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Knee replacement physiotherapy

Maria A Peer, Robert Rush, Peter D Gallacher, Nigel Gleeson
OBJECTIVE: To summarize the evidence regarding the effectiveness and dose-response characteristics of pre-operative exercise programmes on post-operative physical function following total knee arthroplasty. DATA SOURCES: CINAHL, Cochrane Library, PubMed, SPORTDiscus and EMBASE. STUDY SELECTION: Randomized controlled trials were eligible if they provided full description of physiological stress (i.e. mode, frequency, intensity and duration)...
March 29, 2017: Journal of Rehabilitation Medicine
Deborah L Snell, Julia Hipango, K Anne Sinnott, Jennifer A Dunn, Alastair Rothwell, C Jean Hsieh, Gerben DeJong, Gary Hooper
PURPOSE: The evidence supporting rehabilitation after joint replacement, while vast, is of variable quality making it difficult for clinicians to apply the best evidence to their practice. We aimed to map key issues for rehabilitation following joint replacement, highlighting potential avenues for new research. MATERIALS AND METHODS: We conducted a scoping study including research published between January 2013 and December 2016, evaluating effectiveness of rehabilitation following hip and knee total joint replacement...
March 23, 2017: Disability and Rehabilitation
H Bork
Due to current demographic developments with a continuous increase in average life expectancy and improved medical treatment, the number of elderly patients with joint replacement of the lower extremities also has increased in recent years. Most of these patients have not only one but several chronic diseases requiring treatment and medication. Drug-drug interaction and functional restrictions of the elderly additionally reduce the postoperative psychophysical capacity; therefore, special knowledge in rehabilitative treatment and pain management is necessary...
January 2017: Der Orthopäde
M Vavro, E Ziakova, K Gazdikova, D Farkasova
OBJECTIVE: The pilot study objective was to evaluate the effect of comprehensive post-operative physiotherapeutic treatment on the selected physiotherapeutic parameters as well as patients' quality of life after a total knee joint replacement surgery. RESULTS: Thirty patients after total knee joint arthroplasty were enrolled into the pilot study. After completing the physiotherapeutic processes, we have observed among the patients who underwent a total knee replacement surgery, a significant increase in muscle strength as with the flexors as well as the extensors (p = 0...
2016: Bratislavské Lekárske Listy
Mohammadjavad Zehtab, Mohammadhassan Kaseb, Mohammadnaghi Tahmasebi, Mohammad Ayati Firoozabadi
Total knee arthroplasty (TKA) is a commonly performed surgical procedure designed to alleviate knee pain and improve function in individuals with knee osteoarthritis the purpose of collecting the latest information and updating the reports is to summarize the published articles and inform the colleagues. In so doing, the articles published in American journals of arthroplasty and joint surgery and the proceedings of the conferences that were mostly held in 2004 have been utilized so that delicate and precise spotlights retrieved from scholars' breakthroughs can be applied in daily medical practices...
July 25, 2016: Global Journal of Health Science
Adam Tucker, Darren McCusker, Nidhi Gupta, Jonathon Bunn, Mark Murnaghan
INTRODUCTION: Arthroplasty is commonplace in orthopaedic practice, and post operative pain has been shown to substantially hinder recovery and discharge from hospital. OBJECTIVES: The current study assessed a multidisciplinary, multimodal Orthopaedic ERP in terms of its effect on patient perceived post operative pain in hip and knee arthroplasty. Secondary outcome was in the form of a cost analysis. METHODS: A prospective study was performed on consecutive arthroplasty patients across a 6 week period in a district orthopaedic unit...
May 2016: Ulster Medical Journal
Johannes Oppermann, Jan Bredow, Christian K Spies, Julia Lemken, Frank Unglaub, Christoph K Boese, Jens Dargel, Peer Eysel, Jan Zöllner
PURPOSE: The purpose of this study was to examine the effect of postoperative prolonged release oxycodone/naloxone (OXN) in comparison to other opioids (control group) on the early postoperative rehabilitation outcome after total knee replacement. METHODS: In a prospective, noninterventional, nonrandomized clinical trial, 80 patients were assigned to either the OXN group or a control group. Postoperative outcome and pain level at days 3, 6, 21, 35, and 6months were evaluated using the Bowel Function Index, Brief Pain Inventory Short Form questionnaire, the Hospital for Special Surgery score, modified Larson score, and the ability to attend physiotherapy...
