Osteoarthritis and Obesity

This blog is a request of my Aunt who asked if I could post anything relating to obesity and extra wear and tear on the the joints (aka osteoarthritis). It’s considered common knowledge in medicine that obesity increases the risk for arthritis, and I hear my physical therapy patients frequently say that their knees or … Read more

Total Knee Functional Outcome Measure Doesn’t Measure Function

Comparison of self-reported knee injury and osteoarthritis outcome score to performance measures in patients after total knee arthroplasty. PM&R. 2011 Jun;3(6):541-9 Stevens-Lapsley JE1, Schenkman ML, Dayton MR. AbstractOBJECTIVE:To characterize patient outcomes after total knee arthroplasty (TKA) by (1) examining changes in self-report measures (Knee Injury and Osteoarthritis Outcome Score [KOOS]) and performance measures over the … Read more

Total Knee Replacement: More than 85% Last at Least 20 Years

What is the evidence for total knee arthroplasty in young patients?: a systematic review of the literature. Clin Orthop Relat Res. 2011 Feb;469(2):574-83. Keeney JA1, Eunice S, Pashos G, Wright RW, Clohisy JC. AbstractBACKGROUND:TKA is commonly performed to treat advanced inflammatory and degenerative knee arthritis. With increasing use in younger patients, it is important to … Read more

Post Total Knee Replacement; If You Can Walk Fast for 6 Minutes, You Can Walk Fast for 30.

The six-minute walk test is an excellent predictor of functional ambulation after total knee arthroplasty. BMC Musculoskelet Disord. 2013 Apr 24;14:145. Ko V, Naylor JM, Harris IA, Crosbie J, Yeo AE. Abstract BACKGROUND: The Six-minute walk (6 MW) and Timed-Up-and-Go (TUG) are short walk tests commonly used to evaluate functional recovery after total knee arthroplasty … Read more

Without Aggressive Rehabilitation Function Usually Diminished 1 Year Post-Op after Total Knee Replacement

Physical impairments and functional limitations: a comparison of individuals 1 year after total knee arthroplasty with control subjects. Physical Therapy. 1998 Mar;78(3):248-58. From the study: SUBJECTS:Twenty-nine individuals 1 year following TKA (13 women, 16 men) and 40 age- and gender-matched control subjects (18 women, 22 men) were assessed.METHODS:Walking speed, stair-climbing ability, knee torque (in newton-meters), … Read more

Electric Stimulation Increases Strength and Decreases Pain in Patients with Osteoarthritis

Neuromuscular electrical stimulation (NMES) reduces structural and functional losses of quadriceps muscle and improves health status in patients with knee osteoarthritis. J Orthop Res. 2013 Apr;31(4):511-6. From the study: “OA patients presented smaller vastus lateralis thickness (11.9 mm) and fascicle length (20.5%) than healthy subjects (14.1 mm; 24.5%), and also had a 23% smaller knee … Read more

Electric Muscle Stimulation Prevents Atrophy after Total Knee Replacement

Early neuromuscular electrical stimulation to improve quadriceps muscle strength after total knee arthroplasty: a randomized controlled trial. Physical Therapy. 2012 Feb;92(2):210-26. Stevens-Lapsley JE1, Balter JE, Wolfe P, Eckhoff DG, Kohrt WM. From the study: “Sixty-six patients, aged 50 to 85 years and planning a primary unilateral TKA, were randomly assigned to receive either standard rehabilitation … Read more

Physical Therapy after Total Knee Arthoplasty: Neuromuscular Electrical Stimulation Causes a Significant Boost in Quadriceps Strength

Neuromuscular electrical stimulation for quadriceps muscle strengthening after bilateral total knee arthroplasty: a case series. Journal of Orthopaedic & Sports Physical Therapy. 2004 Jan;34(1):21-9. AbstractSTUDY DESIGN:A case series. OBJECTIVES:The purpose of this case series was to assess the effect of high-intensity neuromuscular electrical stimulation (NMES) on quadriceps strength and voluntary activation following total knee arthroplasty … Read more

