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Knee replacement physiotherapy

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...
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 11, 2016: 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)...
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...
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
Nitisha Narayan, Piers D Mitchell, Mark David Latimer
Osgood-Schlatter disease is a common cause of anterior knee pain in adolescents. In a good proportion of cases the pain is relieved through stopping sport alone, or by doing so in conjunction with undertaking physiotherapy. However, resolution of symptoms may take several years. A proportion of teenagers are prevented from participating in sport for a prolonged period as a result of the condition, and some have persisting knee pain into adulthood. We report the use of a new surgical treatment for this disease...
2015: BMJ Case Reports
H Graichen, M Strauch, W Scior, R Morgan-Jones
OBJECTIVE: Primary and long-term fixation of cementless metaphyseal implants in knee revision arthroplasty cases with large bone defects. INDICATIONS: All tibial and femoral bone defects AORI grade 2 and 3. CONTRAINDICATIONS: Cases where stable uncemented fixation of the metaphyseal implant is not possible. SURGICAL TECHNIQUE: Pre-operative evaluation of the failure mode and implant fixation planning. After opening the joint, a synovectomy and mobilisation of medial and lateral recesses routinely performed...
February 2015: Operative Orthopädie und Traumatologie
Daniel J Crespin, Kristen H Griffin, Jill R Johnson, Cynthia Miller, Michael D Finch, Rachael L Rivard, Scott Anseth, Jeffery A Dusek
OBJECTIVE: Given the risks of opioid medications, nonpharmacological strategies should be considered for total joint replacement patients. We investigated acupuncture as an adjunct therapy for postsurgical pain management in a total joint replacement program by examining which total hip and knee replacement patients elected to receive acupuncture and the effect of acupuncture on short-term pain. DESIGN: A total joint replacement program using fast-track physiotherapy offered elective postsurgical acupuncture to all patients, at no additional cost, as an adjunct therapy to opioids for pain management...
June 2015: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Remi Remondière, Marin-Philippe Durafourg
The first direct access initiatives were conducted in 1976 and many English-speaking countries have followed this movement, which is designed to obviate a visit to the doctor for certain procedures, apart from diagnosis. Cooperative actions in this field are exceptional in France. Direct access must be distinguished from advanced practices in hospital in the fields of orthopaedics, musculoskeletal disorders, preoperative assessment and total hip and knee replacement. In hospital, men between the ages of 40 and 59 years have access to this type of consultation, with an excellent correlation between 86% and 100% compared to the physician's practice, opening the way to direct access...
September 2014: Santé Publique: Revue Multidisciplinaire Pour la Recherche et L'action
Denis J Marcellin-Little, Nancy D Doyle, Joanna Freeman Pyke
Patients who have total joint arthroplasty have varying needs related to rehabilitation. In the short term, rehabilitation should be used in all dogs to identify high-risk patients and to minimize the likelihood of postoperative complications. Many patients undergoing total hip replacement recover uneventfully without needing long-term physiotherapy. All patients undergoing total knee replacement and total elbow replacement need rehabilitation to restore limb use and maximize their functional recovery. This article presents rehabilitation considerations for companion animals undergoing total hip replacement, total knee replacement, and total elbow replacement; postoperative complications and how to mitigate risks; and anticipated patient outcomes...
January 2015: Veterinary Clinics of North America. Small Animal Practice
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