Locomotor deficits before and two months after knee arthroplasty

Abstract

Objectives. To quantify the locomotor deficits before and 2 months after a total knee arthroplasty (TKA) in patients with osteoarthritis of the knee, and to compare pre-and postoperative performance. Methods. Locomotor capacity of patients was evaluated using laboratory gait and stair-ascent evaluations (kinematic and kinetic variables, electromyographic activity of 4 muscles of both lower limbs, and spatiotemporal parameters), the timed Up & Go (TUG), and the 6-minute walk (6MW) test. Results. Large locomotor deficits (increased hip flexion, decreased excursions of the knee and ankle, smaller extensor and flexor moments of force at the 3 joints, and muscle activation levels lower in all muscles tested) are still present in patients, particularly in the single-limb support subphase before and 2 months after TKA. These deficits explain the slower walk and stair-ascent speeds and a reduced performance at the TUG and 6MW tests. Conclusions. These results emphasize the need for more careful followup and intensive rehabilitation programs in the first months following TKA.

Functional mobility on discharge day after total knee and hip replacement surgery

“…In addition, during the first few weeks after THR, patients experience hip and knee strength loss and decreased functional capacity, which improve initially, then plateau from 6 months to 1 year. Ouellet and Moffet reported that individuals two months after TKR were 58% slower in completing the timed mobility test compared with healthy controls (32). A minimum of 100 degrees of postoperative knee flexion is desired for a chair rising activity and that a higher chair is more suitable for THR and TKR patients (33).…”

Avaliação da efetividade da cirurgia de artroplastia total de joelho associada à fisioterapia sob o ponto de vista da funcionalidade

“…Como primeira escolha, o tratamento não-medicamentoso inclui educação do paciente, perda de peso, fisioterapia, programas de condicionamento físico e uso de órteses, associadas ou não ao uso de drogas analgésicas antiinflamatórias. Quando há insucesso do tratamento conservador os pacientes com OA grave são então encaminhados para a cirurgia de Artroplastia Total de Joelho (ATJ) (COIMBRA et al, 2002;OUELLET;MOFFET, 2002;MARX et al, 2006;FACCI et al, 2007).…”

“…Deve ser priorizado o tratamento de reabilitação nas primeiras semanas após o procedimento cirúrgico, afim de obter uma recuperação funcional o mais precoce possível. (OUELLET, MOFFET, 2002;LENSSEN et al, 2003). A fisioterapia convencional de forma bem conduzida pode determinar resultados satisfatórios na reabilitação de pacientes submetidos à ATJ.…”

Effect of total knee replacement surgery and postoperative 12 month home exercise program on gait parameters

“…Total knee arthroplasty (TKA) is an effective treatment to reduce pain and subjective disability in patients with osteoarthrosis of the knee, but several studies have shown that muscle strength deficiency [1][2][3] and functional limitations may persist for several years after the operation [4][5][6].…”