Continuous passive motion not affect the knee motion and the surgical wound aspect after total knee arthroplasty

Background This study aimed to assess whether use of continuous passive motion (CPM) could improve range of motion in patients after total knee arthroplasty (TKA), if it could affect the surgical wound aspect (SWA) and if it could influence on pain management after TKA. Methods We randomized 210 patients in two groups, 102 patients in the CPM group, who received a standard rehabilitation protocol together with CPM application; and 108 patients in the no-CPM group, without CPM. Variables as knee motion (flexion, extension, range of motion) and pain were measured before surgery, on the 1st, 2nd and 3rd postoperative day, and in the 2nd, 6th, 12th and 24th postoperative weeks following TKA. The SWA was determined by the “surgical wound aspect score” (SWAS) in the next 48 h after surgery. This scale analyzes swelling, erythema, hematoma, blood drainage and blisters. Results There was an improvement in the knee motion over the course of follow-up in both groups, without significant difference in flexion parameter. We found no significant differences in the total score of SWA, except for hematoma, with less severity in the CPM group. Furthermore, we found no differences in the others SWAS parameters and pain. Conclusions The application of CPM does not provide benefit to our patients undergoing TKA in terms of either improved flexion mobility or decreased pain. No relationship was found between the use of CPM and the global score of SWA following a TKA, except for a decrease in hematoma appearance.

Vertical Drop Jump Biomechanics of Patients With a 3- to 10-Year History of Youth Sport–Related Anterior Cruciate Ligament Reconstruction

Background: A better understanding of movement biomechanics after anterior cruciate ligament reconstruction (ACLR) could inform injury prevention, knee injury rehabilitation, and osteoarthritis prevention strategies. Purpose: To investigate differences in vertical drop jump (VDJ) biomechanics between patients with a 3- to 10-year history of youth sport–related ACLR and uninjured peers of a similar age, sex, and sport. Study Design: Cross-sectional study. Level of evidence III. Methods: Lower limb kinematics and bilateral ground-reaction forces (GRFs) were recorded for participants performing 10 VDJs. Joint angles and GRF data were analyzed, and statistical analysis was performed using 2 multivariate models. Dependent variables included sagittal (ankle, knee, and hip) and coronal (knee and hip) angles at initial contact and maximum knee flexion, the rate of change of coronal knee angles (35%-90% of the support phase; ie, slopes of linear regression lines), and vertical and mediolateral GRFs (normalized to body weight [BW]). Fixed effects included group, sex, and time since injury. Participant clusters, defined by sex and sport, were considered as random effects. Results: Participants included 48 patients with a history of ACLR and 48 uninjured age-, sex-, and sport-matched controls (median age, 22 years [range, 18-26 years]; 67% female). Patients with ACLR demonstrated steeper negative coronal knee angle slopes (β = –0.04 deg/% [95% CI, –0.07 to –0.00 deg/%]; P = .025). A longer time since injury was associated with reduced knee flexion (β = –0.2° [95% CI, –0.3° to –0.0°]; P = .014) and hip flexion (β = –0.1° [95% CI, –0.2° to –0.0°]; P = .018). Regardless of ACLR history, women displayed greater knee valgus at initial contact (β = 2.1° [95% CI, 0.4° to 3.8°]; P = .017), greater coronal knee angle slopes (β = 0.05 deg/% [95% CI, 0.02 to 0.09 deg/%]; P = .004), and larger vertical GRFs (landing: β = –0.34 BW [95% CI, –0.61 to –0.07 BW]; P = .014) (pushoff: β = –0.20 BW [95% CI, –0.32 to –0.08 BW]; P = .001). Conclusion: Women and patients with a 3- to 10-year history of ACLR demonstrated VDJ biomechanics that may be associated with knee motion control challenges. Clinical Relevance: It is important to consider knee motion control during activities such as VDJs when developing injury prevention and rehabilitation interventions aimed at improving joint health after youth sport–related ACLR.

