Abstract
Total Knee Replacement (TKR) has been proven to be an effective procedure not only to eliminate pain but also to achieve better knee function. Recent rehabilitation is basically focused on achieving better ROM and muscle strength. However, improvements of balancing or walking ability in detail have not been sufficiently elucidated yet.
Methods
91 consecutive knees of 70 patients, with medial osteoarthritis undergone TKR have been nominated in this study. All were done by a single surgeon, via mid vastus approach, using cemented PS implant with patellar resurfacing. Patients were arrowed to start full weight bearing from the next day.
Assessing walking ability, gait speed and width of a step were measured. As for balancing, “Functional Reach (FR)” which was the difference between arm's length and maximal forward reach (Duncan PW et al), “Timed Up and Go Test (TUG)” which was time while a patient rose from an arm chair, walked 3 meters, turned, walked back, and sat down again (Podsiadlo D et al), and possible period standing on one leg (one leg standing) were used. Every measurement was performed prior to the operation, 1,2,3,4 weeks, 2 months and 6 months after operation. Data of prior to the operation, 2, and 6 monts after the operation were analyzed by one-way repeated ANOVA, and then differences among means were analyzed using Bonferroni procedures. P-value lower than 5% is regarded as significant.
Result
Every result except for one-leg standing time on contralateral leg (non-operative side) showed the worst during the first week, followed by better results over time (Fig. 1,2,3). One leg standing time of operative leg reached maximum at 2 months of time, while the others revealed improvement even at 6 months of time. Interestingly, postoperative one leg standing period of contra-lateral leg showed improvement with similar tendency until 4 weeks, followed by reaching plateau over time.
Discussion
In 6 months after operation, every result showed better function than that of prior to operation. Generally, the factors other than ROM and muscle strength are hard to be measured for both clinician and patients. However, this study showed total function including dynamic and static balancing ability certainly improved correlatively after TKR until at least 6 months.
