ◽

10.1155/2021/1840613 ◽

2021 ◽

Vol 2021 ◽

pp. 1-10

Author(s):

Ying Dong ◽

Pei Zhang ◽

Lidan Fan

Keyword(s):

Quality Of Life ◽

Total Knee Arthroplasty ◽

Blood Loss ◽

Knee Joint ◽

Knee Osteoarthritis ◽

Knee Arthroplasty ◽

Nursing Intervention ◽

Joint Function ◽

Total Knee

Knee osteoarthritis (KOA) is a degenerative joint disease characterized by articular cartilage degeneration, cartilage exfoliation, osteophyte formation, and synovitis. It seriously affects the knee joint function and quality of life of patients. Total knee arthroplasty is now the most frequently used therapy for end-stage knee arthritis because it can successfully modify the line of lower extremities, restore knee joint function, alleviate pain, and enhance patients’ quality of life; nevertheless, it may cause significant trauma and bleeding. It can easily lead to infection and anemia. In this study, the control group chose total knee arthroplasty and the observation group chose total knee arthroplasty combined with PRP. The results showed that the knee joint function score, visual analog score, blood transfusion, total blood loss, total postoperative drainage, and complications in the observation group were superior to those in the control group. Total knee arthroplasty takes a long time and needs a lot of soft tissue incision, which leads to a lot of blood loss and can cause a variety of complications. Gel has been shown in studies to successfully decrease blood loss during and after total knee arthroplasty, enhance knee joint function recovery, and improve patient quality of life. In this paper, the complications and causes of knee osteoarthritis after total knee arthroplasty were studied. Combined with comprehensive nursing intervention for postoperative recovery, it helps to improve the formation of thrombin and calcium ion, which can effectively reduce blood loss, relieve pain, and promote the recovery of knee joint function. This study analyzed the application of total knee arthroplasty combined with gel in the treatment of knee osteoarthritis.

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Outcomes of the rotating hinge knee in revision total knee arthroplasty with a median follow-up of 6.2 years

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-04205-9 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Jake von Hintze ◽

Mika Niemeläinen ◽

Harri Sintonen ◽

Jyrki Nieminen ◽

Antti Eskelinen

Keyword(s):

Quality Of Life ◽

Total Knee Arthroplasty ◽

Survival Rate ◽

Knee Arthroplasty ◽

Revision Total Knee Arthroplasty ◽

Patient Reported ◽

Total Knee ◽

Revision Tka

Abstract Background The purpose of this study was to determine the mid-term clinical, radiographic and health-related quality of life (HRQoL) outcomes and define the survival rate in patients who had undergone revision total knee arthroplasty (TKA) using the single rotating hinged knee (RHK) design. Methods Between January 2004 and December 2013, 125 revision TKAs were performed at our institution using the single RHK implant. We conducted both a retrospective analysis of prospectively collected outcome data of these patients and a prospective follow-up study of all 39 living patients (41 knees). The follow-up phase included an optional extra follow-up visit, PROM questionnaires, and plain radiographs. Results The ten-year Kaplan-Meier survival rate of the revision RHK knees was 81.7% (95% CI 71.9–91.6%) with re-revision for any reason as the endpoint. Overall, 15 knees (12% of the total) underwent re-revision surgery during the follow-up. The median follow-up was 6.2 years (range, 0–12.7 years) post-operatively for the baseline group. One mechanical hinge mechanism-related failure occurred without any history of trauma or infection. At the time of the final follow-up, the majority of patients evinced a fairly good clinical outcome measured with patient-reported outcome measures and none of the components were radiographically loose. Conclusion We found that in patients undergoing complex revision TKA, fairly good functional outcome and quality of life can be achieved using an RHK implant. Further, it seems that in this type of patient cohort, revision TKA using an RHK implant relieves pain more than it improves ability to function. The NexGen® RHK design can be regarded as a suitable option in complex revision TKA.

