Document Detail


The effect of total knee arthroplasty on joint movement during functional activities and joint range of motion with particular regard to higher flexion users.
MedLine Citation:
PMID:  16131674     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To evaluate active and functional knee excursion of patients before and after total knee arthroplasty (TKA) and to determine whether TKA restores quality of life related to functional activities of daily living. METHODS: Electrogoniometry was used to measure the functional movement of the knee during 11 activities of daily living in 50 patients who underwent TKA. These data were compared with the patient's active range of motion and quality-of-life scores. RESULTS: A cut-off point existed between loss and gain in flexion at between 90 and 95 degrees of preoperative active flexion. Two thirds of patients had preoperative flexion of more than 90 degrees, 83% of them had reduced flexion postoperatively. The remaining one third had preoperative flexion of 90 degrees or less, 85% of them had improved flexion postoperatively. A similar pattern of loss and gain occurred for functional movement of the knee. Reduced functional range was associated with significantly reduced physical quality of life compared with age-matched healthy subjects. CONCLUSION: Although TKA offers excellent pain relief and contributes to the overall well-being of the patient, these results suggest that it also leads to a reduced range of active and functional motion in the majority of patients. This is associated with a lower-than-normal physical quality of life. The design of implants and rehabilitation programmes should be reconsidered so that better range of motion and quality of life can be achieved for patients.
Authors:
P J Rowe; C M Myles; R Nutton
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of orthopaedic surgery (Hong Kong)     Volume:  13     ISSN:  1022-5536     ISO Abbreviation:  J Orthop Surg (Hong Kong)     Publication Date:  2005 Aug 
Date Detail:
Created Date:  2005-08-31     Completed Date:  2006-01-19     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9440382     Medline TA:  J Orthop Surg (Hong Kong)     Country:  China    
Other Details:
Languages:  eng     Pagination:  131-8     Citation Subset:  IM    
Affiliation:
department of Physiotherapy, School of Health Sciences, Queen Margaret University College, Edinburgh, UK. prowe@qmuc.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Activities of Daily Living*
Age Factors
Aged
Aged, 80 and over
Arthroplasty, Replacement, Knee / methods*,  rehabilitation
Cohort Studies
Female
Humans
Male
Middle Aged
Muscle Contraction / physiology*
Muscle, Skeletal / physiology
Osteoarthritis, Knee / diagnosis,  rehabilitation,  surgery
Pain Measurement
Patient Satisfaction
Postoperative Care
Probability
Prognosis
Quality of Life*
Range of Motion, Articular / physiology*
Risk Assessment

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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