Rehabilitation Approaches for Knee Arthroplasty
1,2 Roza V. Petrova, 1,2 Nikolay S. Nikolaev, 3 Mikhail B. Tsykunov
1 Federal Center for Traumatology, Orthopedics and Arthroplasty, Cheboksary, Russian Federation
2 Chuvash State University named after I.N. Ulyanov, Cheboksary, Russian Federation
3 National Medical Research Center of Traumatology and Orthopedics named after N.N. Priorov, Moscow, Russian Federation
Up to 25% of patients after knee arthroplasty are not satisfied with the results of the operation. Revision interventions are performed in60–80% of cases in the first 2–5 years after the primary arthroplasty.Aim. To evaluate the effectiveness of the early postoperative rehabilitation comprehensive program from the standpoint of the InternationalClassification of Functioning (ICF) to improve the results of rehabilitation after arthroplasty.Material and methods. The results of 180 patients rehabilitation after the total knee arthroplasty (TKA) with simultaneous reconstructionof the lower limb biological axis were evaluated in two groups: I – observations (n=120), II – comparisons (n=60). Postoperativerehabilitation in the group I was carried out according to of the early rehabilitation comprehensive program after TKA, developed inthe clinic, in the group II – according to the standard scheme. State of the patient was assessed by the dynamics of the pain syndrome,lower limbs muscle strength, goniometric indicators, the severity of lameness, muscle hypotrophy, limb shortening value, functionalactivity and quality of life. For analysis of changes in the level of damage according to the ICF, clinical tests were used.Results. From the standpoint of the ICF, the results of patients using the early postoperative rehabilitation program were equal or superiorto the results of the comparison group.Conclusion. A rehabilitation program for patients after TKA, formed on the basis of a system for assessing the structural, functional andsocial adaptation characteristics of the patient, is effective and allows to predict the effectiveness of the rehabilitation technologies.
Keywords: gonarthrosis, arthroplasty knee, rehabilitation after endoprosthetics, functional scales, domains, international classification of functions ICF, rehabilitation routing scale, multidisciplinary team
For citation: Petrova R.V., Nikolaev N.S., Tsykunov M.B. Rehabilitation Approaches for Knee Arthroplasty. Bulletin of Rehabilitation Medicine. 2022; 21(2): 61-69. https://doi.org/10.38025/2078-1962-2022-21-2-61-69
- Gubin A.V., Solomyannik I.A., Ochkurenko A.A., Smolentsev D.V., Gorbatyuk D.S., Volkova A.V. Travmatizm, ortopedicheskaya zabolevaemost’, organizaciya travmatologo-ortopedicheskoj pomoshchi v Rossijskoj Federacii v 2019 godu [Injuries, orthopedic morbidity, organization of trauma and orthopedic care in the Russian Federation in 2019]. National Medical Research Center for Traumatology and Orthopedics named after N.N. Priorov. 2021: 385 p. (In Russ.).
- Murylev V.Yu., Alekseev S.S., Elizarov P.M., Kukovenko G.A., Dering F.F., Haptagaev T.H. [Evaluation of Pain Syndrome in Patients after Total Knee Replacement]. Traumatology and Orthopedics of Russia. 2019; 25(2): 19–30. https://doi.org/10.21823/2311-2905-2019-25-2-19-30 (In Russ.).
- Federal’nye klinicheskie rekomendacii «Reabilitaciya pri endoprotezirovanii kolennogo sustava v specializirovannom stacionarnom otdelenii» [Federal clinical guidelines «Rehabilitation in case of knee arthroplasty in a specialized inpatient department»]. Moscow. 2015: 20 p. (In Russ.).
- Behrend H., Giesinger K., Giesinger J. M., Kuster, M. The «forgotten joint» as the ultimate goal in joint arthroplasty: validation of a new patient- reported outcome measure. Journal of Arthroplasty. 2012; 27(3): 430–436. https://doi.org/10.1016/j.arth.2011.06.035
- Alrawashdeh W., Eschweiler J., Migliorini F., El Mansy Y., Tingart M., Rath B. Effectiveness of total knee arthroplasty rehabilitation programmes: A sys- tematic review and meta-analysis. Journal of Rehabilitation Medicine. 2021; 53(6): jrm00200 p. https://doi.org/10.2340/16501977-2827
- Jette D.U., Hunter S.J., Burkett L., Langham B., Logerstedt D.S., Piuzzi N.S., Poirier N.M., Radach L.J.L., Ritter J.E., Scalzitti D.A., Stevens-Lapsley J.E., Tompkins J., Zeni J. Jr. American Physical Therapy Association. Physical Therapist Management of Total Knee Arthroplasty. Physical Therapy. 2020; 100(9): 1603–1631. https://doi.org/10.1093/ptj/pzaa099
- Kornilov N.N., Kulyaba T.A. Artroplastika kolennogo sustava [Arthroplasty of the knee]. SPb. 2012: 68 p. (In Russ.).
- Henderson K.G., Wallis J.A., Snowdon D.A. Active physiotherapy interventions following total knee arthroplasty in the hospital and inpatient rehabilitation settings: a systematic review and meta-analysis. Physiotherapy. 2018; 104(1): 25–35. https://doi.org/10.1016/j.physio.2017.01.002
- Lisi C., Caspani P., Bruggi M., Carlisi E., Scolè D., Benazzo F., Dalla Toffola E. Early rehabilitation after elective total knee arthroplasty. Acta Biomedica Scientifica. 2017; 88(4S): 56–61.
- Rutherford R.W., Jennings J.M., Dennis D.A. Enhancing Recovery After Total Knee Arthroplasty. Orthopedic Clinics of North America. 2017; 48(4): 391– 400. https://doi.org/10.1016/j.ocl.2017.05.002
- Prikaz Minzdrava Rossii ot 12 noyabrya 2012 g. №901n «Ob utverzhdenii Poryadka okazaniya medicinskoj pomoshchi naseleniyu po profilyu «Travmatologiya i ortopediya» [Order of the Ministry of Health of Russia dated November 12, 2012, 901N «On approval of the procedure for providing medical care to the population in the profile «Traumatology and Orthopedics»]. (In Russ.).
- Nikolaev N.S., Petrova R.V., Ivanov M.I., Fadeeva U.G. Ob itogah realizacii pilotnogo proekta «Razvitie sistemy medicinskoj reabilitacii v Rossijskoj Federacii» pri okazanii reabilitacionnoj pomoshchi posle endoprotezirovaniya tazobedrennogo sustava [On the results of the implementation of the pilot project «Development of the system of medical rehabilitation in the Russian Federation» in the provision of rehabilitation assistance after hip arthroplasty]. Bulletin of Rehabilitation Medicine. 2017; (4): 2–10 (In Russ.).
The content is available under the Creative Commons Attribution 4.0 License.