September 2016: Journal of Clinical Anesthesia
Vikki Wylde, Neil Artz, Elsa Marques, Erik Lenguerrand, Samantha Dixon, Andrew D Beswick, Amanda Burston, James Murray, Tarique Parwez, Ashley W Blom, Rachael Gooberman-Hill
BACKGROUND: Primary total knee replacement is a common operation that is performed to provide pain relief and restore functional ability. Inpatient physiotherapy is routinely provided after surgery to enhance recovery prior to hospital discharge. However, international variation exists in the provision of outpatient physiotherapy after hospital discharge. While evidence indicates that outpatient physiotherapy can improve short-term function, the longer term benefits are unknown. The aim of this randomised controlled trial is to evaluate the long-term clinical effectiveness and cost-effectiveness of a 6-week group-based outpatient physiotherapy intervention following knee replacement...
June 13, 2016: Trials
Federica Montagnese, Simone Thiele, Stephan Wenninger, Benedikt Schoser
The treatment of late-onset Pompe disease (LOPD) relies on enzyme replacement therapy (ERT) and physiotherapy but the most appropriate exercise program is not yet established. Whole-body vibration training (WBVT) has showed promising results, improving motor performances in various populations. Our aim is to assess the effects of WBVT performed by two LOPD patients in addition to ERT and physiotherapy. A side-alternating WBVT lasting 2 years; clinical assessments included: manual muscle testing (MRC sumscore), knee extension and arm flection isometric strength (multi-muscle tester M3diagnos), timed function tests (10 m walking, standing-up from chair, ascending 4-steps), 6 min walking (6 MWT), motor disability (Walton Gardner-Medwin scale), pulmonary function...
August 2016: Neurological Sciences
Neil Artz, Samantha Dixon, Vikki Wylde, Elsa Marques, Andrew D Beswick, Erik Lenguerrand, Ashley W Blom, Rachael Gooberman-Hill
OBJECTIVE: To evaluate the feasibility of conducting a randomized controlled trial comparing group-based outpatient physiotherapy with usual care in patients following total knee replacement. DESIGN: A feasibility study for a randomized controlled trial. SETTING: One secondary-care hospital orthopaedic centre, Bristol, UK. PARTICIPANTS: A total of 46 participants undergoing primary total knee replacement. INTERVENTIONS: The intervention group were offered six group-based exercise sessions after surgery...
April 2017: Clinical Rehabilitation
Jorge Hugo Villafañe, Maria Isgrò, Maria Borsatti, Pedro Berjano, Caterina Pirali, Stefano Negrini
OBJECTIVE: We hypothesized that self-administered action observation treatment can increase the effectiveness of inpatient rehabilitation of patients after a primary total knee replacement. DESIGN: A pilot randomized controlled trial. SETTING: Thirty-one inpatients, admitted to our Physical and Rehabilitation Medicine Department. SUBJECTS: After a primary total knee replacement were randomly assigned to either an experimental (n=14) or control (n=17) group...
April 11, 2016: Clinical Rehabilitation
Emma C Johnson, Jeremy Horwood, Rachael Gooberman-Hill
PURPOSE: To explore how the process of undergoing and recovering from knee replacement surgery alters patients' experiences and use of their support networks. METHODS: Ten patients having knee replacement surgery for osteoarthritis were invited to take part in in-depth interviews prior to surgery and 2-4 weeks, 6 and 12 months post-operatively. Transcripts were analyzed using Interpretative Phenomenological Analysis. RESULTS: Three superordinate themes were identified: (1) relationships with health professionals over the knee replacement journey; (2) implications for informal relationships and support networks and (3) providing support to others...
December 2016: Disability and Rehabilitation
Li Wang, Myeongjong Lee, Zhe Zhang, Jessica Moodie, Davy Cheng, Janet Martin
OBJECTIVES: The clinical impact of preoperative physiotherapy on recovery after joint replacement remains controversial. This systematic review aimed to assess the clinical impact of prehabilitation before joint replacement. DESIGN: We searched PubMed, Embase and Cochrane CENTRAL up to November 2015 for randomised controlled trials comparing prehabilitation versus no prehabilitation before joint replacement surgery. Postoperative pain and function scores were converted to Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and function subscales (0-100, high scores indicate worse outcome)...
February 2, 2016: BMJ Open
Jaime Baselga García-Escudero, Pedro Miguel Hernández Trillos
BACKGROUND: Autologous conditioned serum (ACS) is an autologous blood product that has shown efficacy against knee osteoarthritis (OA) in randomized controlled trials. However, there are few reports of its effectiveness in everyday practice. Here, we report clinical efficacy results from a two-year prospective observational study of patients with highly symptomatic knee OA who received ACS in conjunction with physiotherapy. METHODS: 118 patients with unilateral knee OA (Kellgren-Lawrence grades I-IV), who were candidates for surgery but instead chose conservative treatment, were treated with a combination of four intra-articular injections of ACS (2 mL each) once weekly over four weeks and subsequent physiotherapy applied 4 weeks after ACS injection...
