Subscribe to RSS
DOI: 10.1055/a-2151-4849
Comparison of Pre- and Postoperative Motor-proprioceptive Abilities in Patients with Gonarthrosis
Article in several languages: deutsch | EnglishAbstract
Purpose
Both surgeons and patients want to achieve a high level of satisfaction and the best possible functional results within a short time after knee TEP surgery. By using a tool that digitally records various measurement parameters of balance and motor function preoperatively and postoperatively on a mobile basis and with little time expenditure, progressive results can be compared. Individual factors can thus be determined and these can influence the progress in regeneration and training progress perioperatively.
Methods
In a prospective study, 100 patients before and 66 patients after installation of a cement-retained knee TEP were evaluated for the following parameters: balance, maximum strength, and power. All measurements were performed with the KMP measurement platform from MotoSana. The second measurements were performed in each case after a standardised follow-up treatment.
Results
It was shown that there are significant relationships between personal factors such as age, height, body weight and with baseline values and performance measures: maximum strength and power. Furthermore, it was shown that postoperative improvement could be achieved for the most part around balance support. All patients who previously had to hold on with one hand or both hands no longer needed support after surgery to maintain the single-leg stance for the specified time of 15 s. For a more detailed analysis of the balance parameters, the samples were adjusted and only the patients who did not hold on for support pre- and postoperatively were counted. In patients with low and medium initial stance, the sway area increased at the second measurement session, and in patients with large sway areas, it decreased, and the stance became more stable. In the area of maximum strength and power, patients with high baseline values still had higher values after AHB compared with the other patients, but lower values compared with their own baseline values.
Conclusion
Patients who already had very good motor skills before surgery were able to achieve a greater increase in motor skills compared to the weaker group. However, all patients failed to reach their preoperative baseline values after completion of the AHB. Deficits in balance were still detectable in all groups. By using the presented force plate, measurement-based coordinated rehabilitation procedures are possible during and after completion of the AHB. Rehabilitation with individualised improvement of balance and motor function could be expected to prevent dissatisfaction after knee arthroplasty, e.g. due to muscular imbalance in femoropatellar pain syndromes.
Publication History
Received: 20 November 2022
Accepted after revision: 31 July 2023
Article published online:
05 October 2023
© 2023. Thieme. All rights reserved.
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
-
Literatur
- 1 Statistisches Bundesamt. Die 20 häufigsten Operationen insgesamt (OPS 5). Vollstationär behandelte Patientinnen und Patienten in Krankenhäusern 2021. Stand 22.09.2022. Accessed June 12, 2023 at: https://www.destatis.de/DE/Themen/Gesellschaft-Umwelt/Gesundheit/Krankenhaeuser/Tabellen/drg-operationen-insgesamt.html
- 2 Klem NR, Smith A, O’Sullivan P. et al. What Influences Patient Satisfaction after TKA? A Qualitative Investigation. Clin Orthop Relat Res 2020; 478: 1850-1866 DOI: 10.1097/CORR.0000000000001284. (PMID: 32732567)
- 3 Becker R, Döring C, Denecke A. et al. Expectation, satisfaction and clinical outcome of patients after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 2011; 19: 1433-1441 DOI: 10.1007/s00167-011-1621-y. (PMID: 21811857)
- 4 Kiebzak G, Vain P, Gregory A. et al. SF-36 general health status survey to determine patient satisfaction at short-term follow-up after total hip and knee arthroplasty. J South Orthop Assoc 1997; 6: 169-172 (PMID: 9322195)
- 5 Neuprez A, Neuprez AH, Kaux JF. et al. Early clinically relevant improvement in quality of life and clinical outcomes 1 year postsurgery in patients with knee and hip joint arthroplasties. Cartilage 2018; 9: 127-139 DOI: 10.1177/1947603517743000. (PMID: 29262700)
- 6 Ayers DC, Yousef M, Zheng H. et al. The Prevalence and Predictors of Patient Dissatisfaction 5-years Following Primary Total Knee Arthroplasty. J Arthroplasty 2022; 37: 121-128 DOI: 10.1016/j.arth.2022.02.077. (PMID: 35227816)
