Exercise after knee replacement criticalFebruary 03, 2009It may be uncomfortable at first, but doing exercises to strengthen your quadriceps after you've had knee replacement surgery due to osteoarthritis is critical to your recovery. In fact, it can boost the function of your new knee to nearly that of a healthy adult your age. That's the finding of a University of Delaware study published in the February issue of Arthritis Care & Research. The authors include Lynn Snyder-Mackler, Alumni Distinguished Professor of Physical Therapy at the University of Delaware, Stephanie Petterson, clinical faculty at Columbia University, Ryan Mizner, an assistant professor at Eastern Washington University, Jennifer Stevens, an assistant professor at the University of Colorado at Denver, and Drs. Leo Raisis, Alex Bodenstab, and William Newcomb of First State Orthopaedics in Newark, Delaware. "It sounds logical that exercises to strengthen your knee should be a component of your post-operative physical therapy after a total knee replacement, but it's not the convention at all," says Snyder-Mackler. "There are all of these old wives' tales that strength training is a detriment to the patient and that the new knee should be treated delicately," Snyder-Mackler notes. "Our study demonstrates that intensive strength exercise as outpatient therapy is critical to begin three to four weeks after surgery." Nearly 500,000 knee replacements, also known as total knee arthroplasties, are performed every year in the United States to treat severe knee osteoarthritis, the loss of the cushiony cartilage padding the knee. The joint disease leaves its sufferers with persistent pain and limited function, resulting in an overall diminished quality of life. While knee replacement alleviates the pain of osteoarthritis and improves function, patients exhibit impaired quadriceps strength and function for such activities as walking and climbing stairs, and the levels remain below those of healthy people of the same age. In a randomized controlled trial at the University of Delaware's Physical Therapy Clinic conducted between 2000 and 2005, 200 patients who had undergone knee replacements were given six weeks of progressive strength training two or three times a week starting four weeks after surgery. Half of the group also received neuromuscular electrical stimulation (NMES). Their function was compared to that of 41 patients who received conventional rehabilitation and home physical therapy. Quadriceps strength, knee range of motion, and gait were measured in such tests as timed up and go, stair climbing and a six-minute walk. The group in the progressive strength-training program showed significant improvement in quadriceps strength and functional performance. They also demonstrated substantially greater quadriceps strength and functional performance after 12 months than the group that underwent conventional rehabilitation. "This study clearly demonstrates the importance of surgeons encouraging their patients to be compliant with progressive quadriceps strengthening during their rehabilitation to enhance their clinical improvement and function post-total knee replacement," notes Dr. Leo Raisis, a total joint surgeon and adjunct associate professor at the University of Delaware. "Why undergo a $25,000 elective surgery and then not do as much as you can to get the most out of it and improve your quality of life?" Snyder-Mackler says. "Older people are incredibly motivated-they hurt after the surgery and they want to be better. They need to do this." University of Delaware |
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| Related Knee Replacement Current Events and Knee Replacement News Articles Market based reforms have not harmed equity in the NHS, say researchers Recent NHS reforms, such as the introduction of patient choice and provider competition, have not had a deleterious impact on equity with respect to waiting times for elective surgery in England. Joint replacement patients with diabetes greatly benefit from controlled glucose Diabetics undergoing total joint replacement often are at a higher risk of experiencing complications after surgery due to various pre-existing health conditions. Total knee replacements increase mobility and motor skills in older patients According to a new study from researchers at Duke University, total knee arthroplasty (TKA) procedures performed in older patients with osteoarthritis of the knee result in long-term, significant improvement of physical functioning and motor skills when compared to patients who do not receive TKA. Severe obesity increases risks of health problems during surgery Healthcare providers must carefully consider the unique risk factors related to severe obesity in patients undergoing all types of surgery, according to an American Heart Association scientific advisory published in Circulation: Journal of the American Heart Association. Research highlights new approaches to prevent blood clots Blood clotting, or coagulation, is an important process that prevents excessive bleeding when a blood vessel is injured. Nearly half of U.S. adults will develop painful knee osteoarthritis by age 85: study Almost half of all U.S. adults and nearly two-thirds of obese adults will develop painful osteoarthritis of the knee by age 85, a study based at the University of North Carolina at Chapel Hill suggests. How often do hip and knee replacements need revision? A comprehensive study using nationwide data on hip and knee replacements in England has found that one in seventy-five patients require a revision of their joint replacement after three years. New test to diagnose osteoarthritis early A newly developed medical imaging technology may provide doctors with a long-awaited test for early diagnosis of osteoarthritis (OA), scientists from New York reported today at the 236th National Meeting of the American Chemical Society. No justification for denying obese patients knee replacements There is no justification for denying obese patients knee replacement surgery: They benefit almost as much as anyone else from the procedure, concludes a small study published ahead of print in the Annals of the Rheumatic Diseases. Research Examines Factors in Delaying or Declining Total Knee Replacement Surgery A study led by Dr. Ann F. Jacobson, associate professor in Kent State's College of Nursing, unveils the reasons why people may initially choose to postpone but ultimately undergo total knee replacement surgery and emphasizes the need for better patient education before and after the procedure. More Knee Replacement Current Events and Knee Replacement News Articles |
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