Fractures of the distal femur in elderly patients: retrospective analysis of a case series treated with single or double plate

Introduction: We evaluated the radiologic and clinical outcomes of a lateral incision single plate with and a single-incision double plating in elderly patients with osteoporotic distal femoral fractures.Materials and Methods: We performed a retrospective study of 82 cases of distal femoral fractures from May 2004 to June 2018. Group A consisted of 42 patients who underwent single-plate fixation. Group B consisted of 40 patients who underwent double-plate fixation. The mean patient age was 77 years (67–87 years) and 76 years (64–86 years) in groups A and B, respectively. All patients were evaluated for procedure duration, time to union, range of knee motion, Lysholm knee score, and presence of complications.Results: The average procedure time was 81 min (66–92 min) and 110 min (95–120 min) in groups A and B, respectively(p=0.33). One case in group B required bone grafting after 5 months. The average time to union was 14 weeks (9–19 weeks) and 12.2 weeks (8–19 weeks) (p=0.63), and the mean range of knee motion was 105° (90–125°) and 110.7° (90°–130°) (p=0.37) in groups A and B, respectively. There was no significant statistical difference between the two groups in the Lysholm knee score(p=0.44) and knee society score(p=0.53).Conclusion: The clinical and radiological outcomes were similar in the 2 groups. In elderly patients, double plate fixation for distal femoral fractures is an useful method for several advantages such as adequate exposure, easy manipulation, anatomical reduction and stable fixation.

Continuous Passive Motion Not Affect the Knee Motion and the Surgical wound Aspect After Total Knee Arthroplasty

Background. This study aimed to assess whether use of continuous passive motion (CPM) can improve range of motion in patients after total knee arthroplasty (TKA). Moreover, the relationship between the use of CPM with the surgical wound aspect (SWA) and pain management after TKA was analysed.Methods. We randomized 210 patients, 102 patients in the CPM group, who received a standard rehabilitation protocol together with CPM application; and 108 patients in the no-CPM group, without CPM. Variables as knee motion (flexion, extension, range of motion) and pain was measured before surgery, on the 1s, 2nd and 3rd postoperative day, and in the 2nd, 6th, 12th and 24th postoperative weeks following TKA. The SWA was determined by the “surgical wound aspect score” (SWAS) in the next 48 hours after surgery. This scale analyses swelling, erythema, haematoma, blood drainage and blisters. Results. There was an improvement in the knee motion over the course of follow-up in both groups, without significant difference in flexion parameter. We found no significant differences in the total score of SWA, except for haematoma, with less severity in the CPM group. Furthermore, we found no differences in the others SWAS parameters and pain. Conclusions. The application of CPM does not provide benefit to our patients undergoing TKA in terms of either improved flexion mobility or decreased pain. No relationship was found between the use of CPM and the global score of SWA following a TKA, except for a decrease in haematoma appearance.

Prevalence of Physical Activity with Mobility Disabilities among Senior Citizens in a Selected Old Home

The purpose of the study was to identify the mobility problem of aged people in selected old homes. The ages of the respondents are 60 plus age, which is clustered into 3 age groups 60-69 years, 70-79 years, and 80 plus age. This study established among 100% respondents 89.3% have self-bathing capacity, 89.3% have self-dressing capacity, 89.8% have self-toileting capacity, 93.3% have self-teeth washing capacity, 93.7% have self-eating capacity. For finding other problems of aged people set up among 206 participants of the old home area, 35.0% are disability problem. Besides, in old homes 19.9% have suffered diabetic mellitus for a long time, 51.0% suffered from hypertension, 11.7% suffered from low blood pressure, 14.6% have heart problems, 64.6% have urine catching difficulty, 6.8% have kidney disease. Among 206 respondents of the old home, area was 44.2% abnormal posture and they have 36.9% kyphosis, 4.4% scoliosis 0.5% lordosis, and 2.4% another abnormal posture. For the finding of aged people, we have asked some questions to identify pain severity and several labels found that among 206 participants of the old home area were 52.4% have pain during straight walking, 36.9% have neck pain, 56.3% have hip pain or lower back pain, 28.6% have thoraco-lumber pain and 34.0% have pain during sleeping time. Besides On this area respondents there was pain severity 21.4% have mild pain, 22.3% have moderate pain and 24.8% have severe pain. In this paper among 206 respondents of the old home area was 10.7% having a stroke history. Here 3.4% right side, 4.4 left sides, both sides 2.9% paralyzes. In this study Right shoulder motion 56.8% of participants ROM under 150 degrees and Left shoulder motion 61.2% of participants ROM under 150 degrees. Conversely, Right hip motion was 27.7% of participant's ROM under 60 degrees and Left hip motion 30.6% of participant's ROM under 60 degrees. Besides, Right knee motion 56.8% of participants ROM under 120 degrees and Left knee motion 57.3% participants ROM under 120 degrees. After completing the current study we think that everyone should take responsibility to survive the aged people for a long time.