Importance of knee flexion range of motion during the acute phase after total knee arthroplasty

T, Oka; Wada, Osamu; Asai, Tsuyoshi; Maruno, Hideto; Mizuno, Kiyonori

doi:10.1298/ptr.e9996

Cited by 29 publications

(17 citation statements)

References 30 publications

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“…For Range of Motion, the Recupe group demonstrated greater ROM, indicating improved recovery, and the average reached 120 degrees, which is often used as a target for recovery (24). Per a previous study on TKA ROM progression, the non-Recupe group would take 25 days to reach 120 degrees.…”

Section: Discussionmentioning

confidence: 97%

“…Post-op pain decreases 1 month after surgery For patients using Recupe -average 2.34/10 (sd 1.89) For all non-Recupe patients -average 2.86/10 (sd 2.52) P-value − . 24 Pre-op pain Pre-op pain was lower for Recupe patients For patients using Recupe -average 2.80/10 (sd 2.37) For all Non-Recupe patients -average 3.85/10 (sd 3.11)…”

Section: One Month After Surgerymentioning

confidence: 93%

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Improved Range of Motion and Decreased Complications After Total Knee Arthroplasty with Use of Plethy Recupe Remote Patient Monitoring – A Retrospective Study

Hui¹,

Greene

Subramanian³

et al. 2023

Preprint

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Background Home exercise plans are key to recovery from surgeries, but poor compliance limits the benefit. Though non-compliance can be up to 70% from previous research, digital health shows promise in improving compliance. This retrospective study compared pain, range of motion (ROM), and manipulation under anesthesia (MUA) complications after a total knee arthroplasty (TKA) from a clinic where one group used digital health and another did not. There is little previous research on this topic, so this study could show the benefits of digital health on joint replacement rehabilitation. Methods Patients were retrospectively selected from Summit Orthopedics TKA patients from 9/1/21 to 4/30/22. 41 patients used Recupe, a digital app that instructs and monitors home exercises along with live coaching with their TKA rehabillitation. 95 patients did not. Age, sex, and BMI between both groups were very similar. Results ROM improved significantly with the use of Recupe, improving to 120 degrees after 1 month - a key ROM level for functional use as indicated by studies. The non-recupe group improved to 112 degrees in the same timeframe. The need for MUA was significantly better for the Recupe group, where 2% required MUA versus 5% for the other group, indicating a lower risk of major complications. Pain averaged 2.34/10 for the Recupe group after 1 month versus 2.86/10 for the non-recupe group, though the decrease did not reach statistical significance. The Recupe group performed their exercises an average of 5.1 times per week. Conclusions The Recupe group and the Non-Recupe group both attended medical and physical therapy visits, so the significant differences in results are likely due to non-adherence of HEP by the Non-Recupe group. These results suggest that lengthened musculoskeletal recovery amongst workers may be due to non-adherence to their prescribed care plan, and that digital health may be an excellent way to improve their compliance. Clinical Significance Use of Recupe during rehabilitation after a Total Knee Arthroplasty results in significantly faster ROM improvement and significantly decreased risk of Manipulation Under Anesthesia. Pain was also decreased though not to statistical significance.

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Section: Discussionmentioning

confidence: 97%

Section: One Month After Surgerymentioning

confidence: 93%

Improved Range of Motion and Decreased Complications After Total Knee Arthroplasty with Use of Plethy Recupe Remote Patient Monitoring – A Retrospective Study

Hui¹,

Greene

Subramanian³

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…Moreover, range of motion was found to positively correlate with better sleep efficiency, as measured with polysomnography at postoperative days 1, 3, 5, 7, 11, and 14 73 . Nevertheless, one should note that early knee range of motion (e.g., flexion) after TKA may not be a clinically relevant outcome measure, as its prognostic value and correlation with later functional outcomes measures are debated 74,75 . The latter results were confirmed in a similar RCT, where preoperative and postoperative zolpidem administration improved several outcomes compared with placebo, including subjective sleep quality, perceived sleepiness, and increase in early range of motion and muscle strength 76 .…”

Section: The Influence Of Sleep Disturbances On Fracture Outcomesmentioning

confidence: 99%

Relevance of Sleep Disturbances to Orthopaedic Surgery

Beetz

Babiloni

Jodoin

et al. 2021

Journal of Bone and Joint Surgery

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“…A favorable functional knee rehabilitation usually promotes the life quality. Furthermore, knee function at 1 month postoperatively may indicate the likelihood of achieving the clinical goal at 12 months [ 12 ]. The changes in the knee range of flexion plateaued 3 months after total knee arthroplasty [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Retrospective Comparison of Postoperative Fascia Iliaca Block and Multimodal Drug Injection on Early Function of the Knee in Femoral Fractures Using Retrograde Intramedullary Nailing

Luo

Yu-hu

et al. 2022

Pain Research and Management

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Introduction. There is a common concern about the pain and rehabilitation of the knee after femoral retrograde intramedullary nailing. It is essential for early postoperative knee function required for physical self-maintenance in daily life. And a favorable rehabilitation of the knee usually promotes the quality of life. However, early rehabilitation is absent or insufficient for many patients in postoperative management. This retrospective study aims to evaluate the effect of early knee function improvement in comparison to postoperative fascia iliaca blocking (FIB) and multimodal drug injection (MDI). Patients and Methods. A retrospective analysis of 41 patients receiving femoral fracture treatment with retrograde intramedullary nailing, was performed during 2018–2020. 19 patients were treated with MDI as postoperative analgesia, and 22 patients were treated with FIB. Rehabilitation started on the first postoperative day and lasted for 3 months. Visual analog scale (VAS), the range of motion (ROM) of the knee, and single assessment numeric evaluation (SANE) were assessed. Results. There was no significant difference shown in any of the demographic, fracture types, and operative time. All patients performed regular and voluntary knee rehabilitation and weight-bearing at home following the instruction from the orthopedic staff. Pain in the FIB group at postoperative 1-day was milder (1.7 ± 1.1), compared with that in the MDI group (2.8 ± 1.3, p = 0.038 ). There was a significant difference in VAS between two groups at postoperative 1-month ( p = 0.031 ), with a peak score in the FIB group (3.3 ± 0.9). At postoperative 3-month, both groups had pain relief with similar VAS ( p = 0.465 ). The ROM of the knee in both groups was continuously improved during the first three months. The SANE in the MDI group was significantly different compared with FIB at 1-month ( p = 0.026 ). However, scores of SANE were similar in both groups at 3 months ( p = 0.541 ). All patients were identified as fractures union at 9-month or 12-month follow-up. Conclusion. The knee pain was commonly experienced in this series of retrograde femoral nailings. Both MDI and FIB provided immediate and effective pain control after femoral fracture surgery. MDI was more beneficial to continuous pain control and knee rehabilitation in the early follow-up. The extent of pain relief and knee function improvement reached the same level at postoperative 3-month.

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Importance of knee flexion range of motion during the acute phase after total knee arthroplasty

Cited by 29 publications

References 30 publications

Improved Range of Motion and Decreased Complications After Total Knee Arthroplasty with Use of Plethy Recupe Remote Patient Monitoring – A Retrospective Study

Improved Range of Motion and Decreased Complications After Total Knee Arthroplasty with Use of Plethy Recupe Remote Patient Monitoring – A Retrospective Study

Relevance of Sleep Disturbances to Orthopaedic Surgery

Retrospective Comparison of Postoperative Fascia Iliaca Block and Multimodal Drug Injection on Early Function of the Knee in Femoral Fractures Using Retrograde Intramedullary Nailing

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