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The Effectiveness of Client-Centered Intervention With Telerehabilitation Method After Total Knee Arthroplasty

OTJR Occupation Participation and Health ◽

10.1177/15394492211038293 ◽

2021 ◽

pp. 153944922110382

Author(s):

Berkan Torpil ◽

Özgür Kaya

Keyword(s):

Quality Of Life ◽

Total Knee Arthroplasty ◽

Knee Arthroplasty ◽

Intervention Program ◽

Nottingham Health Profile ◽

Performance Measure ◽

Occupational Performance ◽

Significant Difference ◽

Total Knee

There is known to be a decrease in quality of life and perceived occupational performance and satisfaction following total knee arthroplasty (TKA). This study was planned to examine the effectiveness of a client-centered (CC) intervention with the telerehabilitation (TR) method on the quality of life, perceived occupational performance, and satisfaction after TKA. A total of 38 patients who had undergone TKA were randomly assigned to the CC and control groups. A 12-day intervention program was applied to the CC group. The Nottingham Health Profile (NHP) and Canadian Occupational Performance Measure (COPM) were applied before and after intervention. The 12-day intervention showed a strong effect on all parameters in the CC group ( p<.001). In the postintervention comparisons, a significant difference was found in favor of the CC group ( p < .001). CC interventions with the TR method can be used in post-TKA interventions.

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Improved knee biomechanics among patients reporting a good outcome in knee-related quality of life one year after total knee arthroplasty

BMC Musculoskeletal Disorders ◽

10.1186/s12891-017-1479-3 ◽

2017 ◽

Vol 18 (1) ◽

Cited By ~ 15

Author(s):

Josefine E. Naili ◽

Per Wretenberg ◽

Viktor Lindgren ◽

Maura D. Iversen ◽

Margareta Hedström ◽

...

Keyword(s):

Quality Of Life ◽

Total Knee Arthroplasty ◽

Knee Arthroplasty ◽

Knee Biomechanics ◽

Good Outcome ◽

Related Quality ◽

Total Knee ◽

One Year

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The influence of obesity on functional outcome and quality of life after total knee arthroplasty

The Bone & Joint Journal ◽

10.1302/0301-620x.100b5.bjj-2017-1263.r1 ◽

2018 ◽

Vol 100-B (5) ◽

pp. 579-583 ◽

Cited By ~ 16

Author(s):

S. Xu ◽

J. Y. Chen ◽

N. N. Lo ◽

S. L. Chia ◽

D. K. J. Tay ◽

...

Keyword(s):

Quality Of Life ◽

Total Knee Arthroplasty ◽

Functional Outcome ◽

Knee Arthroplasty ◽

Obese Group ◽

Control Group ◽

Obese Patients ◽

Knee Score ◽

Total Knee

AimsThis study investigated the influence of body mass index (BMI) on patients’ function and quality of life ten years after total knee arthroplasty (TKA).Patients and MethodsA total of 126 patients who underwent unilateral TKA in 2006 were prospectively included in this retrospective study. They were categorized into two groups based on BMI: < 30 kg/m2(control) and ≥ 30 kg/m2(obese). Functional outcome was assessed using the Knee Society Function Score (KSFS), Knee Society Knee Score (KSKS), and Oxford Knee Score (OKS). Quality of life was assessed using the Physical (PCS) and Mental Component Scores (MCS) of the 36-Item Short-Form Health Survey.ResultsPatients in the obese group underwent TKA at a younger age (mean, 63.0 years, sd 8.0) compared with the control group (mean, 65.6 years, sd 7.6; p = 0.03). Preoperatively, both groups had comparable functional and quality-of-life scores. Ten years postoperatively, the control group had significantly higher OKS and MCS compared with the obese group (OKS, mean 18 (sd 5) vs mean 22 (sd 10), p = 0.03; MCS, mean 56 (sd 10) vs mean 50 (sd 11), p = 0.01). After applying multiple linear regression with the various outcomes scores as dependent variables and age, gender, and Charlson Comorbidity Index as independent variables, there was a clear association between obesity and poorer outcome in KSFS, OKS, and MCS at ten years postoperatively (p < 0.01 in both KSFS and OKS, and p = 0.03 in MCS). Both groups had a high satisfaction rate (97.8% in the control group vs 87.9% in the obese group, p = 0.11) and fulfillment of expectations at ten years (98.9% in the control group vs 100% in the obese group, p = 0.32).ConclusionAlthough both obese and non-obese patients have significant improvements in function and quality of life postoperatively, obese patients tend to have smaller improvements in the OKS and MCS ten years postoperatively. It is important to counsel patients on the importance of weight management to achieve a more sustained outcome after TKA. Cite this article: Bone Joint J 2018;100-B:579–83.

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