Abstract
Holm B, Kristensen MT, Bencke J, Husted H, Kehlet H, Bandholm T. Loss of knee-extension
strength is related to knee swelling after total knee arthroplasty.
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.
Key Words
List of Abbreviations:
ICC (intraclass correlation coefficient), ROM (range of motion), TKA (total knee arthroplasty), TUG (Timed Up & Go), VAS (visual analog scale)To read this article in full you will need to make a payment
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Article info
Footnotes
Supported by the Lundbeck Foundation for Fast-Track Hip and Knee Arthroplasty, Denmark.
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.
Identification
Copyright
© 2010 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
