engleski

Comparison of two postoperative rehabilitation protocols following total knee arthroplasty

INTRODUCTION: Osteoarthritis (OA) of the knee is a chronic, progressive disorder of the joint. Today, conservative, pharmacological and surgical therapeutic modalities are used in OA treatment. An integral part of the surgical treatment of knee OA, Total knee arthroplasty (TKA), is a very effective way of treating end-stage knee OA, both primary and secondary. Rehabilitation always follows surgery, and is a vital part of the whole treatment. The main goals of rehabilitation are achieving at least 90° flexion in the operated knee, and adequate patient autonomy needed for everyday activities. Today, an abundance of rehabilitation protocols exist worldwide, as there is still no consent on the best modality and intensity of rehabilitation following knee OA. Use of so-called clinical pathways, and aggressive, “fast-track” (FT) protocols is widespread. This study will compare a standard FT rehabilitation protocol to one designed in our Department. HYPOTHESIS: Patients in the “delayed” FT rehabilitation group will achieve faster improvement of knee range of motion and functional tests, when compared to patients in the standard, “early” FT rehabilitation group. AIMS: To determine any differences in knee flexion, postoperative pain, functional tests scores, KSS and WOMAC score results between patients subjected to two rehabilitation protocols. MATERIALS AND METHODS: A hundred patients undergoing TKA in our Department will be stratified into two groups, group R subjected to the standard “early” FT rehabilitation used at our Department, and group T subjected to the tested “delayed” FT rehabilitation. The difference between the two protocols is a full 4 days of resting the knee, without any flexion permitted, in the tested “delayed” FT rehabilitation. Daily measurements of visual analog scale for pain and degrees of knee flexion will be made. On the 8th postoperative day, a measurement of functional knee tests (“Timed up and go”, 6 minute walk, stair climbing) will be made. KSS and WOMAC scores will be gathered in different, set, time points. All of the gathered data will be processed and presented using appropriate statistical methods. EXPECTED SCIENTIFIC CONTRIBUTION OF THE PROPOSED RESEARCH: Evaluation of a new rehabilitation protocol designed at our Department.

Osteoarthritis; Knee; Endoprosthesis; Rehabilitation

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