Features of the development of movements after knee arthroplasty


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Objective: to compare different options for the development of knee joint movements after arthroplasty. Subjects and methods. The investigation involved 130 patients who had undergone knee arthroplasty. According to the postsurgery rehabilitation program, the patients were divided into 4 groups: 1) 25 patients who underwent the core of the rehabilitation program from the first day and active and passive knee flexion exercises from day 3; 2) 25 patients who did knee flexion exercises from day 3 and also received passive movement therapy; 3) 40 patients, in whom movement development was started immediately after surgery; 4) 40 patients, in whom movement development was initiated as soon as possible postsurgery and passive movement therapy was also used. Results. The amount of drainage discharge and the pain visual analogue scale (VAS) scores were higher in Group 4 patients at 1 and 5 days. There was a statistically significant difference in the Knee Society Clinical Rating System (KSS) scores between Groups 1 and 2, Groups 2 and 3, and Groups 2 and 4 at 6 months postsurgery, while that in the WOMAC scores between Groups 1 and 2 at 12 months after arthroplasty. However, no statistically significant difference was found in the KSS scores in the groups at 12 months after arthroplasty. Conclusion. When keeping the adequate balance of the ligamentous apparatus during knee arthroplasty, it is advisable to implement a standard early rehabilitation program without using the hardware techniques. The use of passive movement therapy significantly increases the amount of drainage discharge and worsens pain syndrome.

Full Text

Restricted Access

About the authors

S. M Smetanin

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: dr.smetaninsm@gmail.com
Associate Professor, MD

G. M Kavalersky

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: dr.smetaninsm@gmail.com
Professor, MD

A. A Gritsyuk

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: dr.smetaninsm@gmail.com
Professor, MD

Ya. A Rukin

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: dr.smetaninsm@gmail.com
Associate Professor, Candidate of Medical Sciences

A. V Lychagin

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: dr.smetaninsm@gmail.com
Professor, MD

References

  1. Белякова А.М., Середа А.П., Самойлов А.С. Реабилитация спортсменов после оперативного вмешательства на ахилловом сухожилии. Спортивная медицина: наука и практика. 2017; 7 (1): 73-8. https://doi.org/10.17238/ISSN2223-2524.2017.1.73
  2. Ефименко Н.А., Грицюк А.А., Середа А.П. Диагностика разрывов ахиллова сухожилия. Клиническая медицина. 2011; 89 (3): 64-70.
  3. Самойлов А.С., Середа А.П., Ключников М.С. и др. Опыт применения методов восстановительной медицины в условиях проведения учебно-тренировочных сборов сборных команд России. Медицина экстремальных ситуаций. 2015; 4 (54): 98-106.
  4. Середа А.П. Хирургическое лечение разрывов ахиллова сухожилия. Автореф. дис.. д-ра мед. наук. М., 2014.
  5. Avramidis K., Karachalios T., Popotonasios K. et al. Does electric stimulation of the vastusmedialis muscle influence rehabilitation after total knee replacement? Orthopedics. 2011; 34 (3): 175. doi: 10.3928/01477447-20110124-06
  6. Ling Z., Guo H., Boersma S. Analytical study on the kinematic and dynamic behaviors of a knee joint. Med EngPhys. 1997; 19: 29-36. doi: 10.1016/s1350-4533(96)00031-8
  7. Mizner R.L., Snyder-Mackler L. Altered loading during walking and sit-to-stand is affected by quadriceps weakness after total knee arthroplasty. J Orthop Res. 2005; 23 (5): 1083-90. doi: 10.1016/j.orthres.2005.01.021
  8. Mockford B.J., Thompson N.W., Humphreys P. et al. Does a standard outpatient physiotherapy regime improve the range of knee motion after primary total knee arthroplasty? J Arthroplasty. 2008; 23 (8): 1110-4. doi: 10.1016/j.arth.2007.08.023
  9. Nabatov A.A., Troegubova N.A., Rylova N.V. et al. Sport- and sample-specific features of trace elements in adolescent female field hockey players and fencers. J Trace Elem Med Biol. 2017; 43: 33-7. doi: 10.1016/j.jtemb.2016.11.002
  10. Petterson S.C., Mizner R.L., Stevens J.E. et al. Improved function from progressive strengthening interventions after total knee arthroplasty: a randomized clinical trial with an imbedded prospective cohort. Arthritis Rheum. 2009; 61 (2): 174-83. doi: 10.1002/art.24167
  11. Stevens J.E., Mizner R.L., Snyder-Mackler L. Quadriceps strength and volitional activation before and after total knee arthroplasty for osteoarthritis. J Orthop Res. 2003; 21 (5): 775-9. doi: 10.1016/S0736-0266(03)00052-4
  12. Stevens-Lapsley J.E., Balter J.E., Wolfe P. et al. Early neuromuscular electrical stimulation to improve quadriceps muscle strength after total knee arthroplasty: a randomized controlled trial. Phys Ther. 2012; 92 (2): 210-26. doi: 10.2522/ptj.20110124
  13. Thomas A., Stevens-Lapsley J. Importance of attenuating quadriceps activation deficits after total knee arthroplasty. Exerc Sport Sci Rev. 2012; 40 (2): 95-101. doi: 10.1097/JES.0b013e31824a732b

Supplementary files

Supplementary Files
Action
1. JATS XML

Copyright (c) 2021 Russkiy Vrach Publishing House

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies