What Functional Activities Are Important to Patients With Knee Replacements?

Weiss, Jennifer M.; Noble, Philip C.; Conditt, Michael A.; Kohl, Harold W.; Roberts, Seth; Cook, Karon F.; Gordon, Michael J.; Mathis, Kenneth B.

doi:10.1097/00003086-200211000-00030

Cited by 335 publications

(228 citation statements)

References 23 publications

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“…Patient satisfaction may not be accurately reflected by the KSS and the ROM measured in our study. Outcome measures more sensitive than the KSS may be required to assess the clinical benefits of high flexion [21,38]. Finally, anterior knee pain, which may be associated with deepflexion activities, was not analysed, as it is not distinguished in the KSS.…”

Section: Discussionmentioning

confidence: 99%

Range of motion and function are similar in patients undergoing TKA with posterior stabilised and high-flexion inserts

Malik

Salas²,

Ari

et al. 2009

International Orthopaedics (SICOT)

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It is debatable whether high-flexion (HF) total knee arthroplasty (TKA) designs will improve postoperative flexion and function or will diminish the need for manipulation under anaesthesia (MUA). We retrospectively analysed range of motion (ROM), flexion, Knee Society Score (KSS), and rate of MUA in a consecutive group of patients who underwent TKA with a conventional posterior stabilised (PS) insert or an HF insert using identical surgical technique, implant design, and postoperative care. Fifty TKAs with a standard PS insert were matched for patient's age, gender, preoperative ROM, and KSS with 50 TKA performed with an HF insert. The patient's ROM and KSS were evaluated at six weeks, four months, and one year postoperatively. The outcome variables (flexion, ROM, KSS, and manipulation rate) in both groups were compared using the generalised estimating equations method. A second analysis of patients with preoperative flexion ≥120°was performed. The ROM, flexion, and patient-reported KSS was similar in both groups at each time period. The rate of MUA was also similar. Patients with a preoperative ROM of at least 120°showed similar results. Our study found that one year after surgery, patients who underwent TKA with a PS or an HF insert achieved similar flexion, ROM, and function.

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Section: Discussionmentioning

confidence: 99%

Range of motion and function are similar in patients undergoing TKA with posterior stabilised and high-flexion inserts

Malik

Salas²,

Ari

et al. 2009

International Orthopaedics (SICOT)

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“…14 Furthermore, researchers have begun to recognize the benefit of increased ROM following TKA to Western ADL, which results in higher scores as evaluated by the Hospital for Special Surgery knee rating scale 6 months after TKA. 15 Consequently, further research is required in this field to meet the needs of both Western and non-Western populations.…”

Section: Introductionmentioning

confidence: 99%

Hip, knee, and ankle kinematics of high range of motion activities of daily living

et al. 2006

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Treatment of joint disease that results in limited flexion is often rejected by patients in non-Western cultures whose activities of daily living require a higher range of motion at the hip, knee, or ankle. However, limited information is available about the joint kinematics required for high range of motion activities, such as squatting, kneeling, and sitting cross-legged, making it difficult to design prosthetic implants that will meet the needs of these populations. Therefore, the objective of this work was to generate three-dimensional kinematics at the hip, knee, and ankle joints of Indian subjects while performing activities of daily living. Thirty healthy Indian subjects (average age: 48.2 AE 7.6 years) were asked to perform six trials of the following activities: squatting, kneeling, and sitting cross-legged. Floating axis angles were calculated at the joints using the kinematic data collected by an electromagnetic motion tracking device with receivers located on the subject's foot, shank, thigh, and sacrum. A mean maximum flexion of 1578 AE 68 at the knee joint was required for squatting with heels up. Mean maximum hip flexion angles reached up to 958 AE 278 for squatting with heels flat. The high standard deviation associated with this activity underscored the large range in maximum hip flexion angles required by different subjects. Mean ankle range of flexion reached 588 AE 148 for the sitting cross-legged activity. The ranges of motion required to perform the activities studied are greater than that provided by most currently available joint prostheses, demonstrating the need for high range of motion implant design. ß

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“…1,2 Despite clinical success, some patients have difficulty performing important activities of daily living 3 and experience quadriceps weakness after surgery. 4,5 Postoperative decreases in quadriceps strength can be as high as 60%, 5 some patients have stiffness, limited motion, and instability due to improperly managed collateral ligaments.…”

mentioning

confidence: 99%

Biomechanical effects of total knee arthroplasty component malrotation: A computational simulation

Thompson

Hast

Granger

et al. 2011

Journal Orthopaedic Research

106

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Modern total knee arthroplasty (TKA) is an effective procedure to treat pain and disability due to osteoarthritis, but some patients experience quadriceps weakness after surgery and have difficulty performing important activities of daily living. The success of TKA depends on many factors, but malalignment of the prosthetic components is a major cause of postoperative complications. Significant variability is associated with femoral and tibial component rotational alignment, but how this variability translates into functional outcome remains unknown. We used a forward-dynamic computer model of a simulated squatting motion to perform a parametric study of the effects of variations in component rotational alignment in TKA. A cruciate-retaining and posterior-stabilized version of the same TKA implant were compared. We found that femoral rotation had a greater effect on quadriceps forces, collateral ligament forces, and varus/valgus kinematics, while tibial rotation had a greater effect on anteroposterior translations. Our findings support the tendency for orthopedic surgeons to bias the femoral component into external rotation and avoid malrotation of the tibial component. ß

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What Functional Activities Are Important to Patients With Knee Replacements?

Cited by 335 publications

References 23 publications

Range of motion and function are similar in patients undergoing TKA with posterior stabilised and high-flexion inserts

Range of motion and function are similar in patients undergoing TKA with posterior stabilised and high-flexion inserts

Hip, knee, and ankle kinematics of high range of motion activities of daily living

Biomechanical effects of total knee arthroplasty component malrotation: A computational simulation

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