Article

This study aimed to examine functional mobility and strength loss in
the ankle plantarflexors and dorsiflexors and knee extensors and flexors after
total knee arthroplasty. DESIGN: This was a prospective, longitudinal cohort
study. Maximal voluntary isometric contractions and gait speed assessments were
performed before and after total knee arthroplasty. RESULTS: Twenty patients
undergoing primary total knee arthroplasty were followed. Repeated-measures
analysis of variance results indicated an effect of time on muscle strength, with
all muscle groups being significantly weaker (knee extensors, P < 0.001; knee
flexors, P < 0.001, ankle plantarflexors, P = 0.004; ankle dorsiflexors, P <
0.001) 1 mo postoperatively. Knee extensors were 42% weaker than preoperative
levels, and knee flexors were 34% weaker, whereas the ankle plantarflexors were
17% weaker, and the dorsiflexors were 18% weaker. Three and 6 mos after surgery,
strength in all muscle groups was similar to preoperative levels (P > 0.05 for
all muscle groups). Patient function followed a similar trend, with patients
walking slower 1 mo postoperatively (P < 0.001) and recovering to preoperative
levels by 3 and 6 mos after surgery (P > 0.05). CONCLUSIONS: Patients may benefit
from early postoperative rehabilitation, including strengthening of the
plantarflexors and dorsiflexors, although strengthening of the quadriceps and
hamstrings muscles should continue to be a priority.

Langue : ANGLAIS