2015: PloS One
E Carlos Rodriguez-Merchan, Primitivo Gomez-Cardero
The role of arthroscopic debridement of the knee in haemophilia is controversial in the literature. The purpose of this study is to describe the results of arthroscopic knee debridement (AKD), with the aim of determining whether it is possible to delay total knee replacement (TKR) for painful moderate haemophilic arthropathy of the knee in adult patients. In a 14-year period (1998-2011), AKD was performed for moderate haemophilic arthropathy of the knee in 27 patients with haemophilia A. Their average age at operation was 28...
September 2016: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
V Quack, A V Ippendorf, M Betsch, H Schenker, S Nebelung, B Rath, M Tingart, C Lüring
INTRODUCTION: The aim of multidisciplinary rehabilitation after total knee replacement (TKA) is to reduce postoperative complications and costs and enable faster convalescence. The goals of fast-track rehabilitation, as a multidisciplinary concept, are to reduce the length of hospital stay and achieve early functional improvements by optimizing the perioperative setting. METHOD: A literature review was carried out for the years 1960-2013. The search terms were: "rehabilitation", "training", "physiotherapy", "physical therapy", "recovery", "exercise program", "knee surgery", "TKA", "total knee replacement", "arthroplasty", "intensive", "multidisciplinary", "accelerated", "rapid" or "fast track"...
August 2015: Die Rehabilitation
Maurizio Lopresti, Jacopo Rancati, Erika Farina, Stefano Bastoni, Beatrice Bernabè, Tiziana Succetti, Nicoletta Ligabue, Lorenzo Panella
INTRODUCTION: The knee is the most frequent location for osteosarcoma (60%). Until 30 years ago patients with osteosarcoma were treated with an amputation of the affected limb; today 85% of these cases are treated with a "Limb Salvage" procedure, through replacement of the affected bone with a mega prosthesis implant. AIM: To measure functional recovery of patients with a knee mega-prosthesis and how rehabilitation impacts on quality of life (QOL); another aim is to define rehabilitation guidelines to manage these patients in the rehabilitation pathway...
August 2015: Recenti Progressi in Medicina
Ilana N Ackerman, Jenni A Livingston, Richard H Osborne
BACKGROUND: Despite increasing demand for joint replacement surgery and other health services for hip and knee osteoarthritis (OA), barriers and enablers to individual access to care are not well understood. A comprehensive understanding of drivers at all levels is needed to inform efforts for improving access. OBJECTIVE: The aim of this study was to explore perceived barriers and enablers to receiving conservative (nonsurgical) and surgical treatment for hip and knee OA...
January 2016: Physical Therapy
Neil Artz, Karen T Elvers, Catherine Minns Lowe, Cath Sackley, Paul Jepson, Andrew D Beswick
BACKGROUND: Rehabilitation, with an emphasis on physiotherapy and exercise, is widely promoted after total knee replacement. However, provision of services varies in content and duration. The aim of this study is to update the review of Minns Lowe and colleagues 2007 using systematic review and meta-analysis to evaluate the effectiveness of post-discharge physiotherapy exercise in patients with primary total knee replacement. METHODS: We searched MEDLINE, Embase, PsycInfo, CINAHL and Cochrane CENTRAL to October 4(th) 2013 for randomised evaluations of physiotherapy exercise in adults with recent primary knee replacement...
February 7, 2015: BMC Musculoskeletal Disorders
Neil Artz, Karen T Elvers, Catherine Minns Lowe, Cath Sackley, Paul Jepson, Andrew D Beswick
BACKGROUND: Rehabilitation, with an emphasis on physiotherapy and exercise, is widely promoted after total knee replacement. However, provision of services varies in content and duration. The aim of this study is to update the review of Minns Lowe and colleagues 2007 using systematic review and meta-analysis to evaluate the effectiveness of post-discharge physiotherapy exercise in patients with primary total knee replacement. METHODS: We searched MEDLINE, Embase, PsycInfo, CINAHL and Cochrane CENTRAL to October 4(th) 2013 for randomised evaluations of physiotherapy exercise in adults with recent primary knee replacement...
December 2015: BMC Musculoskeletal Disorders
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