Knee ankylosis or stiffness after a total knee arthroplasty: treatment and long-term outcome

Papagelopoulos, PJ; Dg, Lewallen

doi:10.1016/0968-0160(94)90022-1

Cited by 7 publications

(5 citation statements)

References 36 publications

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“…At 6 weeks, 18 patients (9%) in the usual care group and 11 patients (6%) in the HEP group failed to achieve even a conservative 80° of knee flexion. Patients not achieving 80° knee flexion may also be considered likely candidates for knee manipulation under anesthesia, a procedure used to restore flexion ROM when the knee flexion is less than 50–95° (). Whether more intensive physiotherapy input during this early phase of rehabilitation would markedly reduce the number of patients with inadequate knee flexion is unknown.…”

Section: Discussionmentioning

confidence: 99%

Early Rehabilitation After Total Knee Replacement Surgery: A Multicenter, Noninferiority, Randomized Clinical Trial Comparing a Home Exercise Program With Usual Outpatient Care

Han

Nairn

Harmer

et al. 2015

Arthritis Care & Research

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Objective. To determine, at 6 weeks postsurgery, if a monitored home exercise program (HEP) is not inferior to usual care rehabilitation for patients undergoing primary unilateral total knee replacement (TKR) surgery for osteoarthritis. Methods. We conducted a multicenter, randomized clinical trial. Patients ages 45-75 years were allocated at the time of hospital discharge to usual care rehabilitation (n ‫؍‬ 196) or the HEP (n ‫؍‬ 194). Outcomes assessed 6 weeks after surgery included the Western Ontario and McMaster Universities Osteoarthritis Index pain and physical function subscales, knee range of motion, and the 50-foot walk time. The upper bound of the 95% confidence interval (95% CI) mean difference favoring usual care was used to determine noninferiority. Results. At 6 weeks after surgery there were no significant differences between usual care and HEP, respectively, for pain (7.4 and 7.2; 95% CI mean difference [MD] ؊0.7, 0.9), physical function (22.5 and 22.4; 95% CI MD ؊2.5, 2.6), knee flexion (96°and 97°; 95% CI MD ؊4°, 2°), knee extension (؊7°and ؊6°; 95% CI MD ؊2°, 1°), or the 50-foot walk time (12.9 and 12.9 seconds; 95% CI MD ؊0.8, 0.7 seconds). At 6 weeks, 18 patients (9%) allocated to usual care and 11 (6%) to the HEP did not achieve 80°knee flexion. There was no difference between the treatment allocations in the number of hospital readmissions. Conclusion. The HEP was not inferior to usual care as an early rehabilitation protocol after primary TKR.

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Section: Discussionmentioning

confidence: 99%

Early Rehabilitation After Total Knee Replacement Surgery: A Multicenter, Noninferiority, Randomized Clinical Trial Comparing a Home Exercise Program With Usual Outpatient Care

Han

Nairn

Harmer

et al. 2015

Arthritis Care & Research

View full text Add to dashboard Cite

show abstract

“…In 3 cases the Judet quadricepsplasty technique was performed and in 2 the modified Coonse and Adams quadricepsplasty [1]. Though no further operative treatment was performed, the average range of motion at last follow up was only 55° (range 20°-80°).…”

Section: Discussionmentioning

confidence: 99%

“…Though there is no consensus about timing, manipulation under anaesthesia is usually the first step in the management of stiff TKA [ 1 , 2 , 6 , 7 ]. This procedure is usually undertaken within 2 months of primary surgery.…”

Section: Discussionmentioning

confidence: 99%

“…In Papagelopoulos’s series of 42 stiff knees following TKA, quadricepsplasty combined with arthrolysis was performed in 6 cases of severe joint ankylosis. In 3 cases the Judet quadricepsplasty technique was performed and in 2 the modified Coonse and Adams quadricepsplasty [ 1 ]. Though no further operative treatment was performed, the average range of motion at last follow up was only 55° (range 20°-80°).…”

Section: Discussionmentioning

confidence: 99%

“…It has been estimated that a minimum of 90° of range of motion in the knee is required for activities of daily living. 65° of knee flexion is required in the swing phase of normal gait and 106° of flexion is needed to arise from a chair easily or tie shoe laces [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

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