Physical Therapy and EMS after Total Knee Arthoplasty: More Current = More Muscle

Relationship between intensity of quadriceps muscle neuromuscular electrical stimulation and strength recovery after total knee arthroplasty. Physical Therapy. 2012 Sep;92(9):1187-96. AbstractBACKGROUND:Neuromuscular electrical stimulation (NMES) can facilitate the recovery of quadriceps muscle strength after total knee arthroplasty (TKA), yet the optimal intensity (dosage) of NMES and its effect on strength after TKA have yet to be … Read more

Electric Muscle Stimulation Well Tolerated by Patients at Sufficient Intensities to Strengthen Muscle after Total Knee Replacement

Response of male and female subjects after total knee arthroplasty to repeated neuromuscular electrical stimulation of the quadriceps femoris muscle. Am J Phys Med Rehabil. 2010 Jun;89(6):464-72. AbstractOBJECTIVES:To examine responses to repeated neuromuscular electrical stimulation of the quadriceps femoris muscle in male and female subjects after total knee arthroplasty. DESIGN:Sixty-four subjects who underwent total knee … Read more

Electric Muscle Stimulation BEFORE Total Knee Replacement Improves Outcomes

“Effects of preoperative neuromuscular electrical stimulation on quadriceps strength and functional recovery in total knee arthroplasty. A pilot study. BMC Musculoskelet Disord. 2010 Jun 14;11:119. ” <br) BACKGROUND: Supervised preoperative muscle strengthening programmes (prehabilitation) can improve recovery after total joint arthroplasty but are considered resource intensive. Neuromuscular electrical stimulation (NMES) has been shown to improve … Read more

Physical Therapy and EMS: Restores Activation, Strength 1 Year Post TKA

”The use of neuromuscular electrical stimulation to improve activation deficits in a patient with chronic quadriceps strength impairments following total knee arthroplasty. Journal of Orthopaedic & Sports Physical Therapy. 2006 Sep;36(9):678-85.” This was a single-patient case study of a patient who had high level function but persistent quadriceps weakness and activation deficits 13.5 months post op. … Read more

Muscle Deficits Usually Persist Long after Total Knee Replacement

“Muscle deficits persist after unilateral knee replacement and have implications for rehabilitation. Physical Therapy. 2009 Oct;89(10):1072-9.” From the study: “Participants were 29 women and 19 men who were 55 to 75 years old and had undergone unilateral knee replacement surgery an average of 10 months earlier. The maximal torque and power of the knee extensor and … Read more

How Soon is Too Soon to Lift Weights after Total Knee Arthroplasty?

Progressive strength training (10 RM) commenced immediately after fast-track total knee arthroplasty: is it feasible? Disabil Rehabil. 2012;34(12):1034-40. From the study: “Fourteen patients with unilateral TKA were included from a fast-track orthopedic arthroplasty unit. They received rehabilitation including progressive strength training of the operated leg (leg press and knee-extension), using relative loads of 10 repetition … Read more

Getting the Most out of Your Total Knee, Strength Matters

So I read ALL of Dr. Tarlow’s blog, who first suggested I start a blog on my own. It took me a few weeks but I read every post, and learned A LOT about knee surgery from the surgeon’s perspective.  One topic he wrote about that sticks in my memory showed the more you like … Read more

Hip Abduction Strength More Important to Function than Quadriceps after TKA

Hip abduction strength more important to function than quadriceps after Total Knee Arthroplasty. Physical Therapy. Feb 2011; 91(2): 225–233. From the study: Measurements Strength of quadriceps muscles and hip abductors was measured using an isokinetic dynamometer. Performance-based physical function was assessed with 4 measures: self-selected walking speed, the Figure-of-8 Walk Test, the Stair Ascend/Descend Test, … Read more