- 7 Matsuda S, Kawahara S, Okazaki K. et al. Postoperative alignment and ROM affect patient satisfaction after TKA. Clin Orthop Relat Res 2013; 471: 127-133 DOI: 10.1007/s11999-012-2533-y. (PMID: 22903282)
- 8 Fink B, Egl M, Singer J. et al. Morphologic changes in the vastus medialis muscle in patients with osteoarthritis of the knee. Arthritis Rheum 2007; 56: 3626-3633 DOI: 10.1002/art.22960. (PMID: 17968889)
- 9 Fu S, Duan T, Hou M. et al. Postural Balance in Individuals With Knee Osteoarthritis During Stand-to-Sit Task. Front Hum Neurosci 2021; 15: 760960 DOI: 10.3389/fnhum.2021.760960. (PMID: 34803639)
- 10 Redelbach R, Mahnke A, Anders JO. Digital Measurement of Individual Motor and Proprioceptive Skills in Patients with Osteoarthritis of the Knee Prior to Total Knee Replacement. Z Orthop Unfall 2021; 159: 513-520 DOI: 10.1055/a-1174-0946. (PMID: 32604422)
- 11 Relph N, Herrington L, Tyson S. The effects of ACL injury on knee proprioception: a meta-analysis. Physiotherapy 2014; 100: 187-195 DOI: 10.1016/j.physio.2013.11.002. (PMID: 24690442)
- 12 Devasenapathy N, Maddison R, Malhotra R. et al. Preoperative Quadriceps Muscle Strength and Functional Ability Predict Performance-Based Outcomes 6 Months After Total Knee Arthroplasty: A Systematic Review. Phys Ther 2019; 99: 46-61 DOI: 10.1093/ptj/pzy118. (PMID: 30329137)
- 13 LaStayo PC, Meier W, Marcus RL. et al. Reversing muscle and mobility deficits 1 to 4 years after TKA: a pilot study. Clin Orthop Relat Res 2009; 467: 1493-1500 DOI: 10.1007/s11999-009-0801-2. (PMID: 19333672)
- 14 Stevens JE, Mizner RL, Snyder-Mackler L. Quadriceps strength and volitional activation before and after total knee arthroplasty for osteoarthritis. J Orthop Res 2003; 21: 775-779 DOI: 10.1016/S0736-0266(03)00052-4. (PMID: 12919862)
- 15 Maffiuletti NA, Bizzini M, Widler K. et al. Asymmetry in Quadriceps Rate of Force Development as a Functional Outcome Measure in TKA. Clin Orthop Relat Res 2010; 468: 191-198 DOI: 10.1007/s11999-009-0978-4. (PMID: 19597897)
- 16 Mizner RL, Petterson SC, Stevens JE. et al. Preoperative quadriceps strength predicts functional ability one year after total knee arthroplasty. J Rheumatol 2005; 32: 1533-1539 (PMID: 16078331)
- 17 Saeed Alshahrani M, Reddy RS, Asiri F. et al. Correlation and comparison of quadriceps endurance and knee joint position sense in individuals with and without unilateral knee osteoarthritis. BMC Musculoskelet Disord 2022; 23: 444 DOI: 10.1186/s12891-022-05403-9. (PMID: 35549701)
- 18 Mohammadi F, Taghizadeh S, Ghaffarinejad F. et al. Proprioception, dynamic balance and maximal quadriceps strength in females with knee osteoarthritis and normal control subjects. Int J Rheum Dis 2008; 11: 39-44 DOI: 10.1111/j.1756-185X.2008.00328.x.
- 19 Lee JY, Kim JH, Lee BH. Effect of Dynamic Balance Exercises Based on Visual Feedback on Physical Function, Balance Ability, and Depression in Women after Bilateral Total Knee Arthroplasty: A Randomized Controlled Trial. Int J Environ Res Public Health 2020; 17: 3203 DOI: 10.3390/ijerph17093203. (PMID: 32380679)
- 20 Fernandes L, Roos EM, Overgaard S. et al. Supervised neuromuscular exercise prior to hip and knee replacement: 12-month clinical effect and cost-utility analysis alongside a randomised controlled trial. BMC Musculoskelet Disord 2017; 18: 5 DOI: 10.1186/s12891-016-1369-0. (PMID: 28061841)
- 21 Lewek MD, Rudolph KS, Snyder-Mackler L. Quadriceps femoris muscle weakness and activation failure in patients with symptomatic knee osteoarthritis. J Orthop Res 2004; 22: 110-115 DOI: 10.1016/S0736-0266(03)00154-2. (PMID: 14656668)
- 22 Raizah A, Reddy RS, Alshahrani MS. et al. Investigating Knee Joint Proprioception and Its Impact on Limits of Stability Using Dynamic Posturography in Individuals with Bilateral Knee Osteoarthritis- A Cross-Sectional Study of Comparisons and Correlations. J Clin Med 2023; 12: 2764 DOI: 10.3390/jcm12082764. (PMID: 37109102)
- 23 Domínguez-Navarro F, Igual-Camacho C, Silvestre-Muñoz A. et al. Effects of balance and proprioceptive training on total hip and knee replacement rehabilitation: A systematic review and meta-analysis. Gait Posture 2018; 62: 68-74 DOI: 10.1016/j.gaitpost.2018.03.003. (PMID: 29525292)
- 24 Zeng CY, Zhang ZR, Tang ZM. et al. Benefits and Mechanisms of Exercise Training for Knee Osteoarthritis. Front Physiol 2021; 12: 794062 DOI: 10.3389/fphys.2021.794062. (PMID: 34975542)
- 25 Fleming JD, Ritzmann R, Centner C. Effect of an Anterior Cruciate Ligament Rupture on Knee Proprioception Within 2 Years After Conservative and Operative Treatment: A Systematic Review with Meta-Analysis. Sports Med 2022; 52: 1091-1102 DOI: 10.1007/s40279-021-01600-z. (PMID: 34854058)