Rehabilitation After Total Knee Arthroplasty

Kumar, Prakash; McPherson, Edward J.; Dorr, Lawrence D.; Wan, Zhinian; Baldwin, Kyle A.

doi:10.1097/00003086-199610000-00013

Cited by 101 publications

(15 citation statements)

References 11 publications

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“…Postoperative treatment included the use of a bulky compression dressing, an intraarticular drain, and the drop and dangle technique of Kumar et al [21]. On the first postoperative day, full weightbearing, as tolerated with a cane, and exercises were allowed under the supervision of a therapist.…”

Section: Methodsmentioning

confidence: 99%

Posterior Condylar Offset Does Not Correlate With Knee Flexion After TKA

Ishii¹,

Noguchi²,

Takeda³

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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BackgroundStudies of medial and lateral femoral posterior condylar offset have disagreed on whether posterior condylar offset affects maximum knee flexion angle after TKA.Questions/purposesWe asked whether posterior condylar offset was correlated with knee flexion angle 1 year after surgery in (1) a PCL-retaining meniscal-bearing TKA implant, or in (2) a PCL-substituting mobile-bearing TKA implant.MethodsKnee flexion angle was examined preoperatively and 12 months postoperatively in 170 patients who underwent primary TKAs to clarify the effect of PCL-retaining (85 knees) and PCL-substituting (85 knees) prostheses on knee flexion angle. A quasirandomized design was used; patients were assigned to receive one or the other implant using chart numbers. A quantitative three-dimensional technique with CT was used to examine individual changes in medial and lateral posterior condylar offsets.ResultsIn PCL-retaining meniscal-bearing knees, there were no significant correlations between posterior condylar offset and knee flexion at 1 year. In these knees, the mean (± SD) postoperative differences in medial and lateral posterior condylar offsets were 0.0 ± 3.6 mm and 3.8 ± 3.6 mm, respectively. The postoperative change in maximum knee flexion angle was −5° ± 15°. In PCL-substituting rotating-platform knees, similarly, there were no significant correlations between posterior condylar offset and knee flexion 1 year after surgery. In these knees, the mean postoperative differences in medial and lateral posterior condylar offsets were −0.5 ± 3.3 mm and 3.3 ± 4.2 mm, respectively. The postoperative change in maximum knee flexion angle was −2° ± 18°.ConclusionsDifferences in individual posterior condylar offset with current PCL-retaining or PCL-substituting prostheses did not correlate with changes in knee flexion 1 year after TKA. We should recognize that correctly identifying which condyle affects the results of the TKA may be difficult with conventional radiographic techniques.Level of EvidenceLevel II, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Section: Methodsmentioning

confidence: 99%

Posterior Condylar Offset Does Not Correlate With Knee Flexion After TKA

Ishii¹,

Noguchi²,

Takeda³

et al. 2013

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

show abstract

“…A reabilitação pós-operatória precoce constitui um fator importante para o sucesso do tratamento da artroplastia total de joelho (ATJ), devendo ter início no pós-operatório imediato com seguimento até independência funcional do paciente (Spósito et al, 1988;Drewett et al, 1992;Bohannon;Cooper, 1993;Erickson;Perkins, 1994;Munin et al, 1995;Anouchi et al, 1996;Kumar et al, 1996;Heck, 1998;Fortin et al, 1999;Ishii et al, 1999;Jorn et al, 1999). Nota-se que a ausência de um tratamento reabilitativo contribui negativamente para o grau de função da articulação do joelho, levando a graus variáveis de insucesso (Ververeli et al, 1995;Heck, 1998;Bhave et al, 2005).…”

Section: Lista Das Tabelasunclassified

“…A artroplastia é um procedimento cirúrgico eletivo cuja meta é proporcionar alívio da dor e a restauração dos movimentos de uma articulação e da função dos músculos, ligamentos e outras estruturas de tecido mole que controlam a articulação (Kumar et al, 1996;Zimmerman, 2002).…”

Section: Artroplastiaunclassified

“…Entretanto, estudos de acompanhamento em longo prazo mostram, de forma consistente, a manutenção ou a melhora da AM de joelho com relação aos níveis pré-operatórios, com um arco de movimento total médio de 110° a 115° (Mestriner, Filho, 1993b;Zimmerman, 2002), podendo oferecer em alguns casos, até mais que 130°; a média atingida é em torno de 85 a 107° (Laskin, Beksac, 2004 (Ververeli et al, 1995). Kumar et al (1996) (Spósito et al, 1990;Zimmerman, 2002).…”

Section: Exercícios Para a Amplitude De Movimentounclassified

“…O SF-36 é considerado um bom instrumento genérico de Qualidade de Vida Ligada à Saúde (QVLS), muito disseminado e validado em diferentes contextos, considerado "padrão-ouro" para o constructo "Qualidade de Vida" (QV) (Ciconelli, 1997;Drewett et al, 1992). É utilizado por alguns autores para a realização de trabalhos prospectivos comparativos no pós-operatório de ATJ (Heck et al, 1998;Kumar et al, 1996).…”

Section: Figura 9 -Diagramas De Dispersão Valores Da Flexão Passiva Aunclassified

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