Article

OBJECTIVE: To examine whether changes in knee-extension strength and functional
performance are related to knee swelling after total knee arthroplasty (TKA).
DESIGN: Prospective, descriptive, hypothesis-generating study. SETTING: A
fast-track orthopedic arthroplasty unit at a university hospital. PARTICIPANTS:
Patients (N=24; mean age, 66y; 13 women) scheduled for primary unilateral TKA
were investigated 1 week before surgery and on the day of hospital discharge 2.4
days postsurgery. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: We
assessed all patients for knee-joint circumference, knee-extension strength, and
functional performance using the Timed Up & Go, 30-second Chair Stand, and 10-m
fast speed walking tests, together with knee pain during all active test
procedures. RESULTS: All investigated variables changed significantly from pre-
to postsurgery independent of knee pain. Importantly, knee circumference
increased (knee swelling) and correlated significantly with the decrease in
knee-extension strength (r=-.51; P=.01). Reduced fast-speed walking correlated
significantly with decreased knee-extension strength (r=.59; P=.003) and
decreased knee flexion (r=.52; P=.011). Multiple linear regression showed that
knee swelling (P=.023), adjusted for age and sex, could explain 27% of the
decrease in knee-extension strength. Another model showed that changes in
knee-extension strength (P=.009) and knee flexion (P=.018) were associated
independently with decreased performance in fast-speed walking, explaining 57% of
the variation in fast-speed walking. CONCLUSIONS: Our results indicate that the
well-known finding of decreased knee-extension strength, which decreases
functional performance shortly after TKA, is caused in part by postoperative knee
swelling. Future studies may look at specific interventions aimed at decreasing
knee swelling postsurgery to preserve knee-extension strength and facilitate
physical rehabilitation after TKA.
CI - Copyright (c) 2010 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS