“Quad power” is the key factor blocking functional outcome improvements, he said. In fact, “another important finding” of this study is that patients who had bigger quad activation deficits before surgery struggled more with rehab, he added.
In the randomized controlled trial that Dr Stevens-Lapsley was involved in, neuromuscular electrical stimulation of quadriceps after total knee arthroplasty showed positive results (Phys Ther. 2012;92:210-226).
There is a lot of room for improvement in outcomes after total knee arthroplasty, Dr Stevens-Lapsley and her colleagues report. Overall, the single largest residual deficit after surgery is in the stair-climbing performance test; 75% of patients reported difficulty negotiating stairs years after the procedure. In addition, postoperative walking speed was 20% slower and stair-climbing speed was 50% slower.
Dr Dennis said he thinks that rehab after total knee arthroplasty should become more personalized, especially for those who are more active. “We’re essentially treating those who are at a lower level of function,” he told Medscape Medical News. “We do think some patients could get to rehab earlier and start firing their quads earlier on.”
|Dr Stevens-Lapsley reports that she is a consultant for DJO Global. Dr Jennings has disclosed no relevant financial relationships. Dr Dennis reports that he is a paid consultant for DePuy; receives royalties from DePuy, Innomed, and Wolters Kluwer Health; and owns stock options in Joint Vue.|
Source Medscape Multispecialty
American Academy of Orthopaedic Surgeons (AAOS) 2016 Annual Meeting: Abstract P183. Presented March 04, 2016.
Early neuromuscular electrical stimulation to improve quadriceps muscle strength after total knee arthroplasty: a randomized controlled trial, Stevens-Lapsley JE, Balter JE, Wolfe P, Eckhoff DG, Kohrt WM. Phys Ther. 2012 Feb;92(2):210-26. doi: 10.2522/ptj.20110124. Epub 2011 Nov 17.
Patient Perspective in Limelight at Orthopedics Conference in Medscape Multispecialty
5 Knee Surgery Recovery Activities in National Register of Personal Trainers UK